腎静脈門脈吻合の腎機能に及ぼす影響
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概要
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As previously reported, the reno-portal venous anastomosis had curative effect on the elevated blood pressure of the renal hypertensive dogs and this was probably due to the inactivating ability of the liver to the pressure substance released from the kidney. It has also been reported that this anastomosis han no significant noxious effect on the liver function during the long period of observation. Another important problem which should be solved before this technique can be used clinically is its effect on the renal function. In the present experiments, the renal function before and after the reno-portal venous anastomosis was examined by means of renal "Clearance" in normotensive and hypertensive dogs. Experimental hypertension was produced under the modified GOLDBLATT method by constricting the right renal artery with a tantalum plate or under the modified MASUGI'S method by intravenous administration of the anti-dog-kidney-cortex rabbit immune serum in the previously left nephrectmized dogs. The anastomosis was carried out by end to side anastomosis between the right renal vein and the portal vein or to the root of the superior mesenteric vein. Blood N. P. N., and serum Na, K and Cl were measured to investigate the influence caused by such reno-portal venous shunt. Blood N. P. N., serum Na, K and Cl remained within its normal level. Adult female mongrel dogs weighing approximately 10 kg were used for the experiments. In normotensive dogs, no significant change was noted in both the blood pressure and the renal function after the anastomosis. In hypertensive dogs with constricted renal arteries, the impaired renal function showed a slight improvement after the anastomosis and that was accompanied with normalization of the elevated blood pressure. In the nephrotoxic nephritis, the renal function was compared between the non-anastomosed and the anastomosed group, after induced nephritis. In the anastomosed group, no significant elevation of the blood pressure was followed after the administration of the immune serum, whereas the blood pressure of the non-anastomosed elevated markedly. As to the renal function, however, no significant difference concerning the degree of impairment could be found between the two groups after giving the immune serum. It may be concluded that the reno-portal venous anastomosis has no significant effect on the normal kidney, whereas it has the favourable effect upon the impaired kidney function, especially when this is produced by the constriction of the renal artery.
- 社団法人日本循環器学会の論文
- 1965-10-20