Spielman W S, Thompson C I
Am J Physiol. 1982 May;242(5):F423-35. doi: 10.1152/ajprenal.1982.242.5.F423.
Adenosine is produced by renal tissue and has potent effects on renal blood flow and its distribution, glomerular filtration rate (GFR), and the secretion of renin. Intrarenal infusion of adenosine decreases GFR primarily by decreasing glomerular hydrostatic pressure through its effects in increasing afferent arteriolar resistance and possibly decreasing efferent arteriolar resistance. The fall in GFR due to adenosine is accompanied by little change or an increase in total organ blood flow. Regional renal blood flow during adenosine infusion is redistributed, with a greater percentage of total flow going to the juxtamedullary cortex. Intrarenal adenosine produces marked decreases in water and sodium excretion that are proportionally greater than its effect on GFR, suggesting a possible direct tubular action. Intrarenal adenosine also produces a rapid and pronounced inhibition of renin release that appears to be independent of its hemodynamic or tubular effects. A metabolic hypothesis for the control of glomerular filtration rate and renin release with adenosine acting as a mediator is considered, and criteria for establishing an intrarenal role for adenosine in the regulation of renal function are discussed.
腺苷由肾组织产生,对肾血流量及其分布、肾小球滤过率(GFR)和肾素分泌具有显著影响。肾内输注腺苷主要通过增加入球小动脉阻力并可能降低出球小动脉阻力来降低肾小球静水压,从而降低GFR。腺苷导致的GFR下降伴随着总器官血流量几乎不变或增加。输注腺苷期间,肾局部血流重新分布,髓旁皮质的血流占总血流量的比例更大。肾内腺苷使水和钠排泄显著减少,且减少程度与其对GFR的影响成比例,提示可能存在直接的肾小管作用。肾内腺苷还能迅速且显著地抑制肾素释放,这一作用似乎与其血流动力学或肾小管效应无关。本文考虑了以腺苷作为介质控制肾小球滤过率和肾素释放的代谢假说,并讨论了确定腺苷在肾功能调节中的肾内作用的标准。