Rabkin R, Share L, Payne P A, Young J, Crofton J
J Clin Invest. 1979 Jan;63(1):6-13. doi: 10.1172/JCI109279.
Using the isolated rat kidney perfused with an artificial medium containing glucose as the sole fuel, we studied the renal handling of immunoreactive arginine vasopressin (AVP) and determined the effect of various factors on the ability of the kidney to remove AVP. In control kidneys perfused with AVP at concentrations below 116 muU/ml, the organ clearance of AVP (OC(AVP)) was 1,145+/-47 (SE) mul/min, whereas glomerular filtration rate (GFR) averaged 515+/-37 mul/min. Filtration could thus account for up to 45% of the OC(AVP), the balance presumably being cleared from the peritubular circulation. Of the AVP filtered, only 38% could be recovered in the urine (urinary clearance AVP averaged 205+/-12 mul/min) suggesting that the balance was taken up by the tubular epithelium and degraded. Fractional excretion of filtered AVP rose significantly in the presence of anoxia and cold (10 degrees C) to 49 and 59%, respectively, but was not affected by ouabain or high levels of AVP (458+/-58 muU/ml). The OC(AVP) was not significantly altered by the absence of glucose in the perfusate, anoxia, or ureteral ligation, maneuvers that were associated with significant reductions in GFR. In these and the control experiments, there was a significant inverse correlation between GFR and peritubular clearance emphasizing the importance of the latter (r = -0.749; P < 0.001). Cold, ouabain, and high concentrations of AVP reduced the clearance of AVP by the kidneys. On the basis of these studies we conclude that the kidney clears AVP from the circulation via two pathways, glomerular clearance and peritubular clearance. This exposes both the luminal and contraluminal surfaces of the tubular cells to the hormone, allowing these cells to remove AVP from the filtrate and the peritubular compartment. Noteworthy is the observation that under several conditions when GFR falls reducing the glomerular clearance of AVP, peritubular clearance increases and the total clearance of AVP by the kidney remains constant.
利用灌注含葡萄糖作为唯一燃料的人工培养基的离体大鼠肾脏,我们研究了免疫反应性精氨酸加压素(AVP)的肾脏处理过程,并确定了各种因素对肾脏清除AVP能力的影响。在以低于116 μU/ml的浓度灌注AVP的对照肾脏中,AVP的器官清除率(OC(AVP))为1145±47(SE)μl/min,而肾小球滤过率(GFR)平均为515±37 μl/min。因此,滤过最多可占OC(AVP)的45%,其余部分可能从肾小管周围循环中清除。在滤过的AVP中,只有38%可在尿液中回收(尿AVP清除率平均为205±12 μl/min),这表明其余部分被肾小管上皮细胞摄取并降解。在缺氧和低温(10℃)情况下,滤过AVP的分数排泄率分别显著升至49%和59%,但不受哇巴因或高浓度AVP(458±58 μU/ml)的影响。灌注液中无葡萄糖、缺氧或输尿管结扎这些与GFR显著降低相关的操作,并未显著改变OC(AVP)。在这些实验和对照实验中,GFR与肾小管周围清除率之间存在显著的负相关,强调了后者的重要性(r = -0.749;P < 0.001)。低温、哇巴因和高浓度AVP降低了肾脏对AVP的清除率。基于这些研究,我们得出结论,肾脏通过两条途径从循环中清除AVP,即肾小球清除和肾小管周围清除。这使肾小管细胞的管腔和管腔对侧表面都暴露于该激素,使这些细胞能够从滤液和肾小管周围间隙中清除AVP。值得注意的是,观察到在几种情况下,当GFR下降导致AVP的肾小球清除率降低时,肾小管周围清除率增加,肾脏对AVP的总清除率保持恒定。