Gougoux A, Lemieux G, Lavoie N
Am J Physiol. 1976 Oct;231(4):1010-7. doi: 10.1152/ajplegacy.1976.231.4.1010.
Studies were performed to characterize the renal effects of maleate in anesthetized dogs. Following the intravenous administration of maleate or maleic acid (50 mg/kg), mean fractional bicarbonate excretion (CHCO3/GFR) rose to as high as 26%. Na, K, and phosphate excretion also increased markedly, whereas C1 excretion remained low. An initial transient fall in urinary pH from 6.53 to 6.13 contrasted sharply with the rapid alkalinization of the urine induced by acetazolamide administration. During saline expansion CHCO3/GFR rose from 4 to 37% after maleate administration, whereas Cl excretion did not change significantly. During continuous carbonic anhydrase inhibition with acetazolamide, maleate administration resulted in a further rise in CHCO3/GFR from 22 to 35%. Whereas CPO4/GFR increased only from 1 to 3% during acetazolamide administration, this ratio reached 75% following the addition of maleate. Fumarate, the transisomer of maleate, and malonate, a well-known inhibitor of Krebs cycle, failed to affect bicarbonate excretion. This study demonstrates that maleate inhibits the fraction of bicarbonate reabsorption uncatalyzed by carbonic anhydrase. Impaired anionic reabsorption of bicarbonate or accelerated passive backflux of this ion into proximal tubular lumen are the two mechanisms that best explain the bicarbonaturia induced by maleate.
开展了多项研究以表征马来酸盐对麻醉犬肾脏的影响。静脉注射马来酸盐或马来酸(50mg/kg)后,平均碳酸氢盐排泄分数(CHCO3/GFR)升高至26%。钠、钾和磷酸盐排泄也显著增加,而氯排泄仍处于较低水平。尿液pH值最初从6.53短暂降至6.13,这与乙酰唑胺给药后尿液迅速碱化形成鲜明对比。在盐水扩容期间,给予马来酸盐后CHCO3/GFR从4%升至37%,而氯排泄无显著变化。在用乙酰唑胺持续抑制碳酸酐酶期间,给予马来酸盐导致CHCO3/GFR从22%进一步升至35%。在给予乙酰唑胺期间,CPO4/GFR仅从1%增至3%,而加入马来酸盐后该比值达到75%。马来酸盐的反式异构体富马酸盐以及著名的三羧酸循环抑制剂丙二酸盐均未影响碳酸氢盐排泄。本研究表明,马来酸盐抑制了未被碳酸酐酶催化的碳酸氢盐重吸收部分。碳酸氢盐阴离子重吸收受损或该离子被动回流至近端肾小管管腔加速是最能解释马来酸盐所致碱尿症的两种机制。