Current concepts on the pathophysiology of acute renal failure.
Current concepts on the pathophysiology of acute renal failure.
复制标题
急性肾衰竭病理生理学的最新概念。
DOI：
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发表时间：
1978
影响因子：
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通讯作者：
L. Barnes
中科院分区：
文献类型：
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作者：
J. H. Stein;M. Lifschitz;L. Barnes
近10年来，利用微穿刺技术和血流动力学技术对几种实验性急性肾功能衰竭（ARF）模型进行了评价。其中五种模型已被广泛研究：甘油注射、肾动脉钳夹、肾内去甲肾上腺素输注、硝酸铀酰和氯化汞给药。在前三种模型中，肾缺血是初始损伤，而在两种肾毒性模型中，药物对细胞完整性的直接影响似乎也是有效的。在所有这些模型中，初始损伤后24- 48小时的肾血流量或者自发地恢复正常，或者可以升高到该水平，伴随体积扩张但肾小球滤过率没有恢复。因此，在这些不同的模型中ARF的维持是由于其他因素，包括肾小管阻塞、滤液穿过受损的肾小管上皮渗漏和肾小球毛细血管超滤系数降低。在给定的模型中，可能存在这些改变中的一个或全部三个。虽然这些不同的模型可能不完全类似的临床设置，他们提供了强大的工具，ARF的研究和他们的使用大大增加了我们在这一领域的知识。
In the pase decade, several experimental models of acute renal failure (ARF) have been evaluated with micropuncture and hemodynamic techniques. Five of these models have been most extensively studied: glycerol injection, renal artery clamping, intrarenal norepinephrine infusion, uranyl nitrate, and mercuric chloride administration. In the first three models, renal ischemia is the initiating insult, whereas in the two nephrotoxic models a direct effect of the agent on cellular integrity is also seemingly operative. In all of these models, renal blood flow 24--48 h after the initial insult either spontaneously returns to normal or can be elevated to this level with volume expansion but without restoration of the glomerular filtration rate. Therefore, the maintenance of ARF in these various models is due to other factors, which include tubular obstruction, leakage of filtrate across damaged tubular epithelium, and a decrease in the glomerular capillary ultrafiltration coefficient. In a given model, one or all three of these alterations may be present. Although these various models may not be completely analogous to the clinical setting, they have provided powerful tools for the study of ARF and their use has greatly increased our knowledge in this field.