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

Abstract

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.