Hanley M J, Davidson K
Am J Physiol. 1981 Nov;241(5):F556-64. doi: 10.1152/ajprenal.1981.241.5.F556.
Tubular transport abnormalities have recently been characterized in a rabbit model of ischemic acute renal failure (ARF). These studies demonstrated severe observable morphologic and functional changes in the proximal nephron together with functional changes in the distal nephron. Tubular debris was often produced by perfusion of proximal nephron segments. In the present study, agents used to prevent ARF were tested in this rabbit model of ARF. Rabbits were infused with either 5% body wt 5% manitol or 20 micrograms . kg-1 . min-1 furosemide in 5% body wt normal saline for the 60 min preceding 60 min of total renal ischemia. Mannitol 1) prevented the development of ARF, 2) maintained fluid reabsorption in the proximal convoluted tubule (PCT) (0.59 +/- 0.03 vs. 0.52 +/- 0.1 nl . mm-1 . min-1) and proximal straight tubule (PST) (0.34 +/- 0.05 vs. 0.39 +/- 0.07 nl . mm-1 . min-1), 3) depressed NaCl reabsorption in the cortical thick ascending limb of Henle's loop (TALH), and 4) did not prevent a decrease in ADH-mediated osmotic water flow in the cortical collecting tubule (CCT). Furosemide 1) partially preserved renal function, 2) partially protected the PCT (0.63 +/- 0.05 vs. 0.38 +/- 0.04 nl . mm-1 . min-1) and PST (0.32 +/- 0.04 vs. 0.22 +/- 0.02 nl . mm-1 . min-1), and 3) did not change the transport capacity of the TALH or the ADH response of the CCT. Preservation of proximal nephron integrity was also reflected by the absence of debris formation. There is a direct relation between an agent's ability to protect the functional integrity of the cells of the proximal nephron and its ability to preserve renal function.
肾小管转运异常最近在缺血性急性肾衰竭（ARF）的兔模型中得到了表征。这些研究表明，近端肾单位出现了严重的可观察到的形态和功能变化，同时远端肾单位也有功能变化。近端肾单位节段灌注常常产生肾小管碎片。在本研究中，用于预防ARF的药物在该兔ARF模型中进行了测试。在全肾缺血60分钟之前的60分钟内，给兔子输注5%体重的5%甘露醇或5%体重的生理盐水中20微克·千克⁻¹·分钟⁻¹的呋塞米。甘露醇：1）预防了ARF的发生；2）维持了近端曲管（PCT）（0.59±0.03对0.52±0.1纳升·毫米⁻¹·分钟⁻¹）和近端直小管（PST）（0.34±0.05对0.39±0.07纳升·毫米⁻¹·分钟⁻¹）的液体重吸收；3）抑制了亨氏袢皮质厚升支（TALH）中氯化钠的重吸收；4）未阻止抗利尿激素介导的皮质集合管（CCT）中渗透水流的减少。呋塞米：1）部分保留了肾功能；2）部分保护了PCT（0.63±0.05对0.38±0.04纳升·毫米⁻¹·分钟⁻¹）和PST（0.32±0.04对0.22±0.02纳升·毫米⁻¹·分钟⁻¹）；3）未改变TALH的转运能力或CCT的抗利尿激素反应。近端肾单位完整性的保留也表现为无碎片形成。一种药物保护近端肾单位细胞功能完整性的能力与其保留肾功能的能力之间存在直接关系。
