Briffeuil P, Thu T H, Kolanowski J
Department of Physiology and Pathophysiology, University of Namur, Belgium.
Metabolism. 1996 Mar;45(3):383-8. doi: 10.1016/s0026-0495(96)90295-4.
Although several reports suggest that pharmacologic amounts of glucagon may promote natriuresis, the influence of a physiological or even pathophysiological increase in circulating glucagon levels on kidney function has never been convincingly demonstrated. The present study was therefore undertaken to determine whether a moderate increase in plasma glucagon concentration of blood perfusing the kidney may influence kidney function and promote urinary sodium excretion. To this end, glucagon was infused directly into one renal artery of anesthetized dogs at a rate of 1 ng x kg(-1) x min(-1), calculated to increase glucagon concentration in the blood perfusing the kidney within the pathophysiologic range and thus to levels seen in some catabolic states such as poorly controlled diabetes or starvation. The contralateral kidney was infused with saline only. The estimated concentration of glucagon in blood perfusing the hormone-infused kidney increased with glucagon infusion from 227 pg x mL(-1) during the control period to mean of 779 pg x mL(-1). There was a significant increase in glucagon extraction by this kidney, from 33% in baseline conditions to 61% upon intrarenal infusion of the hormone, and hence venous glucagon levels were only slightly higher than in the contralateral kidney. Despite a more than threefold increase in glucagon levels in blood perfusing the hormone-infused kidney versus the contralateral kidney, this experimentally induced hyperglucagonemia was without influence on renal plasma flow (RFP), glomerular filtration rate (GFR), renal vascular resistance, renal uptake of oxygen and energy-providing substrates. Excretion of Na+, K+, Cl-, and PO4(3-) was likewise unaffected. These results indicate that hyperglucagonemia, at least of a magnitude comparable to that seen in starvation or diabetic decompensation, is devoid of any detectable direct influence on renal hemodynamics or tubular function.
尽管有几份报告表明药理剂量的胰高血糖素可能促进尿钠排泄,但循环中胰高血糖素水平的生理性甚至病理性升高对肾功能的影响从未得到令人信服的证实。因此,本研究旨在确定灌注肾脏的血液中血浆胰高血糖素浓度适度升高是否会影响肾功能并促进尿钠排泄。为此,将胰高血糖素以1 ng×kg⁻¹×min⁻¹的速率直接注入麻醉犬的一条肾动脉,计算得出该剂量可使灌注肾脏的血液中胰高血糖素浓度升高至病理生理范围内,并达到某些分解代谢状态(如糖尿病控制不佳或饥饿)时的水平。对侧肾脏仅注入生理盐水。灌注激素的肾脏的血液中胰高血糖素的估计浓度随着胰高血糖素的注入从对照期的227 pg×mL⁻¹增加到平均779 pg×mL⁻¹。该肾脏对胰高血糖素的摄取显著增加,从基线时的33%增加到肾内注入激素后的61%,因此静脉血中胰高血糖素水平仅略高于对侧肾脏。尽管灌注激素的肾脏的血液中胰高血糖素水平比对照侧肾脏增加了三倍多,但这种实验诱导的高胰高血糖素血症对肾血浆流量(RPF)、肾小球滤过率(GFR)、肾血管阻力、肾脏对氧气和能量供应底物的摄取没有影响。Na⁺、K⁺、Cl⁻和PO₄³⁻的排泄同样未受影响。这些结果表明,至少与饥饿或糖尿病失代偿时所见程度相当的高胰高血糖素血症对肾血流动力学或肾小管功能没有任何可检测到的直接影响。