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出生后早期发育阶段对肾单位减少的血流动力学适应

Hemodynamic adaptation to reduced renal mass in early postnatal development.

作者信息

Chevalier R L

出版信息

Pediatr Res. 1983 Aug;17(8):620-4. doi: 10.1203/00006450-198308000-00003.

DOI:10.1203/00006450-198308000-00003
PMID:6889003
Abstract

Radioactive microspheres, clearance methodology, and glomerular counting techniques were used to compare hemodynamic changes resulting from uninephrectomy at birth with those of sham-operated guinea pigs 8-13 days of age and 18-24 days old. Left renal blood flow doubled from 10-20 days of age, and was approximately 65% higher in animals with reduced renal mass. Cardiac output also doubled from 10-20 days of age but was not significantly affected by uninephrectomy whereas mean arterial blood pressure rose with normal or compensatory renal growth. There was a progressive fall in renal vascular resistance that paralleled the drop in total peripheral resistance during normal growth, but the fraction of cardiac output supplying the remaining kidney of renoprival guinea pigs rose significantly from 7% at 10 days to 11% at 20 days of age. Whole kidney filtration fraction averaged 0.25-0.29 for all groups. There was no change in cortical blood flow distribution with age or after uninephrectomy: 50, 30, and 20% supplied outer, middle, and inner thirds, respectively. Glomerular perfusion rate increased proportionately in all cortical levels during normal or compensatory renal growth, and was higher in outer and inner cortical thirds than in the middle cortex. It is concluded that systemic and intrarenal hemodynamic responses to uninephrectomy at birth are similar to the pattern of normal maturation. Reduction in renal mass and normal somatic growth provide additive stimuli resulting in maintenance of homeostasis.

摘要

采用放射性微球、清除方法和肾小球计数技术,比较出生时单侧肾切除的豚鼠与8 - 13日龄和18 - 24日龄假手术豚鼠的血流动力学变化。左肾血流量在10 - 20日龄时增加一倍,肾质量减少的动物左肾血流量约高65%。心输出量在10 - 20日龄时也增加一倍,但单侧肾切除对其无显著影响,而平均动脉血压随正常或代偿性肾生长而升高。肾血管阻力逐渐下降,这与正常生长过程中总外周阻力的下降平行,但肾缺如豚鼠剩余肾脏的供血心输出量比例从10日龄时的7%显著升至20日龄时的11%。所有组的全肾滤过分数平均为0.25 - 0.29。随着年龄增长或单侧肾切除后,皮质血流分布无变化:分别有50%、30%和20%供应外、中、内三分之一皮质。在正常或代偿性肾生长过程中,所有皮质水平的肾小球灌注率均成比例增加,且外皮质和内皮质三分之一处的肾小球灌注率高于中间皮质。结论是,出生时单侧肾切除的全身和肾内血流动力学反应与正常成熟模式相似。肾质量减少和正常的躯体生长提供了累加刺激,从而维持内环境稳态。

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