慢性閉塞腎の機能とその回復性に関する実験的研究 - フロセミド利尿効果による慢性閉塞腎の機能測定
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概要
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In 38 mongrel dogs with an obstructed kidney produced by 10, 20, 30, 40, 50 and 60-day unilateral ligation, evaluation was made of kidney function just after release of obstruction and 2 months thereafter by both renal clearance and furosemide diuresis tests. The furosemide diuresis meant here refers to urinary output per min during a 15-min period from 5 min to 20 min after the intravenous injection of 10mg furosemide. 1) In the group with 10-day ligation CPAH, CSTS and furosemide diuresis were found decreased to 3.9 %, 2.4 % and 19.0 %, respectively, on the average, of corresponding values for the unaffected kidney just after removal of obstruction and then increased to 54.0 %, 56.9 % and 115.0 % respectively 2 months thereafter. 2) In the group with 20-day ligation CPAH, CSTS and furosemide diuresis were found de-creased to 1.9 %, 0.5 and 3.2 %, respectively, on the average, of corresponding values for the unaffected kidney just after removal of obstruction and then increased to 59.0 %, 67.1 % and 118.1 % respectively 2 months thereafter. 3) In the group with 30-day ligation CPAH, CSTS and furosemide diuresis were found decreased to 0.3 %, 0.4 % and 4.3 %, respectively, on the average, of corresponding values for the unaffected kidney just after removal of obstruction and then increased to 38.8 %, 37.9 % and 55.2 % respectively 2 months thereafter. 4) In the group with 40-day ligation CPAH, CSTS and furosemide diuresis were found decreased to 0.1 %, 0.2 % and 3.3 %, respectively, on the average, of corresponding values for the unaffected kidney just after removal of obstruction and then increased to 12.2 %, 14.9 % and 22.7 % respectively 2 months thereafter. 5) In the group with 50-day ligation CPAH, CSTS and furosemide diuresis were found decreased to 0.3 %, 0.3 % and 0.3 %, respectively, on the average, of corresponding values for the unaffected kidney just after removal of obstruction and then increased to 4.3 %, 3.8 % and 5.9 % respectively 2 months thereafter. 6) In the group with 60-day ligation CPAH, CSTS and furosemide diuresis were found de creased to 0.2%, 0.2 % and 0.0 %, respectively, on the average, of corresponding values for the unaffected kidney just after removal of obstruction and then increased to 3.5 %, 2.6 % and 5.2 % respectively 2 months thereafter. 7) A nonfunctioning kidney was demonstrated both by renal clearance and furosemide diuresis tests just after removal of obstruction in groups receiving ligation for 40 days or longer as well as 2 months after the release in the groups with 50 days or longer ligation. 8) Furosemide acted on the non-obstructed kidney in such a way to increase excretion fraction of water (EFH2O) by 13.3 % just after removal of obstruction and 8.8 % 2 months thereafter, while it caused increase of EFH2O by 20.0 % and 14.9 % respectively on the obstructed kidney. 9) The diuretic effect of furosemide was thus unexpectedly greater on the affected than on the unaffected kidney and, in this respect, was somewhat dissimilar ,to GFR, but there was a positive correlation noted between these parameters. 10) Based on these results and available literature, discussion was made on functional recovery of the obstructed kidney.
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