Karlsen S J, Smevik B, Berg K J
Institute for Surgical Research, National Hospital, University of Oslo, Norway.
J Urol. 1993 Jul;150(1):219-22. doi: 10.1016/s0022-5347(17)35450-2.
Five anesthetized dogs were studied for 4 to 5 hours after administration of extracorporeal shock waves to one kidney, the contralateral organ serving as control. Repetitive major doses of the nonionic monomeric radiographic contrast medium (CM) iohexol were injected intravascularly before and after application of the extracorporeal shock waves for further provocation of kidney function. Urinary excretion of electrolytes, N-acetyl-beta-glucosaminidase (NAG) and kallikrein, clearances of creatinine, inulin and para-amino-hippuric acid (PAH), serum aldosterone level and plasma renin activity (PRA) were determined. On the exposed side there was a significant fall in urinary osmolality. Effective renal plasma flow (ERPF) was reduced and glomerular filtration rate (GFR) was unchanged; thus filtration fraction (FF) was increased. Extraction of PAH was reduced, and true renal plasma flow was unchanged. Urinary osmolality on the control side was unchanged. There was a fall in ERPF and increased GFR; therefore, FF increased. The mean rise of PRA in the exposed kidney was significant after shock waves. Urine volume and urinary excretion of electrolytes and kallikrein were stable bilaterally. Relating the results to those obtained in identical canine experiments without CM, simultaneous administration of CM does not seem to significantly influence the changes in kidney function parameters caused by extracorporeal shock waves in the dog.
对5只麻醉犬进行研究,对一侧肾脏施加体外冲击波后观察4至5小时,对侧肾脏作为对照。在施加体外冲击波前后,经血管内注射大剂量非离子单体放射造影剂(CM)碘海醇,以进一步激发肾功能。测定电解质、N-乙酰-β-氨基葡萄糖苷酶(NAG)和激肽释放酶的尿排泄量,肌酐、菊粉和对氨基马尿酸(PAH)的清除率,血清醛固酮水平和血浆肾素活性(PRA)。在冲击波作用侧,尿渗透压显著下降。有效肾血浆流量(ERPF)降低,肾小球滤过率(GFR)不变;因此滤过分数(FF)增加。PAH的摄取减少,真正的肾血浆流量不变。对照侧的尿渗透压不变。ERPF下降,GFR增加;因此,FF增加。冲击波作用后,冲击波作用侧肾脏PRA的平均升高显著。双侧尿量以及电解质和激肽释放酶的尿排泄量稳定。将这些结果与在未使用CM的相同犬类实验中获得的结果进行比较,同时给予CM似乎不会显著影响犬体外冲击波引起的肾功能参数变化。