Cuche J L, Prinseau J, Baglin A, Guédon J
Nephrologie. 1982;3(3):111-5.
The renal effects of chlorpromazine (CPZ) were studied in sodium-loaded dogs. Intrarenal artery infusion of CPZ at 0.2 microM/kg/min induces a significant decrease of both clearance of PAH and GFR, with no measurable effect on the excretion of electrolytes. This result is interpreted as direct evidence in favor of a physiological role of dopamine, since CPZ is known to be a dopaminergic blocking agent. At 2.0 microM/kg/min, CPZ no longer induces a renal hemodynamic alteration, but has a powerful natriuretic effect associated with an increased kaliuresis, and an increase of the free water clearance; phosphate excretion was unchanged. This effect on the excretion of electrolytes is apparently reversible within the 30 minutes immediately following the discontinuation of the CPZ infusion. The CPZ-induced natriuresis and kaliuresis are not additive to aminophylline's, suggesting a renal cyclic nucleotide phosphodiesterase inhibition. In conclusion, CPZ has a dose-dependent effect on dog kidney: it induces a reduction of the renal hemodynamics at a low dose, and an inhibition of the tubular sodium transport at a high dose.
在钠负荷犬中研究了氯丙嗪(CPZ)对肾脏的影响。以0.2微摩尔/千克/分钟的速度肾内动脉输注CPZ可导致对氨基马尿酸清除率和肾小球滤过率显著降低,而对电解质排泄无明显影响。这一结果被解释为支持多巴胺具有生理作用的直接证据,因为已知CPZ是一种多巴胺能阻断剂。以2.0微摩尔/千克/分钟的速度输注时,CPZ不再引起肾脏血流动力学改变,但具有强大的利钠作用,伴有尿钾增多和自由水清除率增加;磷酸盐排泄未改变。在停止输注CPZ后的30分钟内,这种对电解质排泄的影响显然是可逆的。CPZ诱导的利钠和利尿作用与氨茶碱的作用并非相加,提示对肾脏环核苷酸磷酸二酯酶有抑制作用。总之,CPZ对犬肾有剂量依赖性作用:低剂量时诱导肾脏血流动力学降低,高剂量时抑制肾小管钠转运。