腎循環に対する誘発性低酸素血の影響に関する臨床病態生理学的研究 (前編) : 健常者, 肺結核症, 高血圧症, 腎動脈硬化症の安静時の腎循環動態に就て

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The development of renal clearance tests and renal vein catheterization have made it possible to study the renal hemodynamics of normal individuals and patients with various diseases in a resting condition. The renal hemodynamic response to acute induced hypoxemia has been studied in normal individuals by some investigators. However, there has been no report on renal hemodynamic response to acute induced hypoxemia of patients with pulmonary tuberculosis, hypertension or nephrosclerosis.. The author subjected normal individuals and patients with various diseases to low oxygen respiration with the intention of studying its influence on renal hemodynamics in moderate arterial hypoxemia (the mean arterial oxygen saturation was 60-70%). Materials and Methods The renal clearance of 26 human subjects including healthy individuals (6 cases) and patients with mild or moderate pulmonary tuberculosis (6 cases), hypertension (9 cases) and nephrosclerosis (5 cases) were investigated. The renal vein catheterization study was performed in 18 of these cases which included healthy individuals (5 cases) and patients with mold on moderate pulmonary tuberculosis (5 cases), hypertension (5 cases) and nephrosclerosis (3 cases). Human subjects in the resting condition were made to inhale a 10% oxygen gas mixture for 20 minutes. Intravenous infusions of PAH and STS were done with a constant-speed syringe pump. The author used the Takagi's method for the determination of PAH and the Claus-Brun's method for STS. Results A) Renal hemodynamics in the resting condition: 1) The effective renal blood flow (eff. RBF) were within the normal limit in healthy individuals (group I) and patients with mild (group II A) or moderate (group II B) pulmonary tuberculosis but in hypertension (group III) a slight reduction was seen and it was remarkably decreased in nephrosclerosis (group IV). The behavear of the true renal blood flow (TRBF) was the same as the eff. RBF in all four groups. Therefore, the reduction of the RBF paralleled proportionally the renal functional disturbance. The glomerular filtration rate (GFR) took the normal range in groups I, II and III. In group IV a significant reduction of GFR was seen. The filtration fraction (FF) showed normal values in groups I and II A but significant increases were seen in groups II B, III and IV. 2) No significant deviation of E_^lt;PAH^gt; were seen in groups I, II and III. In group IV a slight fall of E_^lt;PAH^gt; was observed. The total renal resistance (TRR) showed normal values in groups I and II and a significantly high value in group IV. 3) There were significantly correlations between the TRR and the true FF. 4) The reduction of TRBF was due to the increase of TRR. B) Renal hemodynamic response in acute induced hypoxemia: The arterial oxygen saturation in this investigation dropped moderately: in group I the mean arterial oxygen saturation was 60.2%, group II A 63.8%, GROUP II B 68.4%, GROUP III 65.2% and group IV 65.2%: 1) The moderate or remarkable increase of the eff. RBF were seen in group I (+16.3%), group II A (+42.5%) and group III (+14.3%). In group II B (-19.9%) and group IV (-53.1%) the eff. RBF moderately diminished. The TRBF showed distinctly the same response to hypoxemia as the behavear of the eff. RBF.
社団法人日本循環器学会の論文
1964-04-20

腎循環に対する誘発性低酸素血の影響に関する臨床病態生理学的研究 (前編) : 健常者, 肺結核症, 高血圧症, 腎動脈硬化症の安静時の腎循環動態に就て

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