CHANGES IN RENAL BLOOD FLOW AND POSSIBLY THE INTRARENAL DISTRIBUTION OF BLOOD DURING THE NATRIURESIS ACCOMPANYING SALINE LOADING IN THE DOG

Development of concepts on sodium regulation in XX century

The 20th century is the time of the birth of many scientific areas, including the physiology of the kidneys and water-salt metabolism. This article is devoted to the history of the development of one of its directions - the issue of regulation of sodium homeostasis in the body. This article is the first attempt in the Russianspeaking space to summarize the achievements in the study of sodium regulation. For many decades, scientists from different countries have studied the influence of various factors on sodium excretion: blood pressure, atrial peptides, hormones of the neurohypophysis and adrenal glands, renal nerves, infusion of various substances, etc. It was found that sodium excretion does not directly depend on changes in blood pressure and glomerular filtration rate. Atrial peptides causing natriuresis were discovered, their structure and mechanism of action were described in detail. The role of the hormones of the neurohypophysis - vasopressin and oxytocin - in the excretion of sodium, as well as the role of aldosterone and angiotensin II in the reabsorption of this cation was shown. It has been shown that the administration of hypertonic solutions of sodium chloride causes a greater natriuretic response than the administration of other substances (sodium sulfate and acetate, glucose, mannitol, etc.), and the idea of the existence of sodium-s ensitive receptors has also been put forward.

Comparison of the gamma-Pareto convolution with conventional methods of characterising metformin pharmacokinetics in dogs

A model was developed for long term metformin tissue retention based upon temporally inclusive models of serum/plasma concentration (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ C $$\end{document}C) having power function tails called the gamma-Pareto type I convolution (GPC) model and was contrasted with biexponential (E2) and noncompartmental (NC) metformin models. 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The GPC, E2 and NC models were applied to a total of 148 serum samples drawn from 20 min to 72 h following bolus intravenous metformin in seven healthy mongrel dogs. The GPC model was used to calculate area under the curve (AUC), clearance (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ CL $$\end{document}CL), and functions of time, f(t), for drug mass remaining (M), apparent volume of distribution (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V_{d}$$\end{document}Vd), as well as \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$t_{1/2}\ f(t)$$\end{document}t1/2f(t) for \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ C $$\end{document}C, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ M $$\end{document}M and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V_{d}$$\end{document}Vd. The GPC models of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ C $$\end{document}C yielded metformin \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ CL $$\end{document}CL-values that were 84.8% of total renal plasma flow (RPF) as estimated from meta-analysis. The GPC \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ CL $$\end{document}CL-values were significantly less than the corresponding NC and E2 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ CL $$\end{document}CL-values of 104.7% and 123.7% of RPF, respectively. The GPC plasma/serum only model predicted 78.9% drug \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ M $$\end{document}M average urinary recovery at 72 h; similar to prior human urine drug \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ M $$\end{document}M collection results. The GPC model \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$t_{1/2}$$\end{document}t1/2 of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ M $$\end{document}M, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ C $$\end{document}C and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V_d$$\end{document}Vd, were asymptotically proportional to elapsed time, with a constant limiting \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$t_{1/2}$$\end{document}t1/2 ratio of M/C averaging 7.0 times, a result in keeping with prior simultaneous \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ C $$\end{document}C and urine \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ M $$\end{document}M collection studies and exhibiting a rate of apparent volume growth of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V_d$$\end{document}Vd that achieved limiting constant values. A simulated constant average drug mass multidosing protocol exhibited increased \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V_d$$\end{document}Vd and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$t_{1/2}$$\end{document}t1/2 with elapsing time, effects that have been observed experimentally during same-dose multidosing. The GPC heavy-tailed models explained multiple documented phenomena that were unexplained with lighter-tailed models.

The Effects of Angiotensin II on Renal Water and Electrolyte Excretion in Normal and Caval Dogs

The effects of intravenous administration of angiotensin II on renal water and electrolyte excretion were examined during hydropenia, water diuresis, and hypotonic saline diuresis in anesthetized normal dogs and dogs with thoracic inferior vena cava constriction and ascites (caval dogs). The effects of unilateral renal artery infusion of a subpressor dose were also examined.During hydropenia angiotensin produced a decrease in tubular sodium reabsorption, with a considerably greater natriuresis in caval dogs, and associated with a decrease in free water reabsorption (T(c) (H(2)O)). Water and hypotonic saline diuresis resulted in an augmented angiotensin natriuresis, with a greater effect still observed in caval dogs. In these experiments free water excretion (C(H(2)O)) was limited to 8-10% of the glomerular filtration rate (GFR), although distal sodium load increased in every instance. In the renal artery infusion experiments a significant ipsilateral decrease in tubular sodium reabsorption was induced, particularly in caval dogs.These findings indicate that angiotensin has a direct effect on renal sodium reabsorption unrelated to a systemic circulatory alteration. The attenuation or prevention of the falls in GFR and effective renal plasma flow (ERPF) usually induced by angiotensin may partially account for the greater natriuretic response in caval dogs and the augmentation during water or hypotonic saline diuresis. However, a correlation between renal hemodynamics and the degree of natriuresis induced was not always present and, furthermore, GFR and ERPF decreased significantly during the intrarenal artery infusion experiments. Therefore, the present experiments indicate that another mechanism is operative in the control of the angiotensin natriuresis and suggest that alterations in intrarenal hemodynamics may play a role.The decrease in T(c) (H(2)O) and the apparent limitation of C(H(2)O) associated with an increase in distal sodium load localize the site of action of angiotensin to the ascending limb of Henle's loop and the proximal tubule.

Differential mechanisms mediating depressor and diuretic effects of anandamide

BACKGROUND

Anandamide (AEA), one of the endocannabinoid compounds, has an important regulatory function by serving as an autocrine/paracrine or endocrine factor throughout the body via activation of the cannabinoid receptor 1 (CB1) and/or the transient receptor potential vanilloid type 1 (TRPV1) channels. However, the role of AEA in the regulation of renal excretory function is largely unknown. The present study was designed to test the hypothesis that intrarenal administration of AEA enhances renal excretory function leading to a decrease in blood pressure.

METHODS

A metabolically stable analog of AEA, methanandamide (MethA, 300 nmol/kg per min), was infused into the left renal medulla of anesthetized Wistar rats with or without a selective TRPV1 antagonist, capsazepine (Capz, 150 nmol/kg per min) or a selective cannabinoid receptor 1 (CB1) antagonist, AM251 (Am, 150 nmol/kg per min). Ureters were cannulated for collection of urine. A laser-Doppler flowmeter was used to determine the changes of blood flow in the cortex and medulla of the infused kidney.

RESULTS

In the absence of the changes in cortical and medullary blood flow, unilateral intramedullary infusion of MethA significantly increased urine flow rate by 64% ipsilaterally and 62% contralaterally without changing sodium excretion when compared to vehicle controls (P < 0.01). Neither Capz nor Am blocked the MethA-induced increases in urine flow rate bilaterally. Intramedullary infusion of MethA significantly decreased mean arterial pressure (MAP) (P < 0.01), which was blocked by Am but not Capz. Denervation of the infused kidney blocked the MethA-induced increases in urine flow rate bilaterally without altering MethA-induced decreases in MAP.

CONCLUSIONS

Therefore, our data show that intramedullary infusion of AEA increases urine volume excretion and decreases blood pressure via distinct operational mechanisms. While activation of the CB1 receptor may underlie AEA-induced depressor effects, the diuretic effect of AEA appears to be mediated by neuronal reflex of the kidney, which is not sensitive to blockade of the TRPV1 or CB1 receptor.

Influence of hemodilution on the renal blood flow autoregulation during acute expansion in rats

Autoregulation of renal blood flow (RBF) was studied in rats that underwent equivalent blood volume expansion with saline (Sal; 5% body wt), 7% BSA solution (1.4% body wt), and reconstituted whole blood from donor rats (WBL; 1.4% body wt). Renal perfusion pressure (RPP) and renal neural reflexes were prevented by clamping RPP and sectioning the vagus, baro/chemoreceptor, and renal nerves. Sal and BSA expansion increased RBF by approximately 60%, whereas no effect was observed with WBL. RBF autoregulation was markedly attenuated after expansion with cell-free solutions, but no change occurred in WBL-expanded rats. Correction of the fall in hematocrit in Sal- and BSA-expanded rats restored RBF and its autoregulation to control levels. Expansion with Sal or BSA after inhibition of renal vascular tone with intrarenal infusion of papaverine still increased RBF and further changed the RBF-RPP relationship. These findings suggest that the hemodilution plays a central role in the reduction of renal vascular resistance and in the attenuation of the autoregulatory efficiency of renal circulation that accompany expansion with cell-free solutions.

Pharmacological stimulation of arterial chemoreceptors in conscious rats produces differential responses in renal cortical and medullary blood flow

1. There have been no previously published data regarding intrarenal blood flow distribution in acute whole-body hypoxic hypoxia and/or arterial chemoreceptor stimulation in normoxic mammals. 2. Cortical and medullary blood flows were measured simultaneously before and in response to pharmacological stimulation of peripheral arterial chemoreceptors by i.v. injection of almitrine bismesylate (0.25 mg/kg). 3. Arterial chemoreceptor excitation reduced cortical blood flow but only in innervated kidneys. An effect on medullary blood flow was observed in neither innervated nor denervated kidneys. 4. These data indicate that renal cortical and medullary blood flows react differently to arterial chemoreceptor stimulation.

Hemodilution mediates changes in renal hemodynamics after acute volume expansion in rats

The present study examined the factors responsible for triggering renal hemodynamic adjustments during acute volume expansion. The renal hemodynamic effects of graded volume expansion with 0.9% saline (Sal; 1, 2, and 4% of body wt), 7% BSA solution (0.35, 0.70, and 1.4% body wt), or whole blood from a donor rat (WBL; 0.35, 0.70, and 1.4% body wt) were compared in rats anesthetized with pentobarbital sodium. Neural influences on the kidney were eliminated by vagus nerves, baro/chemoreceptor afferents, and renal nerves section, and renal perfusion pressure was controlled at constant level (approximately 120 mmHg) throughout the experiments. In Sal- and BSA-expanded rats, renal blood flow (RBF) increased (Sal: 15, 40, 71%; BSA 17, 49, 107%) and renal vascular resistance (RVR) decreased in parallel with the degree of volume expansion (RVR: Sal 17, 31, 44%; and BSA: 15, 35, 54%). Renal hemodynamics remained unaltered after expansion with WBL. In rats expanded with Sal or BSA, correction of the fall of hematocrit restored RBF and RVR to control levels. Interference with tubuloglomerular feedback by uretheral obstruction had no effect on the decrease in RVR with Sal or BSA. Inhibition of the vascular tone by intrarenal papaverine infusion also did not alter the renal hemodynamic response to volume expansion with Sal or BSA. These findings suggest that the changes in renal hemodynamics after acute expansion are likely mediated by changes in rheologic properties of the blood rather than by changes in active vascular tone.

Reproducibility of technetium-99m mercaptoacetyltriglycine clearance

The aim of this paper was to determine the reproducibility (precision) of technetium-99m mercaptoacetyltriglycine (MAG3) clearance and to compare it with that of chromium-51 ethylenediamine tetra-acetic acid (EDTA). Twelve young volunteers (aged between 21 and 34 years), without any history of medical problems, were enrolled in this study. The test was performed twice, at an interval of 8 days and under similar physiological conditions. After the intravenous injection of both tracers, 15 blood samples were taken between 3 and 240 min. A biexponential fit was adapted to the plasma disappearance curves (5- to 120-min samples for 99mTc-MAG3 and 10- to 240-min samples for 51Cr-EDTA); the clearances were calculated according to Sapirstein and corrected for body surface area. The mean clearance values were 110 (range 85-130) and 226 (range 109-319)ml/min/1.73 m2, respectively, for 51Cr-EDTA and 99mTc-MAG3. For 51Cr-EDTA clearance, the mean difference between the first and the second measurement was -2.1% of the mean of the two successive values (SD: 8.4%). In ten cases, the difference was less than 12%; in two cases, the differences were 15% and 18%, respectively. For 99mTc-MAG3 clearance, the mean difference between the first and the second measurement was -20% of the mean of the two successive values (SD: 25%). In six cases, the difference was less than 12%; in four cases, between 15% and 40%; and in two cases, more than 60%. Methodological factors (impurities contained in the commercial kit, variable protein binding) as well as physiological factors (pH of urine, sodium load, stress) may explain the lack of precision of the 99mTc-MAG3 clearance. It is concluded that changes in 99mTc-MAG3 plasma clearance should be interpreted with care in daily routine.

Drug-induced changes in renal hippurate clearance as a measure of renal blood flow

We studied the accuracy of the plasma 131I-hippurate clearance technique to monitor drug-induced changes in renal blood flow (RBF) by comparing it to a flow probe technique in six conscious, chronically instrumented dogs. Placebo caused no change in RBF, either established by hippurate clearance (ERPFhip) or by renal blood flow probe (RBFprobe). Enalaprilate induced a rise in ERPFhip and RBFprobe (+26 +/- 5 and 44 +/- 12%), as did dopamine (+16 +/- 4 and +33 +/- 5%). Intravenous infusion of norepinephrine induced a rise in ERPFhip (+2 +/- 6%, NS) and in RBFprobe (+18 +/- 3%), as did nitroprusside (+14 +/- 4% and +13 +/- 6%, NS). Indomethacin induced a fall in ERPFhip (-8 +/- 2%) and in RBFprobe (-7 +/- 3%, NS), as did angiotensin II (-19 +/- 1 and -26 +/- 3%). Renal hippurate extraction (Ehip) was affected by enalaprilate, dopamine, and angiotensin II (-5 +/- 2, -7 +/- 1, and +5 +/- 2%, respectively). Hematocrit (Hct) was affected by dopamine, norepinephrine, and nitroprusside (+2 +/- 1, +6 +/- 1, and -6 +/- 2%, respectively). Drug-induced changes in ERPFhip correlated well with changes in RBFprobe (r = 0.902, P < 0.01). Changes in Ehip did not independently affect this relation, whereas changes in Hct did: delta RBF(% of baseline) = 1.529 x delta ERPFhip(% of baseline) + 1.296 x delta Hct(% of baseline). These data indicate that drug-induced changes in plasma hippurate clearance can, even when changes in renal hippurate extraction are unknown, be used as a reliable indicator of changes in renal blood flow if changes in hematocrit are taken into account.

Effect of renal perfusion pressure on renal interstitial hydrostatic pressure and sodium excretion. Role of vasopressin V1 and V2 receptors

Renal interstitial hydrostatic pressure (RIHP) has recently been cited as an important mediator of pressure natriuresis. Our objective was to determine the roles of vasopressin V1 and V2 receptors in mediating the effects of renal perfusion pressure (RPP) on RIHP and sodium excretion (UNaV). The effects of RPP on renal hemodynamics, RIHP, and UNaV were assessed in control Wistar rats (n = 10) and in rats pretreated with intravenous infusion of the specific nonpeptide vasopressin V1 antagonist OPC-21268 (100 micrograms.kg-1.min-1; n = 8) and the V2 antagonist OPC-31260 (40 micrograms.kg-1.min-1; n = 10). Increasing RPP from 95 to 118 mm Hg in control rats increased RIHP (6.4 +/- 1.0 to 9.9 +/- 1.3 mm Hg), UNaV (0.29 +/- 0.03 to 0.52 +/- 0.05 muEq.min-1.g-1), urine flow rate (UFR) (5.2 +/- 0.3 to 7.6 +/- 0.6 microL.min-1.g-1), and the fractional excretion of sodium (FENa). In rats pretreated with V1 antagonist, similar results were obtained for urine osmolality and the responses of RIHP, UNaV, UFR, and FENa to RPP. V2 antagonist reduced urine osmolality (392 +/- 47 compared with 979 +/- 88 mOsm.kg-1 in control rats) and enhanced the responses of UNaV (0.43 +/- 0.08 to 1.32 +/- 0.32 microEq.min-1), UFR (17.8 +/- 3.2 to 29.2 +/- 3.8 microL.min-1.g-1), and FENa to RPP, but the RIHP response resembled that observed in the control and V1 antagonist groups. Renal blood flow and glomerular filtration rate did not differ among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of furosemide and intravenous normal saline fluid load upon the renal resistive index in nonobstructed kidneys in children

Recent literature has shown that relative to baseline the renal resistive index remains unchanged in nonobstructed kidneys and increases in obstructed kidneys after administration of furosemide. To our knowledge the effect upon the renal resistive index of furosemide administered in conjunction with intravenous normal saline fluid load has not been reported. We evaluated the renal resistive index in 13 nonobstructed kidneys in 8 children 6 to 18 years old before and after furosemide and intravenous normal saline fluid load. The mean resistive index decreased from baseline (mean decrease was 0.06 +/- 0.06 standard deviation), with the observation of a resistive index decrease significant to p < 0.005). It appears likely that the combination of an intravenous normal saline fluid load and furosemide caused the resistive index decrease, since a decrease was not observed with furosemide alone; however, these results cannot exclude the possibility that the resistive index decrease was due to the intravenous normal saline fluid load alone. Nonetheless, these data are important since they may provide the foundation for the development of a pharmacologically challenged Doppler sonographic examination using furosemide and intravenous normal saline fluid load to evaluate better potentially obstructed kidneys.

Effects of KB-2796, a new diphenylpiperazine calcium antagonist, on renal hemodynamics and urine formation in anesthetized dogs

The effects of KB-2796, a new calcium antagonist with a diphenylpiperazine moiety, on renal hemodynamics and urine formation were investigated in anesthetized dogs. Intravenous infusion of KB-2796 (10, 30, and 100 micrograms/kg/min) decreased mean blood pressure (MBP) and renal vascular resistance (RVR) in a dose-dependent manner, but did not change renal blood flow (RBF). At the highest dose, glomerular filtration rate (GFR) and urine flow (UF) tended to decrease. Nicardipine (0.1, 0.3, and 1 microgram/kg/min) also dose-dependently decreased MBP, RVR, GFR, and UF. When KB-2796 was infused into the renal artery at lower doses of 3 and 10 micrograms/kg/min, UF and urinary excretion of electrolytes increased without a significant change in RBF and GFR. Intrarenal infusion of KB-2796 at 30 micrograms/kg/min and nicardipine at 0.3 microgram/kg/min produced a significant increase in GFR, RBF, UF, urinary excretion of electrolytes, and renin secretion rate. These results suggest that KB-2796 administered intrarenally exerts a diuretic action via tubular effects and the alteration of renal hemodynamics. However, its diuretic action might be masked by diminished urine formation via a reflex activation of the sympathetic nerves and/or via a reduction of renal perfusion pressure when it is administered systemically.

The recovery of renal function in rats after release of unilateral ureteral obstruction: the effects of moderate isotonic saline loading

Following 24 h of ureteral obstruction in the rat, renal blood flow and glomerular filtration rate are markedly depressed. The effect of saline loading on post-obstructive glomerular filtration (GFR) was studied in 15 female Sprague-Dawley rats in the awake state, 4 h following the release of 24 h of unilateral ureteral obstruction. Group I (n = 8) received 39 microliters min-1 of 0.9% saline only for 1 h prior to study and Group II (n = 7) received 78 microliters min-1 of 0.9% saline for the whole 4 h prior to study. The Cin and CPAH of the post-obstructed kidney were significantly reduced over control values in both groups. Saline loading (Group II) resulted in an improvement in Cin in the post-obstructed kidney compared with group I (3.22 +/- 0.14 vs. 2.19 +/- 0.14 ml/min/kg BW, P less than 0.001). This was independent of any change in CPAH. In two further groups of rats the saline loading protocol was shown to cause a rise in the excretion of urinary cGMP in the post-obstructed kidney, but not the contralateral control kidney. In addition, administration of exogenous atriopeptin (1-24) to non-saline loaded animals resulted in a qualitatively similar alteration in renal function to saline loading, namely a rise in Cin and an increase in excretion of cGMP by the post-obstructed kidney, and no change in CPAH.(ABSTRACT TRUNCATED AT 250 WORDS)

Noradrenaline as a possible mediator in the renal response to vascular expansion with blood in the cat

In chloralose anaesthetized cats with renal arterial pressure kept constant at 100 mmHg, vascular expansion with precirculated blood, 20 ml kg b.w.-1, caused significant increments in arterial inflow rates of blood to the deep (ARBFD) and superficial (ARBFS) renal venous drainage area of 35 +/- (SE)10 and 19 +/- 6%, respectively, and in the excretion rates of water and sodium of 73 +/- 24 and 75 +/- 28%, respectively, while GFR remained essentially unchanged. In acutely denervated kidneys the responses to expansion were not significantly different from those of innervated kidneys, which indicated largely humoral mediation. Arterial plasma concentrations of noradrenaline, adrenalin, and vasopressin fell significantly to values of a half to one-third of pre-expansion values, while plasma dopamine was not significantly changed by expansion. The response to expansion could be (1) reversed by a 'substituting' intraaortic infusion of noradrenaline, and (2) imitated, without volume expansion, by an infusion of an alpha-adrenergic blocking agent (phentolamine). It is concluded that the renal response (excretory and vascular) to volume expansion with blood is largely humorally mediated and that circulating noradrenaline may play a causal role in the response.

Multiple effects of calcium entry blockers on renal function in hypertension

Characterization of the renal effects of calcium entry blockers has not been easy because the inhibition of Ca2+ cellular influx alters several regulatory functions. The ability of calcium blockers to dilate renal vasculature and to increase glomerular filtration rate is largely determined by the preexisting vascular tone. However, the increments in sodium excretion could occur without alterations in renal hemodynamics. Calcium blockers could increase sodium excretion by inducing a redistribution of renal blood flow toward juxtamedullary nephrons, by inhibiting tubuloglomerular feedback responses, or by a direct action on the tubular transport of sodium. These effects are poorly understood at present. In vitro studies show that the blockade of calcium entry enhances renin secretion and decreases prostaglandin synthesis. This dissociation has not been found during long-term administration, which has been proved to be effective for the treatment of essential hypertension with normal maintenance of renal function. In this respect, there are reports indicating that calcium blockers are particularly effective in a subgroup of patients with essential hypertension who exhibit subtle but detectable alterations in calcium metabolism. Further studies are needed to determine whether this significant response to calcium blockers is due to correction of an early defect of calcium cellular kinetics that initiated the increase in blood pressure.

Atrial natriuretic peptide detected by immunocytochemistry in peripheral organs of Tupaia belangeri

ANP (atrial natriuretic peptide), a peptide found in granules of mammalian atrial cardiac myocytes, has been shown to be active in regulation of blood pressure and body water homeostasis. The existence of ANP in atrium, pituitary, adrenal gland, and kidney of the rat had been immunocytochemically demonstrated with an antibody against rat ANP (102-126). We used the same antibody in immunocytochemical studies for the detection of ANP in peripheral organs of the tree shrew (Tupaia belangeri). The antibody stained granules in myocytes of cardiac atria which indicated that it reacted with tree shrew ANP. In contrast to the rat, no immunoreactive cells were found in pituitaries and adrenal glands. However, in the kidneys distal tubules in outer medulla and cortex were labeled. Ascending limbs of distal tubules were intensely stained when either the peroxidase-antiperoxidase (PAP) or the indirect immunofluorescence method were used. Collecting ducts and convoluted distal tubules in the outer cortex showed a granular type of staining when the immunofluorescence method was used. These data indicate that ANP is present in epithelial cells of distal tubules and collecting ducts, where it may be involved in the regulation of renal salt excretion.

Additive effects of atrial natriuretic polypeptide and of renal vasodilating agents in the anesthetized dog

In order to examine the contribution of an increase in renal papillary plasma flow to the mechanism of natriuresis by atrial natriuretic polypeptide (ANP), we compared the natriuretic effects of ANP administered into the renal artery of the dog together with secretin or acetylcholine (ACh). At an equivalent renal vasodilating dose, ACh increased urinary excretion of sodium (UNaV) to 212 +/- 36% of the control associated with a decrease in urine osmolality (62 +/- 6%), whereas secretin did not change UNaV (113 +/- 12%) or urine osmolality (101 +/- 14%). This result was compatible with the view that ACh causes natriuresis mainly by increasing papillary plasma flow. Combined administration of ANP with secretin caused a marked increase in UNaV to 407 +/- 55%, in association with a decrease in urine osmolality to 55 +/- 9%, suggesting that ANP may cause natriuresis by a mechanism similar to that of ACh. Combined administration of ANP with ACh further increased UNaV to 323 +/- 67% and decreased urine osmolality to 50 +/- 6%. These observations suggest that ANP and ACh share common but not identical mechanisms of natriuretic action since ANP caused additional natriuresis during ACh infusion. These findings, however, do not necessarily exclude the possibility that ANP also inhibits renal sodium reabsorption by a direct action.

Atrial natriuretic factor--a new hormone affecting kidney function

A family of biologically active peptides (atrial natriuretic factor - ANF) has recently been identified in mammalian heart atria. The peptides derive from a common 152 amino acid precursor and at least 1% of total messenger RNA activity is specific for the factor. When injected intravenously ANF is hypotensive and natriuretic. Data indicate that atrial natriuretic factor represents a newly discovered hormone involved in the regulation of blood pressure and volume. Cellular release of ANF does not require the activation of the adenylate cyclase system, but is associated with receptor-mediated activation of the cellular polyphosphoinositide mechanism. The natriuretic effect includes increased glomerular filtration rate and specific inhibition of normal sodium reabsorption from the medullary collecting duct. The mechanism of this transport inhibition is not yet known.

Chemically induced renal papillary necrosis and upper urothelial carcinoma. Part 1

In the past, renal papillary necrosis (RPN) has been commonly associated with long-term abusive analgesic intake, but over recent years a wide variety of industrially and therapeutically used chemicals have been shown to induce this lesion experimentally or in man. Destruction of the renal papilla may result in: (1) secondary degenerative cortical changes which precede chronic renal failure or (2) a rapidly metastasizing upper urothelial carcinoma, which has a very poor prognosis. This article will briefly review the published data on the morphology, function, and biochemistry of the normal renal medulla and the pathology associated with RPN, together with the secondary changes which give rise to cortical degeneration or epithelial carcinoma. It will then examine in detail those chemicals which have been reported to cause RPN in an attempt to delineate structure-activity relationships. Finally, the many different theories that have been proposed to explain the pathophysiology of RPN will be examined and an hypothesis will be put forward to explain the primary pathogenesis of the lesion and its secondary consequences.

Chemically induced renal papillary necrosis and upper urothelial carcinoma. Part 2

In the past, renal papillary necrosis (RPN) has been commonly associated with long-term abusive analgesic intake, but over recent years a wide variety of industrially and therapeutically used chemicals have been shown to induce this lesion experimentally or in man. Destruction of the renal papilla may result in: (1) secondary degenerative cortical changes which precede chronic renal failure or (2) a rapidly metastasizing upper urothelial carcinoma, which has a very poor prognosis. This article will briefly review the published data on the morphology, function, and biochemistry of the normal renal medulla and the pathology associated with RPN, together with the secondary changes which give rise to cortical degeneration or epithelial carcinoma. It will then examine in detail those chemicals which have been reported to cause RPN in an attempt to delineate structure-activity relationships. Finally, the many different theories that have been proposed to explain the pathophysiology of RPN will be examined and an hypothesis will be put forward to explain the primary pathogenesis of the lesion and its secondary consequences.

Role of renal papillae in the regulation of sodium excretion during acute elevation of renal perfusion pressure in the rat

We studied the role of renal papillae in the mechanism of increased sodium excretion during acute increase in mean arterial pressure (MAP). Sodium excretion increased dramatically in normal rats after acute increase in MAP by epinephrine (E) infusion (0.4 micrograms/min/100g). Glomerular filtration rate (GFR), renal blood flow (RBF), and papillary plasma flow (PPF) remained unchanged after the E administration. To define the role of the medulla in the mechanism of pressure-induced natriuresis, experiments were performed in a group of rats 8 to 12 days after the development of papillary necrosis induced by bromoethylamine hydrobromide. Urinary sodium and fractional sodium excretions were 2.00 +/- 0.34 microEq/min and 2.37 +/- 0.53% (n = 7), respectively, in papillary necrosis rats infused with saline. Administration of E to papillary necrosis rats, however, failed to increase both urinary sodium (2.89 +/- 0.61 microEq/min) and fractional sodium (FENa, 2.82 +/- 0.63%, n = 6) excretions despite a marked increase in MAP (129 vs 150 mm Hg, p less than 0.01). The RBF increased slightly after E infusion (4.42 vs 3.24 ml/min/100 g, p less than 0.05), but the GFR was not different between the control (0.39 +/- 0.05 ml/min/100g, n = 7) and the E-treated rats (0.43 +/- 0.06, n = 6). Failure to increase sodium excretion during acute increase in MAP was not due to the decreased GFR, since control rats with bilateral partial nephrectomy were able to increase sodium excretion from 1.92 +/- 0.33 to 7.76 +/- 1.63 microEq/min (p less than 0.01) after E infusion. These findings, therefore, suggest that renal papillae play a major role in the mechanism of natriuresis during acute increase in MAP.

Responses of renal hemodynamics and function to acute volume expansion in the conscious dog

The renal vascular and functional responses to acute volume expansion were determined in conscious dogs with all reflexes intact, sinoaortic arterial baroreceptor denervation, arterial baroreceptor denervation plus bilateral stellectomy, and arterial baroreceptor denervation plus bilateral vagotomy. In the intact dogs, when an isotonic saline infusion increased right atrial pressure by 6 mm Hg, arterial pressure increased by 15 +/- 3 from 95 +/- 3 mm Hg (P less than 0.01) and heart rate rose from 87 +/- 4 to 135 +/- 6 beats/min (P less than 0.01), while renal blood flow rose only slightly (4 +/- 2%), and calculated renal resistance was not altered significantly. After arterial baroreceptor denervation, volume expansion with saline induced a greater rise in blood flow (16 +/- 2%), but did not alter arterial pressure, and calculated resistance fell by 19 +/- 3% from 0.72 +/- 0.05 mm Hg/ml per min (P less than 0.01), while heart rate still increased. After arterial baroreceptor denervation and either bilateral stellectomy or vagotomy, volume expansion reduced renal vascular resistance by similar amounts. When intact animals were volume expanded by 20% of estimated blood volume with isooncotic, isotonic 3% dextran in saline solution, and with renal perfusion pressure held constant, central venous pressure increased by 4.5 +/- 0.6 from 1.8 +/- 0.4 mm Hg (P less than 0.01), renal blood flow increased significantly by 16 +/- 5 ml/min (P less than 0.05) from 191 +/- 30 ml/min, while calculated renal vascular resistance decreased significantly by 0.08 +/- 0.02 from 0.62 +/- 0.09 mm Hg/ml per min (P less than 0.05). Average urine flow rate and sodium excretion 10-60 minutes after expansion increased markedly by 1.85 +/- 0.27 ml/min and 9.84 +/- 1.13 muEq/min per kg, respectively (P less than 0.01). After arterial baroreceptor denervation, volume expansion induced a similar rise in central venous pressure and renal blood flow. The diuretic and natriuretic responses were not attenuated by arterial baroreceptor denervation. After arterial baroreceptor denervation plus bilateral vagotomy, there was a significant and similar rise in renal blood flow, whereas diuretic (urine flow rate rose by only 0.50 +/- 0.10 from 0.35 +/- 0.08 ml/min) and natriuretic (sodium excretion rose by only 4.83 +/- 0.95 from 1.50 +/- 0.48 muEq/min per kg) responses were significantly attenuated (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

The role of the kidney in sodium homeostasis during maturation

Evidence is presented that the retention of sodium observed during development is consequent primarily to enhanced tubular reabsorption rather than to low rates of glomerular filtration. The enhanced transport of sodium occurs in nephron segments located beyond the proximal tubule, apparently under the stimulation of the high plasma concentration of aldosterone. This adaptive mechanism may account for the fact that the infant thrives on a rather low intake of sodium, as prevails during the period of breast-feeding. The renin-angiotensin-aldosterone system cannot be fully inhibited even by intravascular volume expansion and this may account for the blunted natriuretic response of the developing animal and human to the acute infusion of saline or albumin solutions. Conversely, the renal sodium loss and the hyponatremia often encountered in premature babies appear to be due to an insufficient rise in aldosterone secretion or to a limited responsiveness of the distal tubule to aldosterone stimulation.

Studies on the mechanism of sodium excretion during drug-induced vasodilatation in the dog

The administration of vasodilating agents such as bradykinin and acetylcholine cause an increase in urinary sodium excretion. Yet the mechanisms involved in this natriuretic effect are not clear. Recent studies with another renal vasodilator, secretin have shown this drug also causes a profound increase in renal blood flow but without major changes in sodium excretion. To attempt to delineate the basis of this difference in sodium excretion with these drugs, the renal functional effects of secretin and bradykinin were compared at an equivalent vasodilating dose. Bradykinin increased renal blood flow from 222 to 342 ml/min, urine volume from 0.2 to 1.2 ml/min, and urine sodium excretion from 28 to 115 mueq/min. Urine osmolality fell from 1,230 to 401 mosmol/kg. Secretin caused a comparable increase in renal blood flow (216 to 325 ml/min) while changes in urine flow, sodium excretion, and urine osmolality were significantly less. In further studies papillary plasma flow was estimated using the albumin accumulation technique. Control papillary plasma flow was 29 ml/min per 100 g. Bradykinin increased urinary sodium excretion 108 mueq/min and decreased urinary osmolality from 1,254 to 516 mosmol/kg in association with a rise in papillary plasma flow to 62 ml/min per 100 g. Urine sodium excretion, urinary osmolality, and urine flow rate, as well as papillary plasma flow rate (32 ml/min per 100 g) were unchanged from control when secretin was administered. Studies with acetylcholine were qualitatively similar to those of bradykinin. Renal blood flow increased from 150 to 248 ml/min, urinary sodium excretion increased from 20 to 243 mueq/min, urinary osmolality decreased from 1,237 to 411 mosmol/kg and papillary plasma flow increased from 39 to 52 ml/min per 100 g. It is suggested that the natriuretic effect of some vasodilators is due, at least in part, to alterations in medullary hemodynamics, as evidenced by the increase in papillary plasma flow seen with bradykinin and acetylcholine, but not secretin.

An analysis of the regulation of sodium excretion during induced changes in plasma sodium concentration in anaesthetized dogs

1. Renal sodium excretion (UNaV) was studied during acute changes in plasma sodium concentration (PNa) induced by altering the concentration of a sodium chloride infusion in anaesthetized dogs. 2. The change in PNa induced other changes, notably in blood pH, the degree of blood dilution, and in glomerular filtration rate and renal plasma flow. No attempt was made to restrain these changes and their effects on UNaV were assessed using factor analysis. This defined new variables ('factors') that are linear functions of the primary variables. Four factors were defined, two of which were related to UNaV. 3. Factor 1 was strongly correlated with UNaV and PNa: its other correlations described the acidosis and plasma dilution of hypernatraemia. Further examination of these inter-relationships by regression analysis and data selection showed that the increase in UNaV with rising PNa depended upon a fall in both the blood pH and PCO2. 4. Factor 2 was negatively correlated with UNaV: its correlations with plasma protein concentration, haematocrit, blood pressure, glomerular filtration rate and renal plasma flow implied that it represented post-glomerular plasma protein concentration and its influence on sodium reabsorption. 5. Thus, two independent processes may regulate UNaV during acute salt loading: one is initiated by changes in PNa and plasma dilution but requires a concomitant acidosis and ventilatory adjustment for its full expression; the second relates UNaV to several variables whose influences could be understood by changes they produce in the peritubular capillary plasma protein concentration.

Renal function studies in an experimental model of papillary necrosis in the rat

Twenty four hours after i.v. injection of bromoethylamine-hydrobromide (BEA) in rats, a uniform papillary necrosis is observed. The present study investigates the renal functional and the papillary haemodynamics in response to acute volume expansion (12% of body weight) in this model. Renal function studies were performed in hydropenic and volume expanded sham- or BEA-injected rats. In hydropenic normal animals a GFR of 1.97 +/- 0.14 ml/min, an urinary osmolarity (UOsm) of 1 011 +/- 94.5 mOsm/kg and a fractional sodium excretion (FENa) of 0.18 +/- 0.026% were obtained. In contrast, BEA-treated hydropenic animals showed a lower GFR (1.16 +/- 0.14 ml/min), UOsm (469 +/- 30.31 mOsm/kg) and a higher FENa (0.37 +/- 0.06%). In volume expansion a similar UOsm and FENa were obtained in both groups. The papillary plasma flow (PPF) was measured in each of the experimental groups by the albumin accumulation technique. The mean value in hydropenic normal animals was 50.65 +/- 2.12 m 100 g-1 min-1 and increased to 66.02 +/- 2.00 ml 100 g-1 min-1 after volume expansion (P less than 0.001). In BEA rats the PPF was 58.86 +/- 2.33 ml 100 g-1 min-1 in hydropenia (P less than 0.01 vs. control animals) and remained unchanged after volume expansion. Thus, during hydropenia, BEA-induced papillary necrosis results with a salt wasting state and an urinary concentration defect. After volume expansion no disturbance in sodium excretion capacity was observed. These results are compatible with the nephron-heterogeneity concept in the regulation of sodium excretion. The histological lesions cannot be explained by a decreased renal papillary plasma flow.

Renal cortical blood flow distribution measured by hydrogen clearance during dopamine and acetylcholine infusion. Effect of electrode thickness and position in cortex

Blood flow distribution in the renal cortex was investigated in control and during i.a. infusion of dopamine (DA) and acetylcholine (Ach) in dogs. Local blood flow in outer cortex (OCF) and in inner cortex (ICF) was measured by platinum electrodes detecting hydrogen washout rate in tissue. Mean cortical blood flow measured by hydrogen washout rate in the renal vein (CFV) was compared with renal arterial blood flow (RAF) measured by electromagnetic flowmeter. With electrodes of 0.05-0.2 mm diameter control blood flow rates in outer and inner cortex were 4.57 +/- (S.D.) 1.73 ml/min.g, and 4.35 +/- 0.57 ml/min.g, which is higher than found using 0.2-0.5 mm electrodes in this and previous studies. OCF and ICF increased proportionally during intraarterial infusion of DA or Ach. The increase in local blood flow per unit volume was about 20% less than the increase in RAF, most likely due to an increase in renal volume and a reduced vasodilatory response in the surrounding of some electrodes. CFV rose almost to the same degree as RAF, showing a diffusion equilibrium for hydrogen gas even at maximal flow rate. During vasoconstriction induced by high doses of DA, OCF and ICF fell proportionately. Thus, equal vascular responses in outer and inner cortex were observed during both vasodilator and vasoconstrictor infusion. This indicates that changes in sodium excretion with renal blood flow may not be associated with a redistribution of cortical peritubular blood flow.

The aldosterone response to surgery and the relationship of the response to postoperative sodium retention

To investigate whether the aldosterone response to surgery is ‘inevitable’ and whether it is the prime cause of postoperative sodium retention, 30 patients undergoing uncomplicated cholecystectomy were givaen four different postoperative intravenous intakes (either ‘low’ or ‘high’ sodium, with and without dextran). Patients on the low sodium intake–a conventional intake of approximately 75 mmol of sodium daily – had a sixfold increase in their plasma aldosterone levels on the day of operation, which slowly declined to the preoperative level by the fifth day after operation, Patients on a high sodium intake, which was between two and three times the low sodium intake, showed only a modest rise (two-fold), which returned to the preoperative level within 8 h of operation. These aldosterone responses appeared to be caused by at least two stimuli, with the evidence suggesting that ACTH and renin were both involved.

Patients on the high sodium intake had the highest positive sodium balance, amounting to approximately 400 mmol of sodium retained by day 4 after operation, despite the fact that the plasma aldosterone level had returned to the preoperative level within 8 h of operation, and thereafter remained below it. No clear evidence was found to show that the plasma aldosterone level had any significant relationship to the amount of sodium each patient retained. The sodium retained was found to be a similar proportion of the sodium intake whether the intake was low or high, the addition of dextran making no consistent difference.

Analysis of the data produced the incidental finding of an increasingly significant correlation, over the 5 postoperative days studied, between the proportion of sodium retained and the patient's preoperative systolic blood pressure. It has long been known that patients with a raised blood pressure excrete a sodium load more rapidly than normotensive patients, but this effect on sodium balance after operation has not previously been recorded.

Effect of bradykinin on the renal medullary osmotic gradient in water diuresis

The effect of bradykinin on the renal medullary osmotic gradient was evaluated in anesthetized dogs which were undergoing water diuresis and which received a unilateral renal arterial infusion of bradykinin. The effect of the peptide on the medullary osmotic gradient was determined by analysis of medullary tissue electrolyte and urea concentrations and by analysis of changes in urine osmolality induced by vasopressin. Bradykinin decreased the total osmolality per kg H2O in tissue from inner medulla and papilla (-18.7 +/- 6% and -19.3 +/- 8%) and increased fractional water excretion (3.8 +/- 1.3%). Furthermore, a direct relationship between changes in free water clearance and changes in papillary tissue, osmolality was found. Finally, the increase in urine osmolality after ADH was significantly less in vasodilated than in control kidneys. These results indicate that bradykinin can diminish the medullary osmotic gradient during water diuresis in the dog. Thus, a bradykinin-induced increase in free water clearance may be accounted for by other than an inhibition of proximal tubular sodium reabsorption.

Intrarenal hemodynamics in cross-circulated hypervolemic and isovolemic rats

The microsphere technique was used to measure renal blood flow and intrarenal flow distribution in cross-circulated pairs of rats. One rat of each pair was made hypervolemic by infusion of blood (2.3% of body weight), followed by intravenous reinfusion to urine to maintain intravascular expansion. The other rat of each pair, which also was urine-reinfused, was kept isvolemic throughout the experiment. As shown previously, blood infusion resulted in a large diuretic and natriuretic response in the hypervolemic partner, while a smaller but statistically significant response occurred in the isovolemic partner. Total renal blood flow did not change in the expanded rats and fell slightly but not significantly in the nonexpanded ones. Blood volume expansion was associated with a significant shift in microsphere concentration from outer to inner cortex. This shift was not, however, correlated with the magnitude of the renal response. The transferred natriuresis in isovolemic partners was not associated with any change in microsphere distribution. We conclude therefore, that redistribution of blood flow to the inner cortex, although a feature of intravascular expansion, is not the primary determinant of volume natriuresis. In addition, the natriuretic activity which develops in the blood of hypervolemic rats can reduce sodium reabsorption in isovolemic rats without intrarenal hemodynamic changes.

Renal intracortical blood flow distribution, function and sodium excretion in response to saline loading of anesthetized and unanesthetized dogs

In order to study the effect of anesthesia on the canine response to saline loading, experiments were performed on 10 dogs, first while awake and then during pentobarbital anesthesia. Individual kidney function and intrarenal blood flow response to saline loading (7.5% body weight) were measured in each condition and all data are reported as the average of a single kidney. CIN is considerably reduced under anesthesia (24.7 +/- 3.2 vs. 43.2 +/- 3.9 ml/min, P less than 0.01). A directionally similar reduction of PAH clearance was noted (89 +/- 17 vs. 122 +/- 13 ml/min). The natriuretic response to saline loading of the dogs reached 290 +/- 61 muEq/min while awake, but only 70 +/- 27 muEq/min while anesthetized. No measurable increase of CIN or CPAH occurred in response to saline loading either in the anesthetized or unanesthetized state. The natriuresis was entirely due to a rise of CNA/GFR in both circumstances. The change of CNA/GFR in response to saline load was also appreciably larger while awake (1.2 leads to 4.7% vs. 0.7 leads to 1.8%). Although the fraction of blood flow to the outermost quarter of the kidney was initially the same (31 +/- 3 vs. 29 +/- 3%) awake or anesthetized, the changes with saline loading were in the opposite direction and the values reached were significantly different (37 +/- 3, awake, vs. 27 +/- 3%, P less than 0.05). We conclude that while increased outer cortical blood flow is not necessary for natriuresis, it may occur during sodium loading and may facilitate sodium excretion.

The effect of saline-induced extracellular volume expansion on the kidney function

The functional parameters of renal function of non-hydrated and hydrated dogs (saline-infused to an extent of 1-2% of the body weight) have been compared. The directly measured renal blood flow and the total renal vascular resistance were the same in the two groups. No difference has been found in glomerular filtration rate, the Cinulin was the same in the two groups. There was no important difference in the PAH clearance and PAH extraction. In the hypervolaemic group, the sodium and water excretion was about threefold that of the non-hydrated animals. The plasma protein concentration was significantly lower in the hydrated group. In our experiments we did not find glomerular factors responsible for the increase of sodium and water excretion. The decrease of tubular reabsorption is attributed partly to the decreased plasma protein concentration, partly to unknown (perhaps natriuretic) humoral factors.

Renal response of the lamb fetus to partial occlusion of the umbilical cord

The role of the fetal kidney during impairment of placental exchange was studied in eight fetal lambs, intact in utero; a standard asphyxial insult for a period of 1 hour was produced by occluding the umbilical cord sufficiently to lower the fetal heart rate by 35 +/- 5 beats/min and the pH by 0.15 units. This asphyxial stress caused a fall in urine output from a control of 0.17 to 0.03 ml/kg/min and of glomerular filtration rate from 1.2 to 0.3 ml/min; release of the occlusion was followed by mild diuresis. The fall in urine output was accompanied by a rise in total primary solutes including concentrations of electrolytes; this rise continued for 1 to 2 hours following the release of the occlusion. Because of the low urinary output during the period of occlusion, there was a fall in excretion of electrolyte; an increase in net acid excretion occurred only after the release of the cord. These experiments show that, although the fetal kidney is capable of contributing to elimination of acid following compression of the cord, there may be an associated net loss of water and electrolytes.

Effect of volume expansion on renal citrate and ammonia metabolism in KCl-deficient rats

When rats with desoxycorticosterone acetate (DOCA)-induced potassium chloride deficiency are given sodium chloride there is simultaneously a partial correction of metabolic alkalosis and a marked reduction in urinary citrate excretion and renal citrate content. To examine DOCA's role in this phenomenon and to determine how sodium chloride alters renal metabolism, rats were made KC1 deficient using furosemide and a KC1-deficient diet. Renal citrate and ammonia metabolism were then studied after chronic oral sodium chloride administration or acute volume expansion with isotonic mannitol. Although both maneuvers partially corrected metabolic alkalosis, sodium chloride raised serum chloride concentration while mannitol significantly decreased it. Urinary citrate excretion decreased to 10% of control in rats given NaCl and to 50% of control in rats infused with mannitol. The filtered load of citrate was constant or increased indicating increased tubular citrate reabsorption. Renal cortical citrate content also decreased approximately 50%. Renal cortical slices from KCl-deficient rats incubated in low or normal chloride media produced equal amounts of 14CO2 from (1, 5-14C) citrate. In addition, urinary ammonia excretion increased by over 300% in both groups. This occurred in the mannitol group despite increased urinary pH and flow rate indicating a rise in renal ammonia production. It seems that neither DOCA nor an increase in serum chloride concentration explains the experimental results. Rather, it appears that volume expansion is responsible for increased renal tubular citrate reabsorption and renal ammonia production. As these renal metabolic responses ordinarily occur in response to acidosis, the data are consistent with the hypothesis that volume expansion reduces renal cell pH in 3KCl-deficient rats.

Changes in renal hemodynamics and sodium excretion during saline infusion in lambs

The renal response to a progressive isotonic extracellular volume (ECV) expansion was studied in 13 lambs of two age groups (5-28 days and 48-57 days). Changes in renal hemodynamics induced by the ECV expansion were followed. Intrarenal blood flow was determined by the microsphere method. For determination of the glomerular filtration rate (GFR) standard clearance techniques were used. Recordings were made during control conditions and when normal saline had been infused in amounts up to 4.5% of the body weight. During the infusion there was an increase in sodium excretion both in absolute values and in relationship to GFR. The increase was, however, much less pronounced in the younger lambs. The GFR did not change significantly during saline infusion. The cortical blood flow increased only in the older lambs. As a consequence the quotient between GFR and cortical blood flow decreased in the older lambs. The possibility of a causal relationship between the fall in filtration fraction so obtained and the more pronounced natriuretic response in the older lambs is discussed. The inner to outer cortical blood flow ratio increased more in the younger lambs during saline infusion. The functional significance of an age related blood flow redistribution is, however, not clear.

Variation of proximal tubular reabsorptive capacity by volume expansion and aortic constriction during constancy of peritubular capillary protein concentration in rat kidney

The present study was undertaken in anesthetized rats to examine the effect of aortic constriction and volume expansion on proximal tubular sodium reabsorption during constancy of flow and fluid composition in the peritubular circulation of the kidney. Efferent arterioles and branch capillaries were perfused at 625 nl/min with an artificial perfusate containing 9 g per oiter of albumin both before and during either aortic constriction or saline infusion. Results of recollection micropuncture studies in those tubules surrounded by artificially perfused capillaries were compared with results in control tubules in which the peritubular capillary flow and fluid composition were allowed to change during aortic constriction or volume expansion following saline infusion. Changes in single nephron filtration rate, fractional and absolute reabsorption induced by both aortic constriction and saline infusion were found to be qualitatively and quantitatively comparable in tubules with constant peritubular capillary microperfusion and in the control tubules with changing peritubular capillary environment due to the experimental maneuvers. Taken together, therefore, the present results indicate that with the use of the peritubular microperfusion technique no evidence is found to support a role of alteration in the peritubular environment in modulating the effect of aortic constriction or saline infusion on tubular sodium reabsorption in the rat nephron. Rather, these results provide indirect evidence in support of intraluminal factors as mediating these responses in tubular reabsorption to volume expansion and aortic constriction.

Renal action of cholera toxin: I. Effects on urinary excretion of electrolytes and cyclic AMP

The infusion of cholera toxin (CT), 4 mug/min, into one renal artery of normal and thyroparathyroidectomized (T-PTX) dogs produced ipsilateral increments in the excretion of Na, K, Ca, Mg and Cl. Phosphate excretion increased from both kidneys, but more from the infused kidney in intact dogs. Unilateral phosphaturia occurred in T-PTX dogs studied five or more days after T-PTX. The changes in electrolyte excretion appeared 40 to 80 min after initiation of CT infusion and the maximal effects were noted after 100 to 140 min. The effects of CT on electrolyte excretion could not be accounted for by changes in glomerular filtration rate or renal plasma flow. Urinary cyclic adenosine monophosphate (AMP) increased from both kidneys but slightly more from the infused kidney. Adenylate cyclase activity of cortex and outer medulla of the infused kidney was 109 to 142% higher than that of the control kidney. The results indicate that CT decreases the net transport of various electrolytes by the renal tubule. This effect is probably mediated by the activation of renal adenylate cyclase(s) sensitive to the enterotoxin.

Observations of the early diuretic response after intravenous administration of bumetanide and furosemide in dogs

A transient natriuretic peak was observed in dogs the third minute after the i.v. administration of the highly active diuretics bumetanide and furosemide. The peak is dependent on the sodium balance such that it is potentiated during positive sodium balance and is not observed in sodium depleted dogs. A relationship exists between the simultaneous occurrence of the peak and abolition of the cortico-medullary electrolyte gradient.

Dependence of saline-induced natriuresis upon exposure of the kidney to the physical effects of extracellular fluid volume expansion

In many previous studies, the natriuresis induced by saline loading has been demonstrated to persist even though glomerular filtration rate (GFR) has been decreased to below pre-expansion levels by a reduction in renal artery pressure. In such studies, however, the kidney has been exposed to the effects of volume expansion for varying periods of time before renal artery pressure was controlled. The present experiments were designed to evaluate whether this period of exposure induces critical changes in intrarenal factors that are responsible for the natriuresis.Experiments were carried out in rats, in which renal artery pressure was decreased to 70 mm Hg either at the onset of saline loading (immediate clamping experiments) or after 45 min of saline loading had elapsed (delayed clamping experiments). In the delayed clamping experiments, consonant with previous studies, mean sodium excretion, 3.2 mueq/min, remained markedly increased above control, despite a reduction in GFR to 91% of the hydropenic control value. In contrast, when renal artery pressure was comparably reduced at the onset of saline loading mean sodium excretion was only trivially increased, 0.4 mueq/min, although GFR increased to 140% of the hydropenic control value. These results exclude an important role for either a circulating hormone or a reduction in plasma oncotic pressure in the natriuretic response to saline loading, and indicate that intrarenal factors are the critical determinants of the natriuresis. We have used the difference in response to saline loading in the immediate and delayed clamping experiments to evaluate the role of two intrarenal factors, interstitial hydrostatic pressure and renal plasma flow. Interstitial pressure changes were estimated from changes in tubular pressure and diameter by using the in situ compliance characteristics of the tubules. In a group of rats saline loaded without aortic clamping, interstitial pressure increased by 4-5 mm Hg and renal plasma flow increased by 2.5 ml/min. During the period of reduced renal artery pressure, however, neither interstitial pressure nor renal plasma flow was detectably increased above control in either the immediate or the delayed clamping experiments. The only noteworthy difference between the experiments in which a natriuresis occurred (unclamped and delayed clamping studies) and the experiments in which no natriuresis occurred is that in the former group the kidney was at least transiently exposed both to an increase in renal plasma flow and interstitial pressure. These findings indicate, first, that extracellular fluid volume expansion can induce a natriuresis only if the kidney has been exposed to at least a transient increase in either interstitial hydrostatic pressure or renal plasma flow (or both); and, second, that a sustained increase in interstitial pressure and renal plasma flow is not required for the natriuresis to persist.

Superficial and juxtamedullary nephron function during saline loading in the dog

A modification of the microdissection technique of Hanssen was utilized in dogs to measure superficial (SNGFR) and juxtamedullary nephron filtration rate (JMGFR) in control and saline-expanded dogs. During control studies SNGFR was 60+/-4 and JMGFR was 72+/-5 nl/min. During saline loading SNGFR was 74+/-8 and JMGFR was 65+/-6 nl/min. The ratio SNGFR: JMGFR significantly increased from 0.84+/-0.03 to 1.15+/-0.08. Glomerular perfusion rate (GPR) was measured with the microsphere method during control and saline loading. Superficial GPR did not change significantly but juxtamedullary GPR increased from 225+/-42 to 323+/-39 nl/min. Calculated superficial nephron filtration fraction was unchanged after saline expansion but juxtamedullary filtration fraction decreased from 0.34+/-0.07 to 0.24+/-0.07. The data demonstrate a tendency for filtration to shift toward the superficial part and plasma flow toward the deep part of the kidney cortex. GFR in juxtamedullary nephrons appears to be less plasma flow-dependent than in superficial nephrons. The fall in filtration fraction in the deep cortex may affect sodium excretion by juxtamedullary nephrons.