Gabbai F B, Peterson O W, Khang S, Wilson C B, Blantz R C
Division of Nephrology-Hypertension, University of California, San Diego, School of Medicine 92161.
Am J Physiol. 1994 Sep;267(3 Pt 2):F423-7. doi: 10.1152/ajprenal.1994.267.3.F423.
The cell-free isolated perfused kidney (IPK) is characterized by normal glomerular filtration rate (GFR) and very low filtration fraction (FF). Addition of erythrocytes to the perfusate (IEPK) increases FF while maintaining "normal" GFR levels. Micropuncture studies were performed in IPK and IEPK to establish the determinants of the glomerular ultrafiltration process responsible for low FF in IPK and to evaluate the impact of the addition of erythrocytes on these determinants. Nephron filtration rate was similar in IPK and IEPK (40 +/- 4 vs. 39 +/- 4 nl/min), whereas nephron perfusate flow was significantly higher in IPK (1,247 +/- 100 vs. 112 +/- 13 nl/min), leading to a superficial nephron FF of 3.4 +/- 0.2% in IPK and 36 +/- 2% in IEPK. Glomerular hydrostatic pressure (PG) and transcapillary hydrostatic pressure gradient (delta P) were 53 +/- 2 and 33 +/- 1 mmHg, respectively, in IPK and 51 +/- 3 and 34 +/- 2 mmHg in IEPK, all normal values. Glomerular arteriolar resistances were significantly lower in IPK than in IEPK, and the glomerular ultrafiltration coefficient (LpA) was significantly lower in IPK (0.053 +/- 0.010 vs. 0.100 +/- 0.020 nl.s-1.mmHg-1), but both values are within the normal in vivo range. These results demonstrate that low FF in IPK is not due to decreased delta P or LpA values but to the high renal perfusion rate required to maintain normal PG and delta P values. Addition of erythrocytes increases glomerular arteriolar resistances and restores glomerular hemodynamics to a pattern nearly identical to in vivo conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
无细胞分离灌注肾(IPK)的特征是肾小球滤过率(GFR)正常而滤过分数(FF)极低。向灌注液中添加红细胞(IEPK)可增加FF,同时维持“正常”的GFR水平。对IPK和IEPK进行了微穿刺研究,以确定导致IPK中FF较低的肾小球超滤过程的决定因素,并评估添加红细胞对这些决定因素的影响。IPK和IEPK中的肾单位滤过率相似(40±4对39±4 nl/分钟),而IPK中的肾单位灌注液流量显著更高(1247±100对112±13 nl/分钟),导致IPK中浅表肾单位FF为3.4±0.2%,IEPK中为36±2%。IPK中的肾小球静水压力(PG)和跨毛细血管静水压力梯度(ΔP)分别为53±2和33±1 mmHg,IEPK中为51±3和34±2 mmHg,均为正常值。IPK中的肾小球小动脉阻力显著低于IEPK,IPK中的肾小球超滤系数(LpA)显著更低(0.053±0.010对0.100±0.020 nl·s-1·mmHg-1),但这两个值均在正常体内范围内。这些结果表明,IPK中FF较低并非由于ΔP或LpA值降低,而是由于维持正常PG和ΔP值所需的高肾灌注率。添加红细胞可增加肾小球小动脉阻力,并使肾小球血液动力学恢复到与体内情况几乎相同的模式。(摘要截短于250字)