Atrial natriuretic peptide and furosemide effects on hydraulic pressure in the renal papilla.

Atrial natriuretic peptide and furosemide effects on hydraulic pressure in the renal papilla.
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心钠素和速尿对肾乳头液压的影响。

DOI:
10.1038/ki.1988.142
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发表时间:
1988
影响因子:
19.6
通讯作者:
Brenner,BM
Brenner,BM
中科院分区:
医学1区
文献类型:
--
作者:
Méndez,RE;Dunn,BR;Troy,JL;Brenner,BM

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房利钠肽和速尿对肾乳头水压的影响。心房肽(ANP)已被证明优先增加血流量到髓旁肾和增加血管直肠血流量。为了确定肾内血流分布的这种改变对髓内结构压力关系的影响及其作为anp诱导尿钠的决定因素的意义,我们测量了慕尼黑- wistar大鼠肾乳头血管和小管元件的水压,分别在血容量基线期和实验期。1组大鼠静脉输注rANP[4 - 27],分别以4µg/kg初滴量和0.5µg/kg/min连续输注,通过血浆置换维持小血容。ANP输注导致明显的尿钠、利尿和菊糖清除率增加。在这种全身输注开始的90秒内,直肠血管的水压明显增加,超过了Henle和集束管回路中出现的小压力增量。在第2组大鼠中输注速尿,其剂量与第1组大鼠尿流量的增加相同,血管和小管元素的增加幅度较小且相当,这表明第1组观察到的压差反应不是由于小管流体流速的增加,而是一种特异性的anp诱导的血管效应。第三组大鼠在阻止ANP全肾血流动力学影响的情况下接受ANP输注。这导致尿钠和利尿明显减弱,并且在组1中观察到直血管和小管之间的压差消失。因此,1组大鼠在灌注ANP时乳头状血管和小管结构之间的水压失衡可能阻碍了局部乳头间质对液体的重吸收,从而成为ANP诱导尿钠和利尿的重要机制。
Atrial natriuretic peptide and furosemide effects on hydraulic pressure in the renal papilla. Atrial peptides (ANP) have been shown to preferentially increase blood flow to juxtamedullary nephrons and to augment vasa recta blood flow. To determine the effect of this alteration in intrarenal blood flow distribution on pressure relationships in inner medullary structures and their significance as a determinant of ANP-induced natriuresis, we measured hydraulic pressures in vascular and tubule elements of the renal papilla exposed in Munich-Wistar rats in vivo during an euvolemic baseline period and again during an experimental period. Rats in Group 1 received intravenous infusion of rANP [4–27], administered as a 4 µg/kg prime and 0.5 µg/kg/min continuous infusion, and were maintained euvolemic by plasma replacement. Infusion of ANP resulted in significant natriuresis, diuresis and increase in inulin clearance. Within 90 seconds of initiation of this systemic infusion, vasa recta hydraulic pressures were markedly increased and exceeded the small pressure increment occurring in loops of Henle and collecting ducts. Infusion of furosemide in Group 2 rats at a dosage which reproduced the increase in urine flow in Group 1 was associated with small and equivalent increases in both vascular and tubule elements, indicating that the differential pressure response observed in Group 1 was not due to increased tubule fluid flow rates, but was rather a specific ANP-induced vascular effect. Group 3 rats received an infusion of ANP in a setting where its whole kidney hemodynamic effects were prevented. This resulted in a marked blunting of natriuresis and diuresis, and obliteration of the pressure differential between vasa recta and tubules observed in Group 1. Thus, the hydraulic pressure imbalance between papillary vascular and tubule structures occurring during infusion of ANP in euvolemic Group 1 rats may impede fluid reabsorption from local papillary interstitium, and thereby serve as an important mechanism of ANP-induced natriuresis and diuresis.
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