Fine E J, Blaufox M D, Blumenfeld J D, Laragh J H, Chun K J, Heller S L, Bongiovanni J A
Department of Nuclear Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA.
J Nucl Med. 1996 May;37(5):838-42.
Exercise induced renal dysfunction is reported to occur in treated hypertensive patients but not seen normotensive subjects. It is unclear if this phenomenon is related to the disease or to treatment.
Four normal volunteers and 15 hypertensive subjects (antihypertensive medications were discontinued for more than 4 wk) were studied with upright radionuclide renography at rest and during bicycle exercise. The amount of exercise was sufficient to increase the heart rate at least 20 bpm above the resting value. All subjects were healthy, without evidence of left ventricular hypertrophy renal disease or hypertensive retinal disease. BUN, serum creatinine concentration and urinalysis were normal in all subjects. Renograms were performed for 12-15 min after injection of either 1 mCi[123]orthoidohippurate (OIH) or 2-7 mCi 99mTc-mercaptoacetyltriglycine (MAG3). Visual analysis and mean transit time calculation were performed on the rest and exercise studies.
Seven of 14 hypertensive subjects and none of the normal volunteers demonstrated abnormal prolongation in renal transit during exercise which was not seen on the resting renogram. Four of these seven subjects had a history of hypertension for 2 yr or less.
About 50% of individuals with mild-to-moderate hypertension and normal renal function may have abnormal renal transit of renal excretion agents during exercise, although their baseline studies are normal. This finding is unassociated with therapy and appears to be related directly to the pathophysiology of essential hypertension.
据报道，运动诱发的肾功能障碍发生在接受治疗的高血压患者中，但在血压正常的受试者中未见。尚不清楚这种现象是与疾病有关还是与治疗有关。
对4名正常志愿者和15名高血压受试者（停用抗高血压药物超过4周）在静息和自行车运动期间进行直立放射性核素肾图检查。运动量足以使心率比静息值至少增加20次/分钟。所有受试者均健康，无左心室肥厚、肾病或高血压视网膜病的证据。所有受试者的血尿素氮、血清肌酐浓度和尿液分析均正常。在注射1毫居里[123]邻碘马尿酸（OIH）或2 - 7毫居里99m锝 - 巯基乙酰三甘氨酸（MAG3）后进行12 - 15分钟的肾图检查。对静息和运动研究进行视觉分析和平均通过时间计算。
14名高血压受试者中有7名在运动期间出现肾脏通过时间异常延长，而静息肾图未见此现象，4名正常志愿者均未出现。这7名受试者中有4名高血压病史为2年或更短。
约50%轻度至中度高血压且肾功能正常的个体在运动期间可能出现肾脏排泄剂的肾脏通过异常，尽管他们的基线检查正常。这一发现与治疗无关，似乎直接与原发性高血压的病理生理学有关。
