Conger J D, Schultz M F, Miller F, Robinette J B
University of Colorado Health Sciences Center, Denver.
Kidney Int. 1994 Aug;46(2):318-23. doi: 10.1038/ki.1994.277.
Renal blood flow (RBF) autoregulation has been found to be impaired in both norepinephrine (NE) and renal artery clamp (RAC) rat ischemic acute renal failure models. However, the decline in RBF at the normal lower limit of autoregulation is greater in NE-ARF. The present study was designed to determine if this difference in autoregulatory profiles has potential functional and morphologic significance. After demonstrating a fall in RBF to renal perfusion pressure reduction to 90 mm Hg that was twofold more in one week NE- than RAC-ARF (p < 0.001), separate rats of both ischemic ARF types with nearly identical levels of azotemia and glomerular filtration rate reduction and sham-ARF rats were subjected to four-hour controlled reduction in mean arterial pressure to 90 by transient phlebotomy at one week. On day 9, two days after mean arterial pressure reduction, blood urea nitrogen (BUN), serum creatinine (SCr) and creatinine clearance (CCr) showed continued improvement in RAC-ARF, but there were significant increases in BUN (46 +/- 22 to 72 +/- 10 mg/dl) and SCr (1.2 +/- 0.2 to 1.5 +/- 0.2 mg/dl) and a decline in CCr (0.434 +/- 0.127 to 0.334 +/- 0.079 ml/min) in the NE-ARF group (all P < 0.02). The mean sum of scores of morphologic indices of ARF was higher in NE- than RAC-ARF kidneys of rats sacrificed on day 9 but interstitial edema was the only individual index that was worse in NE-ARF.(ABSTRACT TRUNCATED AT 250 WORDS)
在去甲肾上腺素（NE）和肾动脉夹闭（RAC）大鼠缺血性急性肾衰竭模型中，均发现肾血流量（RBF）自身调节功能受损。然而，在NE诱导的急性肾衰竭（NE-ARF）中，RBF在自身调节正常下限的下降幅度更大。本研究旨在确定这种自身调节曲线的差异是否具有潜在的功能和形态学意义。在证实将肾灌注压降至90 mmHg时，RBF下降幅度在一周龄的NE-ARF中是RAC-ARF的两倍（p < 0.001）后，将两种缺血性ARF类型且氮质血症水平和肾小球滤过率降低程度几乎相同的大鼠以及假手术ARF大鼠，在一周龄时通过短暂放血将平均动脉压控制降低至90 mmHg持续4小时。在第9天，即平均动脉压降低两天后，血尿素氮（BUN）、血清肌酐（SCr）和肌酐清除率（CCr）显示RAC-ARF持续改善，但NE-ARF组的BUN（从46±22增至72±10 mg/dl）和SCr（从1.2±0.2增至1.5±0.2 mg/dl）显著升高，CCr下降（从0.434±0.127降至0.334±0.079 ml/min）（所有P < 0.02）。在第9天处死的大鼠中，NE-ARF肾脏的ARF形态学指标评分总和高于RAC-ARF，但间质水肿是NE-ARF中唯一更严重的单项指标。（摘要截断于250字）
