Renal perfusion in blacks - Alterations caused by insuppressibility of intrarenal renin with salt
Renal perfusion in blacks - Alterations caused by insuppressibility of intrarenal renin with salt
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DOI：
10.1161/01.hyp.0000024349.85680.87
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发表时间：
2002-08-01
期刊：
影响因子：
8.3
通讯作者：
Hollenberg, NK
中科院分区：
文献类型：
--
作者：
Price, DA;Fisher, NDL;Hollenberg, NK
我们已经报道，肾内肾素-血管紧张素系统活性的增加可能是负责减少肾血浆流量（RPF）在明显健康的黑人相比，健康的白人在高盐平衡。为了确定这些差异是否只存在于高盐状态，我们进行了以下研究，集中在低盐摄入期间对肾素系统的操纵。我们测量了19名健康黑人和22名健康白人的对氨基马尿酸和菊粉清除率，分别作为RPF和肾小球滤过率的指标，随机顺序高（200 mmol/d）和低（10 mmol/d）盐平衡。11名黑人和12名白人的一个亚组在低盐平衡时另外接受血管紧张素11输注（3 ng/kg/分钟，持续45分钟）和卡托普利，以评估RPF对转化酶抑制剂的反应的差异。19名白人有显着较高的RPF时，与黑人相比（P = 0.033）时，研究高盐。然而，在低盐平衡期间，两组的RPF相当。血浆肾素活性在两组两种饮食相似。在低盐平衡时接受血管紧张素II和卡托普利的亚组中，白人和黑人的肾血管反应没有差异。这些数据提供了额外的支持的概念，肾内组织肾素系统是更活跃的黑人比白人在一个典型的（高盐）饮食和差异主要反映了不完全的组织肾素抑制盐摄入量的增加。所涉及的机制可能有助于增加黑人肾损伤的易感性。
We have reported that an increased intrarenal renin-angiotensin system activity may be responsible for the reduction in renal plasma flow (RPF) in apparently healthy blacks in comparison to healthy whites during high salt balance. To ascertain whether these differences only exist in the high salt state, we performed the following study, concentrating on the manipulation of the renin system during low salt intake. We measured in 19 healthy blacks and 22 healthy whites para-aminohippurate and inulin clearances as an indication of RPF and glomerular filtration rate, respectively, on both high (200 mmol/d) and low (10 mmol/d) salt balance in random order. A subset of I I blacks and 12 whites additionally received an angiotensin 11 infusion while in low salt balance (3 ng/kg per minute for 45 minutes) and captopril to assess differences in RPF response to a converting enzyme inhibitor. The 19 whites had significantly higher RPF when compared with blacks (P = 0.033) when studied on high salt. However, during low salt balance, the RPFs were comparable in the 2 groups. Plasma renin activity was similar in the 2 groups on both diets. In the subset that received angiotensin It and captopril while in low salt balance, the renal vascular response was not different in whites and blacks. These data provide additional support for the concept that the intrarenal tissue renin system is more active in blacks than whites on a typical (high salt) diet and that the difference reflects primarily incomplete tissue renin suppression with an increase in salt intake. The mechanism involved may contribute to the increased susceptibility to renal injury in blacks.