Smith F G, Abraham J
Department of Medical Physiology, University of Calgary, AB, Canada.
Can J Physiol Pharmacol. 1995 Jan;73(1):107-12. doi: 10.1139/y95-015.
Despite the widespread use of furosemide in the treatment of various fluid and electrolyte disorders in the preterm and term human infant and child, the physiological effects of this potent diuretic agent on renal function and renin release during postnatal maturation are poorly understood. To test the hypothesis that the renal and renin responses to furosemide are altered during postnatal maturation, experiments were carried out in conscious chronically instrumented newborn lambs (11 +/- 3 days, n = 7) and older lambs (28 +/- 3 days, n = 6), at least 5 days after surgery under halothane anesthesia for placement of catheters. Renal function and plasma renin activity (PRA) were measured for 1 h before and 2 h after intravenous injection of furosemide (2 mg/kg; 0.2 mL/kg) or vehicle (0.2 mL/kg). Glomerular filtration rate (GFR) decreased after furosemide administration to both groups of lambs. However, the time course of this decrease in GFR was different, occurring sooner in older lambs (30 min) than in newborns (90 min). GFR remained significantly decreased after 150 min in both age-groups. The natriuretic and diuretic responses to furosemide were similar in newborns and older lambs, peak diuretic and natriuretic responses occurring within 30 min. PRA increased dramatically in both age-groups after furosemide; the response was accentuated in newborns. After 2 h, PRA was still elevated in newborns but returned towards control levels in older lambs. These data demonstrate that both the GFR and renin responses to furosemide are altered during ontogeny.
尽管速尿在治疗早产和足月人类婴幼儿的各种体液和电解质紊乱方面被广泛应用,但这种强效利尿剂在出生后成熟过程中对肾功能和肾素释放的生理影响却知之甚少。为了验证在出生后成熟过程中肾脏和肾素对速尿的反应会发生改变这一假设,对清醒且长期植入仪器的新生羔羊(11±3天,n = 7)和较大羔羊(28±3天,n = 6)进行了实验,这些羔羊在氟烷麻醉下进行导管植入手术后至少5天。在静脉注射速尿(2mg/kg;0.2mL/kg)或赋形剂(0.2mL/kg)前1小时和后2小时测量肾功能和血浆肾素活性(PRA)。两组羔羊注射速尿后肾小球滤过率(GFR)均下降。然而,GFR下降的时间进程不同,较大羔羊(30分钟)比新生羔羊(90分钟)出现得更早。在两个年龄组中,150分钟后GFR仍显著降低。新生羔羊和较大羔羊对速尿的利钠和利尿反应相似,利尿和利钠反应峰值在30分钟内出现。速尿给药后两个年龄组的PRA均显著增加;新生羔羊的反应更明显。2小时后,新生羔羊的PRA仍升高,但较大羔羊的PRA恢复到对照水平。这些数据表明,在个体发育过程中,GFR和肾素对速尿的反应均发生了改变。