Madrid M I, Salom M G, Tornel J, López E, Fenoy F J
Departamento de Fisiología y Farmacología, Facultad de Medicina, Universidad de Murcia, Spain.
J Am Soc Nephrol. 1998 Sep;9(9):1588-95. doi: 10.1681/ASN.V991588.
The present study examined the effect of renal denervation on the impairment of the pressure-diuresis response produced by nitric oxide synthesis blockade. The experiments were performed in Inactin-anesthetized Munich-Wistar rats. The animals with innervated kidneys had lower baseline values of renal blood flow, GFR, sodium excretion (UNaV), and urine flow (V) than rats with denervated kidneys. Also, renal denervation shifted pressure-diuresis and natriuresis toward lower pressures. A low dose of N(omega)-nitro-L-arginine methyl esther (NAME, 3.7 nmol/kg per min) reduced UNaV and the fractional excretion of sodium (FENa) and blunted pressure-natriuresis only in rats with innervated kidneys, whereas it had no effects in rats with denervated kidneys. A medium dose of NAME (37 nmol/kg per min) lowered FENa only in rats with innervated kidneys. The administration of NAME (37 nmol/kg per min) blunted pressure-diuresis and natriuresis in kidneys with or without the renal nerves, but the effect was more pronounced in rats with innervated kidneys. A high dose of NAME (3.7 micromol + 185 nmol/kg per min) increased UNaV and FENa only in rats with innervated kidneys, whereas it reduced GFR, V, UnaV, and FENa in rats with denervated kidneys. However, pressure-natriuresis and diuresis were blunted by this high dose of NAME independently of the presence or absence of renal nerves. These results demonstrate that renal nerves potentiate the renal effects of low doses of NAME on renal function and pressure-diuresis and natriuresis. However, high doses of NAME abolish pressure-diuresis independently of renal nerves, and the natriuretic effect of NAME in innervated kidneys may be attributed to reflex inhibition of sympathetic tone due to the rise in arterial pressure.
本研究考察了肾去神经支配对一氧化氮合成阻断所导致的压力-利尿反应受损的影响。实验在经戊巴比妥钠麻醉的慕尼黑-威斯塔大鼠身上进行。与肾去神经支配的大鼠相比,肾神经完整的动物肾血流量、肾小球滤过率、尿钠排泄量(UNaV)和尿量(V)的基线值更低。此外,肾去神经支配使压力-利尿和利钠作用向更低压力偏移。低剂量的N(ω)-硝基-L-精氨酸甲酯(NAME,3.7 nmol/kg每分钟)仅降低了肾神经完整大鼠的UNaV和钠排泄分数(FENa),并减弱了压力-利钠作用,而对肾去神经支配的大鼠无影响。中等剂量的NAME(37 nmol/kg每分钟)仅降低了肾神经完整大鼠的FENa。给予NAME(37 nmol/kg每分钟)会减弱有或无肾神经的肾脏的压力-利尿和利钠作用,但在肾神经完整的大鼠中这种作用更明显。高剂量的NAME(3.7 μmol + 185 nmol/kg每分钟)仅增加了肾神经完整大鼠的UNaV和FENa,而降低了肾去神经支配大鼠的肾小球滤过率、V、UnaV和FENa。然而,无论有无肾神经,这种高剂量的NAME都会减弱压力-利钠和利尿作用。这些结果表明,肾神经增强了低剂量NAME对肾功能以及压力-利尿和利钠作用的肾脏效应。然而,高剂量的NAME会消除压力-利尿作用,且与肾神经无关,NAME在肾神经完整的肾脏中的利钠作用可能归因于动脉压升高导致的交感神经张力反射性抑制。