Assessment of intrarenal blood flow distribution and sodium excretion using contrast ultrasonography

使用超声造影评估肾内血流分布和钠排泄

• 批准号: 06671142
• 负责人: YUASA Shigekazu
• 金额: $ 1.28万
• 依托单位: Kagawa Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06671142/
• 关键词: Contrast ultasonography; Intrarenal blood flow distribution; Total renal blood flow; Saline natriuresis; Pressure natriuresis; Endothelium-derived nitric oxide; Angiotensin II; Angiotensin II receptor antagonist; 生食負荷Na利尿

The importance of the distribution of intrarenal blood flow in the regulation of various renal functions, such as urine concentration and sodium excretion, has been well recognized. However, there have been no reliable methods to measure local blood flow in the kidney in vivo. We studied the correlations between regional renal Blood flow and sodium excretion in vivo using contrast ultrasonograpy combined with intraaortic injection of a sonicated 5% albumin in mongrel dogs. Satisfactory sonographic enhancement in renal parenchyma was obtained by the sonicated 5% albumin of 0.15-0.25ml/kg. Furthermore, the inner/outer renal cortex ratio of peak intensity significantly increased during the intrarenal acetylcholine infusion. Intravenous infusion of nitric oxide (NO) synthesis inhibitor, N^G-nitro-L-arginine methyl ester (L-NAME), at a low dose significantly inhibited the natriuretic response to acte extracellular volume expansion with isotonic saline without altering total renal plasma flow and the distribution of renal cortical blood flow. This inhibitory effect of L-NAME was completely abolished by the pretreatment with angiotensin II receptor (AT_1) antagonist, L-158,809, suggesting an angiotensin II dependency of the reduced renal excretory response to acute extracellular volume expansion during NO synthesis inhibition.In addition, we obtained effective signal enhancement in color Doppler flow imaging in the kidney with an intravenous injection of the contrast agent consisting of galactose/palmitic acid in patients with renal vascular or parenchymal diseases. Thus, these results suggest that the correlations between regional renal blood flow and sodium excretion can be detected by a quantitative analysis of signal enhancement in humans.

肾内血流分布在调节尿浓度和钠排泄等各种肾功能中的重要性已得到充分认识。然而，目前还没有可靠的方法来测量体内肾脏局部血流量。我们使用对比超声检查结合杂种狗主动脉内注射超声处理的 5% 白蛋白，研究了体内局部肾血流量和钠排泄之间的相关性。 0.15-0.25ml/kg的5%白蛋白超声处理后，肾实质得到满意的超声增强。此外，在肾内乙酰胆碱输注期间，内/外肾皮质峰值强度比显着增加。低剂量静脉输注一氧化氮（NO）合成抑制剂N^G-硝基-L-精氨酸甲酯（L-NAME）可显着抑制等渗盐水对细胞外容量扩张的利尿钠反应，而不会改变肾血浆总流量和肾皮质血流的分布。 L-NAME 的这种抑制作用被血管紧张素 II 受体 (AT_1) 拮抗剂 L-158,809 预处理完全消除，这表明在 NO 合成抑制过程中，肾排泄反应减少对急性细胞外容量扩张具有血管紧张素 II 依赖性。此外，我们通过静脉注射在肾脏彩色多普勒血流成像中获得了有效的信号增强。 由半乳糖/棕榈酸组成的造影剂在患有肾血管或实质疾病的患者中的应用。因此，这些结果表明，可以通过对人体信号增强的定量分析来检测局部肾血流量和钠排泄之间的相关性。

项目成果

Sumikura Tohru: "Effect of low calcium diet on blood pressure and pressure natriuresis response in rats : role of the renin-angiotensin system." Jpn J Nephrol. 36 (6). 702-708 (1994)

Sumikura Tohru：“低钙饮食对大鼠血压和压力尿钠反应的影响：肾素-血管紧张素系统的作用。”

隅蔵 透: "低Ca食ラットの血圧及びNa利尿反応に関する検討-特にrenin-angiotension系の関与について-" 日本腎臓学会誌. 36. 705-708 (1994)

Toru Sumikura：“低钙饮食大鼠血压和利尿钠反应的研究 - 特别是肾素血管紧张素系统的参与 -”日本肾病学会杂志 36. 705-708 (1994)。

Takafumi Yura: "Role for Doppler ultrasound in the assessment of renal circulation:Effects of dopamine and dobutamine on renal hemodynamics in humans." Nephron. 71. 168-175 (1995)

Takafumi Yura：“多普勒超声在肾循环评估中的作用：多巴胺和多巴酚丁胺对人体肾血流动力学的影响。”

Fujita Yumiko: "Assessment of the distribution of renal cortical blood flow by contrast ultrasonography." Jpn J Nephrol. 36 (3). 218-226 (1994)

Fujita Yumiko：“通过超声造影评估肾皮质血流的分布。”

藤岡 宏: "生理食塩水負荷による細胞外液量増大時のNa利尿反応における内皮由来nitric oxideの役割に関する検討" 日本腎臓学会誌. 36. 201-208 (1994)

Hiroshi Fujioka：“内皮源性一氧化氮在生理盐水负荷导致细胞外液体积增加期间钠利尿反应中的作用的研究”日本肾病学会杂志 36. 201-208 (1994)。