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压力性利钠作用在肾电解质排泄长期调控中的作用

Role of pressure natriuresis in long-term control of renal electrolyte excretion.

作者信息

Mizelle H L, Montani J P, Hester R L, Didlake R H, Hall J E

机构信息

Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson 39216-4505.

出版信息

Hypertension. 1993 Jul;22(1):102-10. doi: 10.1161/01.hyp.22.1.102.

Abstract

If pressure natriuresis is to play an important role in arterial pressure control, renal perfusion pressure must have a long-term effect on urinary sodium excretion. The aim of this study was to quantitate the importance of renal perfusion pressure per se in controlling renal hemodynamics and electrolyte excretion chronically. Female mongrel dogs (n = 6) were instrumented with bilateral renal artery catheters for measurement of renal perfusion pressure and occluders on both renal arteries for servo-control of renal perfusion pressure at different levels; the urinary bladder was split for determination of renal clearances and electrolyte excretion from each kidney separately. Because both kidneys were exposed to the same neurohumoral influences, any changes in renal function could be attributed to differences in renal perfusion pressure between the two kidneys. After 5 days of control, renal perfusion pressure to one kidney was reduced from 86.7 +/- 0.2 to 74.2 +/- 0.6 mm Hg for 12 days, and pressure in the contralateral kidney increased to 91.5 +/- 0.4 mm Hg. Sodium excretion decreased from 41 +/- 2 to 25 +/- 1 mmol/d in the servo-controlled kidney and increased from 41 +/- 1 to 55 +/- 1 mmol/d in the contralateral kidney during 12 days of servo-control. Urine volume, chloride excretion, and potassium excretion exhibited similar patterns during servo-control. In addition, autoregulation of effective renal plasma flow and glomerular filtration rate was relatively well maintained; however, in the low-pressure kidney, glomerular filtration rate was slightly but significantly lower (approximately 8%) than in the contralateral kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

如果压力性利钠在动脉血压控制中发挥重要作用,肾灌注压必须对尿钠排泄产生长期影响。本研究的目的是定量肾灌注压本身在长期控制肾血流动力学和电解质排泄方面的重要性。对6只雌性杂种犬进行双侧肾动脉插管以测量肾灌注压,并在双侧肾动脉上安装阻塞器以将肾灌注压伺服控制在不同水平;将膀胱切开以分别测定每个肾脏的肾清除率和电解质排泄。由于两个肾脏受到相同的神经体液影响,肾功能的任何变化都可归因于两个肾脏之间肾灌注压的差异。在对照5天后,将一侧肾脏的肾灌注压在12天内从86.7±0.2 mmHg降至74.2±0.6 mmHg,而对侧肾脏的压力升至91.5±0.4 mmHg。在12天的伺服控制期间,伺服控制肾脏的钠排泄从41±2 mmol/d降至25±1 mmol/d,对侧肾脏的钠排泄从41±1 mmol/d增至55±1 mmol/d。在伺服控制期间,尿量、氯排泄和钾排泄呈现相似的模式。此外,有效肾血浆流量和肾小球滤过率的自身调节相对保持良好;然而,在低压肾脏中,肾小球滤过率略低于对侧肾脏,但差异显著(约8%)。(摘要截断于250字)

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