Journal of Applied Physiology, Vol 60, Issue 4 1333-1340, Copyright © 1986 by American Physiological Society
Lung fluid balance during acute renal failure in sheep
B. T. Peterson, J. A. Brooks and R. W. Hyde
To determine whether uremia changes lung vascular permeability, we measured
the flow of lymph and proteins from the lungs of acutely uremic sheep.
Acute renal failure was induced by either bilateral nephrectomy or by
reinfusing urine. Both models of renal failure increased the plasma
creatinine from 0.8 +/- 0.3 to 11 +/- 1 mg/dl in 3 days but caused no
significant change in the flow of lymph from the lungs. To determine
whether uremia increased the protein clearance response to elevated
pulmonary microvascular pressures, we inflated a balloon in the left atrium
for 2 h before and 3 days after inducing acute renal failure. In seven
sheep, before removing the kidneys, the 20 cmH2O elevation of left atrial
pressure increased the protein clearance 3.9 +/- 3.0 ml/h (from 9.5 +/- 4.9
to 13.4 +/- 5.4 ml/h). Three days after the bilateral nephrectomy the same
increase in left atrial pressure increased the protein clearance 6.4 +/-
3.6 ml/h (from 6.1 +/- 2.1 to 12.5 +/- 5.2 ml/h), which was a significantly
larger increase than that measured before the nephrectomy (P less than
0.05). Sham nephrectomy in seven sheep caused the protein clearance
response to the elevated left atrial pressure to fall from 4.7 +/- 1.9 ml/h
before the sham nephrectomy to 2.6 +/- 1.4 ml/h 3 days later (P less than
0.05). Uremia due to reinfusion of urine in five sheep did not affect the
protein clearance response to elevations in left atrial pressure. Neither
model of acute uremia increased the postmortem extravascular lung water
volume.(ABSTRACT TRUNCATED AT 250 WORDS)
