Allen T J, Waldron M J, Casley D, Jerums G, Cooper M E
Department of Medicine, Austin and Repatriation Medical Centre, Heidelberg, Australia.
Diabetes. 1997 Jan;46(1):19-24. doi: 10.2337/diabetes.46.1.19.
The effects of dietary salt restriction on the renin-angiotensin system, glomerular filtration rate (GFR), renal size, and albuminuria were assessed in streptozotocin diabetic rats. Two series of experiments were performed: one short-term with severe salt restriction and the second long-term with moderate salt restriction. The first studied the effect of a very-low-salt diet for 4 weeks on GFR, renal size, and plasma angiotensin II concentration in diabetic and control rats. Diabetic and control male Sprague-Dawley rats received either a very-low-salt (0.005% NaCl) or a normal-salt (0.4% NaCl) diet. Diabetes was associated with a 49% increase in GFR, a 34% increase in kidney weight, and an 85% reduction in plasma angiotensin II when compared with control rats (P < 0.001). Sodium restriction in diabetic rats reduced GFR, restored plasma angiotensin II to control values, and retarded kidney growth when compared with diabetic rats receiving a normal sodium diet. GFR correlated negatively with plasma angiotensin II (r = -0.65, P < 0.001) and positively with kidney weight (r = 0.66, P < 0.001). In the second experiment, serial measurements of albuminuria and GFR were performed in control, diabetic, and salt-restricted (0.05% NaCl) control and diabetic rats over 24 weeks. Albuminuria showed a continuous rise in the diabetic rats when compared with control rats. Salt restriction attenuated the increase in albuminuria over the whole study period as well as reducing blood pressure and kidney weight in the diabetic rats. In conclusion, sodium restriction was associated with a lower GFR and kidney weight after 4 weeks and reduced levels of albuminuria, kidney weight, and blood pressure after 24 weeks in diabetic rats. Salt restriction may have an important role in the prevention and treatment of diabetic nephropathy.
在链脲佐菌素诱导的糖尿病大鼠中评估了饮食限盐对肾素 - 血管紧张素系统、肾小球滤过率（GFR）、肾脏大小和蛋白尿的影响。进行了两个系列的实验：一个是短期的严格限盐实验，另一个是长期的适度限盐实验。第一个实验研究了极低盐饮食4周对糖尿病大鼠和对照大鼠的GFR、肾脏大小及血浆血管紧张素II浓度的影响。糖尿病和对照雄性Sprague-Dawley大鼠分别接受极低盐（0.005% NaCl）或正常盐（0.4% NaCl）饮食。与对照大鼠相比，糖尿病大鼠的GFR增加了49%，肾脏重量增加了34%，血浆血管紧张素II降低了85%（P < 0.001）。与接受正常钠饮食的糖尿病大鼠相比，糖尿病大鼠的钠限制降低了GFR，使血浆血管紧张素II恢复到对照值，并抑制了肾脏生长。GFR与血浆血管紧张素II呈负相关（r = -0.65，P < 0.001），与肾脏重量呈正相关（r = 0.66，P < 0.001）。在第二个实验中，对对照、糖尿病以及限盐（0.05% NaCl）的对照和糖尿病大鼠在24周内进行了蛋白尿和GFR的连续测量。与对照大鼠相比，糖尿病大鼠的蛋白尿持续升高。限盐在整个研究期间减轻了蛋白尿的增加，同时降低了糖尿病大鼠的血压和肾脏重量。总之，限盐在4周后与糖尿病大鼠较低的GFR和肾脏重量相关，在24周后降低了蛋白尿水平、肾脏重量和血压。限盐可能在糖尿病肾病的预防和治疗中起重要作用。
