Sakai T, Harris F H, Marsh D J, Bennett C M, Glassock R J
Kidney Int. 1984 Apr;25(4):619-28. doi: 10.1038/ki.1984.66.
Previous studies of the early autologous phase of bilateral nephrotoxic serum nephritis (NSN) in rats showed that whole kidney and single nephron glomerular filtration rate (GFR) were maintained at normal levels despite a 60% reduction in the product of surface area and hydraulic permeability (Kf). Factors responsible for this compensation were an increase of net ultrafiltration pressure, due primarily to an increased glomerular capillary pressure (PGC). This study was designed to investigate some possible causes of the compensation. Rats with bilateral NSN and normal GFR had an increased extracellular fluid volume (ECFV) 2 weeks after induction of NSN; control subjects did not change. To determine whether this ECFV expansion was responsible for triggering the compensation, we developed a unilateral NSN model with one diseased and one normal kidney. Unilaterally diseased rats did not experience an increase of ECFV. Values of Kf were 0.069 +/- 0.012 nl sec-1 mm Hg-1 in control subjects, 0.037 +/- 0.005 in bilateral NSN, and 0.043 +/- 0.006 in unilateral NSN. The elevation in PGC was the same in unilateral NSN as in bilateral NSN subjects and the same was true for the hydrostatic pressure difference across glomerular capillaries (delta P). Furthermore, in paired measurements on both kidneys of rats with unilateral NSN, PGC was significantly higher in the unilaterally diseased kidney than in the nondiseased kidney; sham control subjects had no difference. These results are interpreted to indicate that the signal that causes elevation of net ultrafiltration pressure is not a consequence of a systemic effect of NSN, but arises within the diseased kidney itself. To determine whether that signal involved some change in the mechanisms mediating autoregulation measurements were made of the response of whole kidney GFR and RBF to acute changes in arterial BP. Control rats and rats with NSN autoregulated both GFR and blood flow equally well. Tubuloglomerular feedback was studied by microperfusing loops of Henle and measuring proximal stop-flow pressure and early proximal flow rate. Stop-flow pressure was 4.0 mm Hg higher in rats with NSN at a loop perfusion rate of 10 nl/min, approximately the same difference that was found by direct measurement of PGC, but the sensitivity of response to changes in perfusion rate was the same in NSN as in control subjects. Finally, end proximal tubule flow rate was higher in NSN than in control subjects reflecting decreased proximal reabsorption. Thus, a normal feedback mechanism receives a signal that should cause afferent arteriolar constriction in NSN rats.(ABSTRACT TRUNCATED AT 400 WORDS)
以往对大鼠双侧肾毒性血清性肾炎(NSN)早期自体阶段的研究表明,尽管表面积与水力传导率(Kf)的乘积降低了60%,但全肾和单个肾单位的肾小球滤过率(GFR)仍维持在正常水平。造成这种代偿的因素是净超滤压力增加,主要是由于肾小球毛细血管压力(PGC)升高。本研究旨在探讨这种代偿的一些可能原因。诱导NSN后2周,双侧NSN且GFR正常的大鼠细胞外液量(ECFV)增加;对照组则无变化。为了确定这种ECFV扩张是否是触发代偿的原因,我们建立了一个一侧肾脏患病而另一侧正常的单侧NSN模型。单侧患病的大鼠未出现ECFV增加。对照组的Kf值为0.069±0.012 nl·sec⁻¹·mmHg⁻¹,双侧NSN组为0.037±0.005,单侧NSN组为0.043±0.006。单侧NSN中PGC的升高与双侧NSN组相同,肾小球毛细血管跨壁静水压差(ΔP)也是如此。此外,在对单侧NSN大鼠的双侧肾脏进行配对测量时,单侧患病肾脏的PGC明显高于未患病肾脏;假手术对照组则无差异。这些结果被解释为表明导致净超滤压力升高的信号不是NSN全身效应的结果,而是在患病肾脏本身产生的。为了确定该信号是否涉及介导自身调节机制的某些变化,对全肾GFR和肾血流量(RBF)对动脉血压急性变化的反应进行了测量。对照组大鼠和NSN大鼠对GFR和血流量的自身调节同样良好。通过微灌注髓袢并测量近端停流压力和近端早期流速来研究球管反馈。在髓袢灌注速率为10 nl/min时,NSN大鼠的停流压力高4.0 mmHg,这一差异与直接测量PGC时发现的差异大致相同,但NSN大鼠对灌注速率变化的反应敏感性与对照组相同。最后,NSN大鼠近端小管末端流速高于对照组,反映近端重吸收减少。因此,正常的反馈机制接收到一个信号,该信号在NSN大鼠中应导致入球小动脉收缩。(摘要截断于400字)