Wu X, Sonnenberg H
Department of Physiology, University of Toronto, Ontario, Canada.
Clin Exp Hypertens. 1995 Nov;17(8):1269-85. doi: 10.3109/10641969509037408.
Abnormalities in renal handling of calcium, magnesium, or phosphate have been implicated in the development and/or maintenance of human hypertension. We have shown recently that renal excretion of these ions is correlated to blood pressure in Dahl salt-sensitive as well as salt-resistant rats. The present study was designed to determine whether renal perfusion pressure per se could affect excretion of these ions. Urinary excretion of calcium, magnesium, and phosphate was studied in anaesthetized Sprague-Dawley rats under basal conditions and during an intravenous infusion of angiotensin II (ANG II), vasopressin (AVP) or phenylephrine (PE). A cuff, placed around the aorta between the two renal arteries, allowed maintenance of normal perfusion pressure in the left kidney, while that in the right kidney was allowed to rise. Infusion of pressor agents raised mean arterial blood pressure to comparable levels (means +/- SE): ANG II (n = 7), before = 102 +/- 4, during = 133 +/- 3 mmHg, AVP (n = 8), before = 110 +/- 7, during = 136 +/- 5 mmHg, PE (n = 6), before = 111 +/- 6, during = 141 +/- 6 mmHg. Although there was no difference in excretion of calcium, magnesium and phosphate between the two kidneys under basal conditions, infusion of ANG II or PE induced hypercalciuria, hypermagnesiuria and hyperphosphaturia in the right kidney which was exposed to the increased arterial pressure. Such effects did not appear in the pressure-controlled left kidney. Infusion of AVP was associated with reduced excretion of calcium and magnesium, and increased excretion of phosphate, in the normotensive kidney. The response to the similarly increased renal perfusion pressure in this group was also reduced for calcium and magnesium, and enhanced for phosphate. The results indicate (1) renal excretion of calcium, magnesium and phosphate is renal perfusion pressure-dependent; the higher the renal perfusion pressure, the greater the excretion of these ions. (2) Independently of perfusion pressure, AVP can inhibit phosphate reabsorption and stimulate divalent cation reabsorption.
钙、镁或磷酸盐的肾脏处理异常与人类高血压的发生和/或维持有关。我们最近发现,在 Dahl 盐敏感型和盐抵抗型大鼠中,这些离子的肾脏排泄与血压相关。本研究旨在确定肾脏灌注压本身是否会影响这些离子的排泄。在基础条件下以及静脉输注血管紧张素 II(ANG II)、血管加压素(AVP)或去氧肾上腺素(PE)期间,对麻醉的 Sprague-Dawley 大鼠的钙、镁和磷酸盐的尿排泄进行了研究。在两条肾动脉之间的主动脉周围放置一个袖带,使左肾维持正常灌注压,而右肾的灌注压则升高。输注升压药使平均动脉血压升高到可比水平(平均值±标准误):ANG II(n = 7),之前 = 102 ± 4,期间 = 133 ± 3 mmHg,AVP(n = 8),之前 = 110 ± 7,期间 = 136 ± 5 mmHg,PE(n = 6),之前 = 111 ± 6,期间 = 141 ± 6 mmHg。尽管在基础条件下两肾之间的钙、镁和磷酸盐排泄没有差异,但输注 ANG II 或 PE 会导致暴露于升高动脉压的右肾出现高钙尿、高镁尿和高磷尿。这种效应在压力控制的左肾中未出现。在血压正常的肾脏中,输注 AVP 与钙和镁排泄减少以及磷酸盐排泄增加有关。该组中肾脏灌注压同样升高时,钙和镁的反应也降低,而磷酸盐的反应增强。结果表明:(1)钙、镁和磷酸盐的肾脏排泄依赖于肾脏灌注压;肾脏灌注压越高,这些离子的排泄量越大。(2)独立于灌注压,AVP 可抑制磷酸盐重吸收并刺激二价阳离子重吸收。