The Isolated Kidney and Its Response to Diuretic Agents

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Abstract
A pump-lung-kidney prepn. for perfusion of the isolated dog kidney is descr. When compared to values obtained in situ, glomerular filtration rate, clearance of para-aminohippurate, extraction of p-aminohippurate, U/P ratio of creatinine, and rate of Na excretion are reduced when the kidney is transferred to the pump. The rate of K excretion is relatively unchanged whereas total renal vascular resistance is increased. The use of heparin as an anticoagulant in the perfused blood in preference to defibrination was thought to have reduced the accumulation of vasoconstrictor substances. Further work needs to be done to minimize the chemical and physical changes that occur in blood maintained in vitro in order to improve the functional capacities of the isolated kidney. It was shown that aminophylline and Salyrgan have direct effects on the isolated kidney. Aminophylline markedly reduced total renal vascular resistance, but there was no consistent change in the rate of glomerular filtration. Diuresis resulted without significant changes in glomerular filtration rate in most instances and therefore must be attributed to diminished tubular reabsorption of Na and water. In several expts. no diuresis resulted. Salyrgan administered intra-arterially in a dose of 8 mg. of mercury induced complete or partial renal vascular shutdown and oliguria. When administered in the venous reservoir, however, the vasoconstrictor action was minimized. The resulting diuresis was due to a diminished tubular reabsorption of Na and water. Addition of aminophylline to the Salyrgan soln. abolished the vasospastic action noted with intra-arterial Salyrgan alone.

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