Bouby N, Ahloulay M, Nsegbe E, Déchaux M, Schmitt F, Bankir L
INSERM Unité 90, Hôpital Necker-Enfants Malades, Paris, France.
J Am Soc Nephrol. 1996 Jun;7(6):842-51. doi: 10.1681/ASN.V76842.
To evaluate the possible influence of chronic alterations in urine concentrating activity (CA) on renal hemodynamics, adult male Sprague-Dawley rats were submitted for 7 days to one of three different levels of CA. CA was either reduced by increasing water intake (mixing the food with a gel bringing 1.6 mL water per g food) (Low-CA), or increased by chronic intraperitoneal infusion of 1-desamino 8-D-arginine vasopressin (200 ng/day) (High-CA). Low-CA, High-CA, and control rats were housed in metabolic cages, ate the same quantity of dry food (the amount provided being slightly lower than the spontaneous intake), and had free access to drinking water. The only difference between groups thus concerned the water intake-vasopressin axis. Radiolabeled (14C)inulin was infused chronically by osmotic minipumps. Urine was collected during Days 5, 6, and 7, and blood samples were taken for determination of plasma composition (P), absolute and fractional (FE) urinary excretion, and clearance (C) of inulin, creatinine, urea, and main electrolytes. This protocol produced mean 24-h urine osmolality (Uosm) ranging from 500 to 3500 mosmol/kg H2O without inducing any disturbance in body fluids or plasma osmolality (Posm). Results show that GFR (Cinulin) was markedly and positively correlated with Uosm (r = 0.798, P < 0.001) and free water reabsorption (r = 0.819, P < 0.001). For Uosm = 2500 mosm/kg H2O, GFR was 47% higher than for Uosm = 500 mosm/kg H2O. Ccreat underestimated GFR in High-CA and overestimated it in Low-CA. FEurea was inversely related to Uosm, as expected from the increased reabsorption known to occur at low urine flows. It is tentatively proposed that the intrarenal recycling of urea, triggered by vasopressin and essential to the urinary concentrating mechanism, might influence GFR indirectly by modifying the composition of the tubular fluid at the macula densa and thus the intensity of the tubuloglomerular feedback control of GFR. Even if this mechanism remains to be confirmed, this study unequivocally demonstrates, in normal conscious rats, that the level of urinary concentrating activity has a major influence on basal GFR.
为评估尿浓缩活性(CA)的慢性改变对肾血流动力学的可能影响,将成年雄性Sprague-Dawley大鼠分为三组,使其处于三种不同水平的CA状态7天。通过增加水摄入量(将食物与每克食物含1.6毫升水的凝胶混合)降低CA(低CA组),或通过慢性腹腔注射1-去氨基-8-D-精氨酸加压素(200纳克/天)增加CA(高CA组)。低CA组、高CA组和对照组大鼠饲养在代谢笼中,进食相同量的干食物(提供的量略低于自发摄入量),并可自由饮用饮用水。因此,各组之间的唯一差异在于水摄入 - 加压素轴。通过渗透微型泵长期输注放射性标记(14C)菊粉。在第5、6和7天收集尿液,并采集血样以测定血浆成分(P)、菊粉、肌酐、尿素和主要电解质的绝对和分数(FE)尿排泄以及清除率(C)。该方案产生的平均24小时尿渗透压(Uosm)范围为500至3500毫摩尔/千克H2O,且未引起任何体液或血浆渗透压(Posm)紊乱。结果表明,肾小球滤过率(Cinulin)与Uosm显著正相关(r = 0.798,P < 0.001)和自由水重吸收显著正相关(r = 0.819,P < 0.001)。对于Uosm = 2500毫摩尔/千克H2O,肾小球滤过率比Uosm = 500毫摩尔/千克H2O时高47%。高CA组中肌酐清除率(Ccreat)低估了肾小球滤过率,低CA组中则高估了肾小球滤过率。如预期的那样,在低尿流时已知重吸收增加,尿素分数排泄(FEurea)与Uosm呈负相关。初步推测,由加压素触发且对尿液浓缩机制至关重要的尿素肾内循环,可能通过改变致密斑处肾小管液的成分,进而影响肾小球滤过率的肾小管 - 肾小球反馈控制强度,间接影响肾小球滤过率。即使这一机制仍有待证实,但本研究明确表明,在正常清醒大鼠中,尿液浓缩活性水平对基础肾小球滤过率有重大影响。