RENAL HEMODYNAMICS AND SODIUM EXCRETION IN DOGS WITH GRADED VALVULAR DAMAGE, AND IN CONGESTIVE FAILURE
RENAL HEMODYNAMICS AND SODIUM EXCRETION IN DOGS WITH GRADED VALVULAR DAMAGE, AND IN CONGESTIVE FAILURE
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DOI：
10.1152/ajplegacy.1961.200.3.601
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发表时间：
1961-01-01
影响因子：
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通讯作者：
RUDOLPH, AM
中科院分区：
文献类型：
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作者：
BARGER, AC;YATES, FE;RUDOLPH, AM
为了研究进行性心脏损害时肾脏变化的顺序，在一组正常状态下、三尖瓣关闭不全后、肺动脉狭窄叠加后和明显衰竭后的狗中研究了肾血浆流量、肾小球滤过率、钠和水排泄。轻度瓣膜损伤时，基础Ccr[肌酸清除率]不变，略有上升或下降，而CPAH[对氨基马尿酸清除率]通常下降。在这个阶段，肾脏对快速盐水输注的反应迟缓; CCr、CPAH、钠和水排泄量约为正常值的50%。在坦率失败的基础CCr是不变的，从控制水平，或只是略有下降，直到后期的过程中的疾病。所有犬的基础CPAH均显著降低，3只犬的滤过分数升高至0.38。生理盐水输注产生很少或没有上升的CCr和CPAH，盐和水的保留几乎是完全的。据推测，肾血流量的早期减少和对盐水输注的缓慢反应是肾中交感神经活动增加的结果，并且是趋于使循环恢复正常的压力感受器反射的一部分。
In an attempt to study the sequence of renal changes which occur with progressive cardiac impairment, renal plasma flow, glomerular filtration rate, sodium and water excretion were investigated in a group of dogs in the normal state, following the production of tricuspid insufficiency, and then after the superimposition of pulmonary artery stenosis, and the development of frank failure. With mild valvular damage basal Ccr[creatine clearance] was unchanged, rose or fell slightly, while CPAH[para-aminohippurate clearance] usually was decreased. At this stage the renal response to a rapid saline infusion was sluggish; CCr, CPAH, sodium and water excretion rose approximately 50% of normal. In frank failure basal CCr was unchanged from control levels, or only slightly reduced until late in the course of the disease. Basal CPAH was markedly reduced in all the dogs, with filtration fraction rising to 0.38 in three dogs. Saline infusion produced little or no rise of CCr and CPAH, and salt and water retention was nearly complete. It is postulated that the early decrease in renal blood flow, and the sluggish response to a saline infusion is the result of increased sympathetic nervous activity in the kidney, and is part of baroreceptor reflex tending to restore the circulation toward normal.