Aladjem M, Spitzer A, Goldsmith D I
Pediatr Res. 1982 Oct;16(10):840-5. doi: 10.1203/00006450-198210000-00008.
The role played by the relative degree of expansion of the intravascular and extravascular compartments in limiting the natriuretic response of fluid-loaded developing animals was determined in 1-, 2-, 3- and 6-wk-old puppies. Volume expansion was induced by infusing either isotonic saline, 10% body weight or isoncotic albumin in saline 5% body weight, and measurements of glomerular filtration rate, sodium excretion, fractional excretion of sodium, and plasma volume were made. Each expansion procedure resulted in an increase in the absolute excretion of sodium at all ages (P less than 0.001). The greatest natriuretic effect was observed in the 3-wk-old puppies, the average of the two solutions being 19, 30, 70, and 28 muEq/min/kg in the 1, 2, 3, and 6-wk-old animals, respectively. The difference in natriuresis among the age groups was due predominantly to differences in the magnitude of the increase in fractional excretion of sodium. At all ages, a greater absolute excretion of sodium was encountered during volume expansion with saline than observed with albumin (P less than 0.05). The intravascular volume increased by a similar % at all ages (P greater than 0.1), and saline and albumin yielded equivalent degrees of intravascular expansion (approximately 50%). The results demonstrate that age-related changes in natriuretic response to volume expansion cannot be attributed to differences in either the degree of expansion or the distribution of the load. In addition, the observations indicate that the mechanism underlying the difference between the response to isotonic saline and isoncotic albumin in saline is already operative at birth, and that it is independent of nephron heterogeneity since the proportion of superficial nephrons must have changed during the period of nephrogenesis. The collecting duct, which is sensitive to both isotonic saline and isoncotic albumin, is likely to be responsible for the parallel development of the renal response to these two methods of intravascular volume expansion.
在1周龄、2周龄、3周龄和6周龄的幼犬中,研究了血管内和血管外腔室的相对扩张程度在限制液体负荷发育中动物的利钠反应方面所起的作用。通过输注等渗盐水(体重的10%)或5%体重的生理盐水等渗白蛋白来诱导容量扩张,并测量肾小球滤过率、钠排泄、钠分数排泄和血浆容量。每种扩张程序在所有年龄段均导致钠的绝对排泄增加(P<0.001)。在3周龄的幼犬中观察到最大的利钠作用,两种溶液在1周龄、2周龄、3周龄和6周龄动物中的平均值分别为19、30、70和28μEq/分钟/千克。各年龄组之间利钠作用的差异主要归因于钠分数排泄增加幅度的差异。在所有年龄段,盐水容量扩张期间的钠绝对排泄量均高于白蛋白(P<0.05)。所有年龄段的血管内容量增加百分比相似(P>0.1),盐水和白蛋白产生的血管内扩张程度相当(约50%)。结果表明,对容量扩张的利钠反应的年龄相关变化不能归因于扩张程度或负荷分布的差异。此外,观察结果表明,生理盐水和生理盐水等渗白蛋白反应差异的潜在机制在出生时就已起作用,并且它与肾单位异质性无关,因为浅表肾单位的比例在肾发生期间必定发生了变化。对生理盐水和等渗白蛋白均敏感的集合管可能是肾脏对这两种血管内容量扩张方法反应平行发展的原因。