Dirks J H, Wong N L
Yale J Biol Med. 1978 May-Jun;51(3):255-63.
The renal and proximal tubule response to contralateral kidney exclusion was studied in a variety of circumstances. Recollection micropuncture studies were performed to assess the response to contralateral kidney clamping in the normal or a remnant kidney of the dog. Acute clamping of the contralateral kidney for a normal and unilateral remnant kidney resulted in marked reduction in proximal TF/P inulin ratios in the experimental kidney reflecting a 15 percent reduction in fluid reabsorption. Mean fractional excretion of sodium, potassium and water increased significantly in remnant kidney dogs but no significant change was observed in normal dogs except for potassium excretion. The marked reduction in proximal reabsorption occurred as soon as 5-15 minutes after contralateral kidney clamping and was compensated by distal reabsorption. Acute obstruction of the contralateral ureter results in a similar markedly reduced proximal tubular reabsorption. The reduction in proximal reabsorption induced by contralateral clamping occurred in the presence of reduced perfusion pressure and volume expansion and to some extent with renal denervation. When prostaglandin E(2) or acetycholine were infused prior to contralateral kidney clamping, proximal reabsorption remained at control levels and the contralateral clamping response was blocked. Similar blockade occurred after treatment with indomethacin. Acute reduction in nephron mass causes a marked depression of proximal tubular sodium and fluid absorption not obviously accounted for by hemodynamicphysical factors and humoral factors may be involved. The level of distal reabsorption to increased proximal delivery following contralateral clamping, determines the net urinary excretion.
在多种情况下研究了肾脏及近端肾小管对侧肾切除的反应。进行了回顾性微穿刺研究，以评估狗的正常肾脏或残余肾脏对侧肾夹闭的反应。对正常肾脏和单侧残余肾脏急性夹闭对侧肾脏，导致实验肾脏近端管液/血浆菊粉比值显著降低，反映出液体重吸收减少了15%。残余肾脏的狗钠、钾和水的平均排泄分数显著增加，但正常狗除钾排泄外未观察到显著变化。对侧肾脏夹闭后5 - 15分钟内近端重吸收即显著降低，并由远端重吸收代偿。对侧输尿管急性梗阻导致近端肾小管重吸收同样显著降低。对侧夹闭引起的近端重吸收减少发生在灌注压降低和容量扩张的情况下，并且在一定程度上与肾去神经支配有关。在对侧肾脏夹闭前输注前列腺素E(2)或乙酰胆碱时，近端重吸收维持在对照水平，对侧夹闭反应被阻断。吲哚美辛治疗后也出现类似的阻断作用。肾单位数量急性减少导致近端肾小管钠和液体吸收显著降低，这显然不能用血流动力学物理因素来解释，可能涉及体液因素。对侧夹闭后近端输送增加时远端重吸收的水平决定了净尿排泄量。
