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清醒犬输注血管加压素期间水合过度的肾脏效应

Renal effects of overhydration during vasopressin infusion in conscious dogs.

作者信息

Bie P, Munksdorf M, Warberg J

出版信息

Am J Physiol. 1984 Jul;247(1 Pt 2):F103-9. doi: 10.1152/ajprenal.1984.247.1.F103.

Abstract

The antidiuretic and possibly natriuretic effects of small doses of vasopressin (AVP) were investigated in conscious dogs. Plasma composition and renal excretion of water, Na+, and K+ were measured after overhydration by 20 ml/kg performed during infusion of AVP at rates of 50, 100, 150, 200, or 400 pg X min-1 X kg body wt-1 or of 1-desamino-8-D-arginine vasopressin (DDAVP) 50 pg X min-1 X kg body wt-1. Hydration lowered plasma osmolality and sodium concentration by 4.2 +/- 0.3 and 3.8 +/- 0.2%, respectively; plasma protein showed a larger decrease, 8.5 +/- 0.4% (P less than 0.01). Urine osmolality during hydration was 52 +/- 3 mosmol/kg H2O. AVP infusion at 100 pg X min-1 X kg-1 elevated plasma vasopressin by 1.7 +/- 0.3 pg/ml and urine osmolality by 1,049 +/- 152 mosmol/kg H2O and elicited marked natriuresis and kaliuresis but no change in osmolar clearance. During DDAVP infusion urine osmolality was 1,365 +/- 134 mosmol/kg H2O, but electrolyte excretion was indistinguishable from control. It is concluded that 1) AVP is associated with marked natriuresis and kaliuresis even in doses required to prevent water diuresis, 2) DDAVP--although strongly antidiuretic--does not affect electrolyte excretion, and 3) the water load causes disproportionate dilution of plasma protein and osmolality, probably due to protein redistribution.

摘要

在清醒犬中研究了小剂量血管加压素(AVP)的抗利尿及可能的利钠作用。在以50、100、150、200或400 pg·min⁻¹·kg体重⁻¹的速率输注AVP或50 pg·min⁻¹·kg体重⁻¹的1-去氨基-8-D-精氨酸血管加压素(DDAVP)期间,通过20 ml/kg进行水负荷后,测量血浆成分以及水、Na⁺和K⁺的肾排泄。水负荷使血浆渗透压和钠浓度分别降低了4.2±0.3%和3.8±0.2%;血浆蛋白下降幅度更大,为8.5±0.4%(P<0.01)。水负荷期间尿渗透压为52±3 mosmol/kg H₂O。以100 pg·min⁻¹·kg⁻¹的速率输注AVP使血浆血管加压素升高1.7±0.3 pg/ml,尿渗透压升高1049±152 mosmol/kg H₂O,并引起明显的利钠和利尿作用,但渗透清除率无变化。在输注DDAVP期间,尿渗透压为1365±134 mosmol/kg H₂O,但电解质排泄与对照组无差异。得出以下结论:1)即使在预防水利尿所需的剂量下,AVP也与明显的利钠和利尿作用有关;2)DDAVP虽然具有强烈的抗利尿作用,但不影响电解质排泄;3)水负荷导致血浆蛋白和渗透压不成比例的稀释,可能是由于蛋白重新分布所致。

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