体位變換及び運動の腎機能に及ぼす影響に關する研究

抄録

To keep a good rest is considered as essential in the treatment of diseases which may cause renal damages, but the reason why the rest is so important is not clarified yet.
In the present studies, the effects of standing and exercise on renal blood flow (RBF), glomerular filtration rate (GFR), filtration fraction (FF) and sodium, potassium and protein excretions were examined by clearance methods, in 6 normals and 34 patients with essential hypertension, cardiac and renal diseases.
In both standing and exercise, RBF, GFR and sodium excretions were observed to have a tendency to decrease, and FF to increase in many cases, however the decreases of RBF, GFR and sodium excretions were greater in exercise than in standing generally. And these decreases were severe in patients with renal diseases, while the changes of RBF and GFR were slight or insignificant in normals.
These changes of renal functions in standing and exercise are similar to the effects of adrenalin, and the possibility that the sympathetic nervous regulations participate in the effects of these conditions on renal haemodynamics was discussed.
After exercise, RBF and GFR were restored to the former levels within 30 minutes in most cases, although the recoveries were delayed to some extent in patients with renal diseases and essential hypertension.
No correlations were found between the original level of RBF and its decrease in these conditions.
The effects of standing and exercise on proteinuria were observed to have no definite tendency, and the author could not find any correlation between the protein content of urine and the changes of RBF and GFR.
In patients with orthostatic proteinuria, the decrease of RBF while standing were very severe and continued for a long period, and it is presumed that the decrease of RBF may play the important role as one of causative factors in the mechanism of the proteinuria in this disease.