Renovascular Responses to High and Low Perfusate Calcium Steady-State Experiments in the Isolated Perfused Rat Kidney with Baseline Vascular Tone

Abstract

Acute hypercalcemia is commonly observed in surgical patients after calcium infusion while acute hypocalcemia is common during rapid citrated blood transfusion. Although high and low ionized calcium ([Ca2+]) within the clinical range produce an increase or decrease in cardiac performance and systemic vessel resistance, respectively, their effects on renal vessels have not been quantified. A possible renal vasoconstriction that might occur with high [Ca2+] is of clinical interest because it is a factor which may contribute to impaired renal circulation and decreased function. In this study we examined the renovascular responses to [Ca2+], which was varied within the clinical range under hemodynamically controlled conditions. We instituted high and low [Ca2+] in the per fusate, which consisted of Krebs–Henseleit buffer containing albumin, 60–65 g/liter. Stable high (n= 10) or low (n= 7) [Ca2+] (1.93 ± 0.02 and 0.59 ± 0.01 mM,respectively) was instituted for 10 min and preceded and followed by normal [Ca2+] of the same duration. In a separate protocol (n= 8) verapamil (10−5M) was added to the perfusate 10 min before high [Ca2+] was tested. We measured changes in renal flow at a constant perfusion pressure of 110 mm Hg and also characterized the renal vessels over a range of pressures by pressure vs flow plots. High [Ca2+] was associated with a small decrease in flow (from 28.8 ± 2.4 to 26.9 ± 2.6 ml/min/g,P< 0.02), indicating a small vasopressor effect. This effect was also shown by a leftward shift in the pressure vs flow plots. These changes were prevented by verapamil. GFR decreased (from 0.35 ± 0.04 to 0.28 ± 0.06 ml/min/g,P< 0.01) without a significant change in sodium excretion or fractional sodium excretion. Low [Ca2+] was associated with increased renal flow (from 30.8 ± 2.1 to 35.2 ± 2.7 ml/min/g,P< 0.02), indicating a vasodilator effect. This effect was also shown by a rightward displacement of the pressure vs flow plots. GFR increased from 0.51 ± 0.03 to 0.56 ± 0.04 ml/min/g,P< 0.01, as did sodium excretion (from 2.32 ± 0.22 to 3.87 ± 0.49 μEq/min,P< 0.01) and fractional sodium excretion (from 2.33 ± 0.26 to 3.61 ± 0.49%,P< 0.01). We conclude, first, that in the isolated perfused rat kidney, high [Ca2+] is a weak vasopressor while low [Ca2+] has vasodilator action. Second, high [Ca2+] effects are abolished by verapamil pretreatment. These findings illuminate mechanisms of high [Ca2+] effects on renovascular tone.