Miracle Cynthia M, Rieg Timo, Mansoury Hadi, Vallon Volker, Thomson Scott C
Department of Medicine, Division of Nephrology-Hypertension, University of California and Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive 9151, San Diego, CA 92161, USA.
Am J Physiol Renal Physiol. 2008 Oct;295(4):F995-F1002. doi: 10.1152/ajprenal.00491.2007. Epub 2008 Jun 18.
Heightened sensitivity of the diabetic proximal tubule to dietary salt leads to a paradoxical effect of salt on glomerular filtration rate (GFR) via tubuloglomerular feedback. Diabetic hyperfiltration is a feedback response to growth and hyperreabsorption by the proximal tubule. The present studies were performed to determine whether growth and hyperfunction of the proximal tubule are essential for its hyperresponsiveness to dietary salt and, hence, to the paradoxical effect of dietary salt on GFR. Micropuncture was performed in four groups of inactin-anesthetized Wistar rats after 10 days of streptozotocin diabetes drinking tap water or 1% NaCl. Kidney growth was suppressed with ornithine decarboxylase (ODC) inhibitor, DFMO (200 mg.kg(-1).day(-1)), or placebo. Single nephron GFR (SNGFR) was manipulated by perfusing Henle's loop so that proximal reabsorption (Jprox) could be expressed as a function of SNGFR in each nephron, dissociating primary effects on the tubule from the effects of glomerulotubular balance. Alone, DFMO or high salt reduced SNGFR and suppressed Jprox independent of SNGFR. Suppression of Jprox was eliminated and SNGFR increased when high salt was given to rats receiving DFMO. ODC is necessary for hyperresponsiveness of the proximal tubule to dietary salt and for the paradoxical effect of dietary salt on GFR in early diabetes. This coupling of effects adds to the body of evidence that feedback from the proximal tubule is the principal governor of glomerular filtration in early diabetes.
糖尿病近端小管对饮食中盐的敏感性增强,通过管球反馈导致盐对肾小球滤过率(GFR)产生矛盾的影响。糖尿病性高滤过是对近端小管生长和重吸收增强的一种反馈反应。本研究旨在确定近端小管的生长和功能亢进是否对其对饮食中盐的高反应性至关重要,从而对饮食中盐对GFR的矛盾影响至关重要。在链脲佐菌素诱导糖尿病10天后,给四组接受自来水或1%氯化钠的inactin麻醉的Wistar大鼠进行微穿刺。用鸟氨酸脱羧酶(ODC)抑制剂DFMO(200mg·kg⁻¹·天⁻¹)或安慰剂抑制肾脏生长。通过灌注髓袢来控制单肾单位GFR(SNGFR),以便近端重吸收(Jprox)可以表示为每个肾单位中SNGFR的函数,从而将对小管的主要影响与球管平衡的影响区分开来。单独使用时,DFMO或高盐会降低SNGFR并抑制Jprox,且与SNGFR无关。当给接受DFMO的大鼠高盐时,Jprox的抑制被消除,SNGFR增加。ODC对于早期糖尿病近端小管对饮食中盐的高反应性以及饮食中盐对GFR的矛盾影响是必需的。这种效应的耦合增加了证据,表明近端小管的反馈是早期糖尿病肾小球滤过的主要调节因素。