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幼鼠急性单侧输尿管梗阻解除后的深部肾单位功能

Deep nephron function after release of acute unilateral ureteral obstruction in the young rat.

作者信息

Buerkert J, Martin D, Head M, Prasad J, Klahr S

出版信息

J Clin Invest. 1978 Dec;62(6):1228-39. doi: 10.1172/JCI109243.

Abstract

The effects of acute unilateral ureteral obstruction (UUO) of 18 h duration on deep nephron function was evaluated in 14 weanling rats with the technique of micropuncture. After release of UUO, 3.4 +/- 0.66% (SE) of the filtered water remained at the tip of the collecting duct nearly fivefold greater than in controls (0.75 +/- 0.10%). Similar differences were seen in fractional sodium that remained at this site. The ratio of tubular fluid osmolality to that of plasma was also reduced in the UUO group (1.53 +/- 0.06 vs. 4.60 +/- 0.26 in controls, P less than 0.001). Single nephron glomerular filtration rate of cortical and deep nephrons was significantly less (P less than 0.001) after release of UUO. Although the percentage of filtering nephrons was significantly reduced in both nephron populations, the decline in glomerular filtration rate was greater in cortical than in juxtamedullary nephrons (cortical:juxtamedullary nephrons = 27.6 +/- 4.5% vs. 53.3 +/- 5.2% in controls, P less than 0.005) which suggests that single nephron glomerular filtration rate is redistributed to deep nephrons after release of UUO. In contrast to cortical nephrons, the amount of tubular fluid which remains near the bend of the loop of Henle of deep nephrons was greater after release of UUO. This appeared to be the result of a decrease in the reabsorption of both water (tubular fluid:plasma inulin = 2.41 +/- 0.16 vs. 7.94 +/- 0.69 in controls, P less than 0.001) and sodium (52.3 +/- 4% vs. 40.7 +/- 2.9% of the filtered sodium in controls, P less than 0.02). It is suggested that this altered reabsorption occurs along both the proximal tubule and descending limb of the loop of Henle of juxtamedullary nephrons. Inner medullary plasma flow (IMPF), as measured with the [125I]albumin-accumulation technique, was significantly depressed before release of UUO, but exceeded control values 90 min postrelease. Such changes imply that the filtration fraction of deep nephrons is decreased and that physical factors in the proximal tubular reabsorption of sodium have been altered. When papillary solute content was measured before release of UUO it was low (428 +/- 23 vs. 1,205 +/- 106 mosmol/kg in controls, P less than 0.001) which indicates that the decline in papillary osmolality is not a consequence of the increased IMPF seen after ureteral release, but rather precedes it. In fact, the decline in papillary osmolality may contribute to the increase in IMPF after release of UUO and to the decreased reabsorption of fluid along the descending limb of the loop of Henle.

摘要

采用微穿刺技术,在14只断乳大鼠中评估了持续18小时的急性单侧输尿管梗阻(UUO)对深层肾单位功能的影响。解除UUO后,3.4±0.66%(标准误)的滤过水留在集合管末端,几乎是对照组(0.75±0.10%)的五倍。在该部位保留的分数钠也有类似差异。UUO组肾小管液渗透压与血浆渗透压的比值也降低(分别为1.53±0.06和对照组的4.60±0.26,P<0.001)。解除UUO后,皮质肾单位和深层肾单位的单肾单位肾小球滤过率显著降低(P<0.001)。尽管两个肾单位群体中滤过肾单位的百分比均显著降低,但皮质肾单位的肾小球滤过率下降幅度大于近髓肾单位(皮质肾单位:近髓肾单位为27.6±4.5%,而对照组为53.3±5.2%,P<0.005),这表明解除UUO后单肾单位肾小球滤过率重新分布到深层肾单位。与皮质肾单位相反,解除UUO后,深层肾单位亨氏袢弯曲处附近的肾小管液量增加。这似乎是水(肾小管液:血浆菊粉为2.41±0.16,而对照组为7.94±0.69,P<0.001)和钠(52.3±4%,而对照组为滤过钠的40.7±2.9%,P<0.02)重吸收减少的结果。提示这种重吸收改变发生在近髓肾单位的近端小管和亨氏袢降支。用[125I]白蛋白蓄积技术测量的内髓质血浆流量(IMPF),在解除UUO前显著降低,但在解除后90分钟超过对照组值。这些变化意味着深层肾单位的滤过分数降低,并且近端小管钠重吸收的物理因素已改变。在解除UUO前测量乳头溶质含量时发现其较低(428±23,而对照组为1205±106毫渗摩尔/千克,P<0.001),这表明乳头渗透压的降低不是输尿管解除后IMPF增加的结果,而是在此之前就已发生。事实上,乳头渗透压的降低可能导致解除UUO后IMPF增加以及沿亨氏袢降支的液体重吸收减少。

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