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肾脏的神经控制——存在肾-肾反射吗?

Neural control of the kidney--are there reno-renal reflexes?

作者信息

Zanchetti A, Stella A, Golin R, Genovesi S

出版信息

Clin Exp Hypertens A. 1984;6(1-2):275-86. doi: 10.3109/10641968409062565.

Abstract

Circulatory, secretory (renin release) and excretory (tubular sodium and water reabsorption) renal functions are known to be under neural control exerted by sympathetic fibers. Influences on circulatory and secretory functions are modulated by vagally mediated reflexes originated from low pressure (or volume) receptors in the cardiopulmonary area. The possibility that reno-renal reflexes may also exist has raised interest recently. Mechanoreceptors and chemoreceptors have been described in the kidney, and electrophysiological evidence of reno-renal reflexes is available. However, electrical stimulation of afferent renal nerves has failed to reflexly influence circulatory, secretory and excretory functions of the contralateral kidney. Deafferentation studies have been more successful, however. Transient denervation of one kidney by renal nerve cooling is accompanied by reduction of sodium and water excretion from the contralateral kidney with negligible changes in blood flow and glomerular filtration rate. The contralateral antidiuretic activity is prevented either by denervation of the contralateral kidney or by interruption of the afferent fibers running in the spinal dorsal roots. This definitely shows that a reno-renal reflex exists, consisting in a tonic inhibition of contralateral sympathetic activity controlling tubular reabsorption of sodium and water, and renin release.

摘要

已知肾的循环、分泌(肾素释放)和排泄(肾小管钠和水重吸收)功能受交感神经纤维施加的神经控制。对循环和分泌功能的影响由源自心肺区域低压(或容量)感受器的迷走神经介导的反射调节。肾-肾反射也可能存在的可能性最近引起了人们的兴趣。肾脏中已描述了机械感受器和化学感受器,并且有肾-肾反射的电生理证据。然而,电刺激肾传入神经未能反射性地影响对侧肾脏的循环、分泌和排泄功能。不过,去传入神经研究更为成功。通过肾神经冷却对一侧肾脏进行短暂去神经支配,伴随着对侧肾脏钠和水排泄的减少,而血流量和肾小球滤过率的变化可忽略不计。对侧抗利尿活性可通过对侧肾脏去神经支配或通过中断在脊髓背根中运行的传入纤维来阻止。这明确表明存在肾-肾反射,其包括对控制肾小管钠和水重吸收以及肾素释放的对侧交感神经活动的紧张性抑制。

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