Role of cardiac atria in the human renal response to changing plasma volume.
Role of cardiac atria in the human renal response to changing plasma volume.
复制标题
心房在人肾对血浆容量变化的反应中的作用。
DOI：
10.1152/ajprenal.1988.254.4.f562
复制
发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Murad,F
中科院分区：
文献类型：
--
作者：
Myers,BD;Peterson,C;Molina,C;Tomlanovich,SJ;Newton,LD;Nitkin,R;Sandler,H;Murad,F
我们检查了心房在水浸期间和浸水之后对连续体积扩张和收缩的肾脏反应中的作用。在浸泡的健康志愿者（第 1 组，n = 9）中，心房直径、心房钠尿肽 (ANP) 和尿钠排泄的血浆水平增加，而肾血管阻力 (RVR) 和滤过分数下降。浸泡后每个参数都以相反方向变化。对经肾小球右旋糖酐转运的分析表明，经肾小球水压差 (delta P) 与滤过分数平行变化。九名去神经同种异体心脏移植受者（第 2 组）的基线心房直径、血浆 ANP、RVR 和滤过分数显着升高。心房直径和血浆 ANP 在浸泡期间和浸泡后与第 1 组平行变化。然而，RVR 相应的相互变化较小，并且过滤分数始终保持恒定。根据跨肾小球葡聚糖转运，我们计算出 delta P 在浸泡期间和浸泡后逐渐增加，表明主要是传出小动脉张力。尽管血浆 ANP 比第一组高六倍，但浸泡后状态也与钠潴留增强相关。这些发现与心脏去神经支配的效果一致，从而使传出交感神经不受阻碍地流向肾脏。他们认为后者是肾脏对人体血浆容量变化的反应的重要调节剂。
We examined the role of cardiac atria in the renal response to sequential volume expansion and contraction, during and directly following water immersion. In immersed healthy volunteers (group 1, n = 9) atrial diameter, plasma levels of atrial natriuretic peptide (ANP), and natriuresis increased, whereas renal vascular resistance (RVR) and filtration fraction declined. Each parameter changed in an opposite direction postimmersion. An analysis of transglomerular dextran transport suggests that transglomerular hydraulic pressure difference (delta P) changed in parallel with filtration fraction. Baseline atrial diameter, plasma ANP, RVR, and filtration fraction were significantly elevated in nine recipients of denervated cardiac allografts (group 2). Atrial diameter and plasma ANP changed in parallel with group 1 during and after immersion. However, corresponding reciprocal changes in RVR were smaller and filtration fraction remained constant throughout. From transglomerular dextran transport, we compute that delta P increased progressively during and after immersion, suggesting predominant efferent arteriolar tone. The postimmersed state was associated also with enhanced sodium retention despite sixfold higher plasma ANP than in group 1. These findings are consistent with an effect of cardiac denervation to leave unopposed efferent sympathetic nervous traffic to the kidney. They suggest that the latter is an important modulator of the renal response to changing plasma volume in humans.