Novarini A, Coruzzi P, Bruschi G, Ravanetti C, Musiari L, Biggi A, Borghetti A
G Ital Cardiol. 1982;12(10):695-701.
In 25 patients with essential hypertension and 9 control subjects we have studied the effects of central hypervolemia during water immersion on both renin-angiotensin-aldosterone system and renal function (diuresis volume and urine excretion of Na, k and osmoles). Reduction of blood pressure, plasma renin activity and aldosterone was found to be similar in both groups; renal excretion of water, Na, K and osmoles was significantly higher in the hypertensive group compared to the controls. These urinary features may be related to a reduced proximal tubular reabsorption by cardiorenal reflex due to cardiopulmonary volume receptors stimulation without any change of GFR measured as the creatinine clearance. The urinary pattern, observed during water immersion in hypertensive group without any change of plasma sodium, osmolality or protein concentration, was comparable to "exaggerated natriuresis"; this may suggest that also "exaggerated natriuresis" is due either to renal vasodilatation or to renal tubular sympathetic activity reduction secondary to a cardiorenal reflex by cardiopulmonary volume expansion.
在25例原发性高血压患者和9例对照受试者中，我们研究了水浸期间中心血容量过多对肾素 - 血管紧张素 - 醛固酮系统和肾功能（尿量以及钠、钾和渗透压的尿排泄量）的影响。发现两组患者血压、血浆肾素活性和醛固酮的降低情况相似；与对照组相比，高血压组水、钠、钾和渗透压的肾排泄量显著更高。这些尿液特征可能与心肺容量感受器刺激通过心肾反射导致近端肾小管重吸收减少有关，而以肌酐清除率衡量的肾小球滤过率没有任何变化。在高血压组水浸期间观察到的尿液模式，在血浆钠、渗透压或蛋白质浓度无任何变化的情况下，与“夸张性利钠”相当；这可能表明“夸张性利钠”也是由于肾血管舒张或心肺容量扩张通过心肾反射继发的肾小管交感神经活动减少所致。
