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首页> 外文期刊>American Journal of Physiology >Glomerular heteroporous membrane modeling in third trimester and postpartum before and during amino acid infusion.
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Glomerular heteroporous membrane modeling in third trimester and postpartum before and during amino acid infusion.

机译：输注氨基酸前后，在妊娠晚期和产后肾小球异孔膜模型。

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Human pregnancy is associated with substantial increments in glomerular filtration rate (GFR) and renal plasma flow (RPF). We have previously demonstrated that permselectivity to neutral dextrans is altered in pregnancy, theoretical analysis of the dextran sieving curves suggesting that elevated GFR is due to increased RPF and decreased glomerular oncotic pressure (pi(GC)) with no evidence of increased transglomerular hydrostatic pressure difference (DeltaP). These conclusions have been challenged, with claims that the rise in GFR is primarily a result of a decrement in pi(GC). With refined laboratory and infusion protocols, we have reexplored the determinants of ultrafiltration in a serial study of 11 healthy women in late pregnancy (LP) and 4 mo postpartum (PP), both in the baseline state and after increasing GFR and RPF by infusion of amino acids. Results were analyzed using two computer modeling programs. Increased GFR in LP (38%, P < 0.05) was due to a combination of elevated RPF (22%) and a decrement in pi(GC) and associated with an increased ultrafiltration coefficient, without evidence of increased DeltaP, and additional amino acid-provoked GFR increments (P < 0.05) produced similar findings. In addition, refined methodology permitted collection of sufficient data on excreted large-radii dextrans (>60 A) to better define the nondiscriminatory "shunt" pathway (omega(0)) and the standard deviation of pore size (S) about the mean radius of the distribution. Thus it was possible to demonstrate that the physiological increase in total protein excretion in LP is associated with a prominent shunt and an upward shift in breadth of distribution of pore sizes. This ability to quantify omega(0) and S will now permit better evaluation of the pathophysiological changes in the glomerulus associated with pregnancy in women with renal disease and in gravidas developing preeclampsia.
机译：人类妊娠与肾小球滤过率（GFR）和肾血浆流量（RPF）的大量增加有关。我们以前已经证明了妊娠期对中性葡聚糖的渗透选择性会发生改变，对葡聚糖筛分曲线的理论分析表明，GFR升高是由于RPF升高和肾小球渗透压（pi（GC））降低，而没有证据表明肾小球静水压差增加（DeltaP）。这些结论受到质疑，声称GFR的上升主要是pi（GC）下降的结果。借助完善的实验室和输液方案，我们在基线状态下以及通过输注GFR和RPF增加GFR和RPF后的11名健康孕妇的晚期妊娠（LP）和4 mo产后（PP）的系列研究中，探索了超滤的决定因素。氨基酸。使用两个计算机建模程序对结果进行了分析。 LP的GFR升高（38％，P <0.05）是由于RPF升高（22％）和pi（GC）降低所致，并且与超滤系数增加相关，而没有DeltaP和其他氨基酸增加的证据诱发的GFR增量（P <0.05）产生了相似的发现。此外，完善的方法还允许收集有关排泄的大半径右旋糖酐（> 60 A）的足够数据，以更好地定义非歧视性“分流”途径（omega（0））和平均半径附近的孔径标准偏差（S）的分布。因此，有可能证明LP中总蛋白排泄量的生理增加与明显的分流和孔径分布广度的上移有关。这种对omega（0）和S进行定量的能力现在可以更好地评估患有肾脏疾病的妇女和先兆子痫的孕妇妊娠相关肾小球的病理生理变化。

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