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首页> 美国政府科技报告 >Factors Influencing Renal Vasculature during Anesthesia, Trauma, and Oliguric Renal Failure States in Man
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Factors Influencing Renal Vasculature during Anesthesia, Trauma, and Oliguric Renal Failure States in Man

机译：影响人体麻醉，创伤和少尿肾功能衰竭状态下肾血管系统的因素

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Micropuncture studies revealed a reduction in both proximal tubular pressure and glomerular filtration rate in animal models of acute renal failure, making a vascular or glomerular mechanism the most attractive. Application of arteriography and xenon washout to assessing renal cortical perfusion in man revealed a global reduction in patients with acute renal failure sufficient to account for the failure of filtration and function. An identical hemodynamic and angiographic picture in patients in whom acute renal failure followed shock, hemolysis, sepsis, and a wide variety of pharmacologically and chemically unrelated nephrotoxins suggested an intrarenal final common pathway. Investigations in this laboratory revealed a striking influence of prior sodium intake on the pathogenesis of acute renal failure, raising the possibility that the renin-angiotensin system was involved. This led to an exploration of the role of angiotensin in the control of the normal renal circulation, where it plays a key role, and to a systematic exploration of angiotensin antagonists and their influence on the renal circulation. Because in models of acute renal failure the angiotensin antagonist led to a drop in blood pressure, major recent investigation was oriented toward developing agents with increased specificity for the kidney. Most recent investigation has involved the exploration of intraglomerular angiotensin receptors which appear to differ from those in the vasculature. (Author)

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