Terzi F, Cheval L, Barlet-Bas C, Younes-Ibrahim M, Buffin-Meyer B, Burtin M, Beaufils H, Marsy S, Girolami J P, Kleinknecht C, Doucet A
Institut National de la Santé et de la Recherche Médicale (INSERM) U 426, Faculté Xavier Bichat, Paris, France.
Am J Physiol. 1996 Jun;270(6 Pt 2):F997-1003. doi: 10.1152/ajprenal.1996.270.6.F997.
Tubular overwork is thought to be a promoter of the tubular hypertrophy and renal failure that occur in response to renal mass reduction. Because Na-K-adenosinetriphosphatase (Na-K-ATPase) is an index of tubular work, we evaluated the effects of subtotal nephrectomy and of enalapril therapy, which delays the evolution of renal lesions, on tubular hypertrophy and Na-K-ATPase activity along the rat nephron. Within 6 wk, 70% reduction of renal mass engendered hypertrophy of the proximal convoluted tubule (PCT), thick ascending limb (TAL), and collecting duct (CD), as well as parallel increments in Na-K-ATPase activity per millimeter tubule length (Na-K-ATPase activity per unit surface area was not modified by subtotal nephrectomy). Chronic enalapril therapy prevented part of the hypertrophy (but not Na-K-ATPase stimulation) of the PCT and the whole stimulation of Na-K-ATPase (but not hypertrophy) in the CD, whereas it had no effect on the TAL. Enalapril effect on Na-K-ATPase in CD might result from reduced bradykinin metabolism, as the reduction in urinary excretion of bradykinin observed in subtotally nephrectomized rats was prevented by enalapril therapy.
肾小管过度负荷被认为是对肾单位减少作出反应时发生的肾小管肥大和肾衰竭的一个促进因素。由于钠钾三磷酸腺苷酶(Na-K-ATPase)是肾小管工作的一个指标,我们评估了肾大部切除术以及能延缓肾损害进展的依那普利治疗对大鼠肾单位各段肾小管肥大和Na-K-ATPase活性的影响。在6周内,肾质量减少70%导致近端曲管(PCT)、髓袢升支粗段(TAL)和集合管(CD)肥大,以及每毫米肾小管长度的Na-K-ATPase活性平行增加(肾大部切除术未改变单位表面积的Na-K-ATPase活性)。慢性依那普利治疗可预防PCT的部分肥大(但不影响Na-K-ATPase的刺激)以及CD中Na-K-ATPase的全部刺激(但不影响肥大),而对TAL无影响。依那普利对CD中Na-K-ATPase的作用可能是由于缓激肽代谢减少所致,因为依那普利治疗可防止肾大部切除大鼠中观察到的缓激肽尿排泄减少。