Herrera-Acosta J, Guerrero J, Erbessd M L, Paz-Barahona M, Chessal F, Alarcón-Segovia D, Peña J C
Nephron. 1978;22(1-3):128-37. doi: 10.1159/000181433.
High plasma renin activity (PRA) was found in 16 of 42 randomly selected nonuremic systemic lupus erythematosus (SLE) patients. Mild hypertension was present in 3 of the 16.6 high-PRA and 10 normal-PRA patients were admitted to a metabolic ward. Salt restriction produced a disproportionate rise in both PRA and aldosterone, a decrease in glomerular filtration rate (GFR) and a slightly greater negative sodium balance in the group with high PRA. Potassium excretion was less than intake in both groups. Balance studies were performed in 6 additional high-PRA patients before and during indomethacin administration (150 mg/24 h). PRA and aldosterone were markedly suppressed by indomethacin. UnaV was significantly greater than in the control period despite of the 28% reduction in GFR. These results suggest that high PRA is secondary to impaired distal tubular sodium reabsorption. Such a defect could be responsible for the relatively low frequency of hypertension in lupus nephritis.
在42例随机选取的非尿毒症系统性红斑狼疮（SLE）患者中，有16例血浆肾素活性（PRA）升高。16例高PRA患者中有3例存在轻度高血压。16例高PRA患者和10例正常PRA患者入住代谢病房。限盐使高PRA组的PRA和醛固酮不成比例地升高，肾小球滤过率（GFR）降低，负钠平衡略增加。两组的钾排泄均少于摄入量。在另外6例高PRA患者中，于吲哚美辛给药前及给药期间（150mg/24h）进行了平衡研究。吲哚美辛显著抑制了PRA和醛固酮。尽管GFR降低了28%，但尿钠排泄分数（UnaV）仍显著高于对照期。这些结果表明，高PRA继发于远端肾小管钠重吸收受损。这种缺陷可能是狼疮性肾炎中高血压相对少见的原因。
