Kahn T, Bosch J, Levitt M F, Goldstein M H
Am J Physiol. 1975 Sep;229(3):746-53. doi: 10.1152/ajplegacy.1975.229.3.746.
Effects of sodium nitrate were compared with sodium chloride loading on transport of electrolytes by the nephron. Maximal levels of free water clearance/clomerular filtration rate (CH2O/GFR) averaged 8.4% with nitrate loading and 14.4% with saline loading. Since ethacrynic acid and chlorothiazide exert their major natriuretic effect in the distal nephron, the increment in Na ad Cl reabsorbed beyond the proximal tubule. The administration of these agents resulted in an increase in fractional sodium excretion (CNa/GFR) of 21.1%, urinary sodium excretion (UNaV) of 1,126 mueq/min, and urinary chloride excretion (UClV) of 848 mueq/min during nitrate loading compared with an increase in CNa/GFR of 37.6%, UNaV of 2,362 mueq/min, and UClV of 2,397 mueq/min during saline loading. The smaller diuretic-induced increment in Na and Cl excretion in the nitrate studies suggests, as do the hydrated studies, that less Cl and Na are reabsorbed in the distal nephron during nitrate than saline loading. At every level of UNaV, fractional bicarbonate reabsorption was higher, urine pH was lower, and urinary potassium excretion (UKV) was higher in the nitrate studies. Thus, compared with saline loading, sodium nitrate decreases chloride and sodium reabsorption in the distal nephron. The higher hydrogen and potassium secretion in the nitrate studies may be consequent to the decreased ability of the distal nephron to reabsorb chloride.
将硝酸钠与氯化钠负荷对肾单位电解质转运的影响进行了比较。硝酸钠负荷时自由水清除率/肾小球滤过率(CH2O/GFR)的最高水平平均为8.4%,而氯化钠负荷时为14.4%。由于依他尼酸和氯噻嗪主要在远端肾单位发挥利钠作用,钠和氯在近端小管之外的重吸收增加。与氯化钠负荷期间相比,在硝酸钠负荷期间给予这些药物导致钠排泄分数(CNa/GFR)增加21.1%,尿钠排泄量(UNaV)为1126μeq/min,尿氯排泄量(UClV)为848μeq/min;而氯化钠负荷期间CNa/GFR增加37.6%,UNaV为2362μeq/min,UClV为2397μeq/min。硝酸钠研究中利尿剂诱导的钠和氯排泄增加幅度较小,这与水合研究结果一致,表明在硝酸钠负荷期间远端肾单位中氯和钠的重吸收比氯化钠负荷时少。在每个UNaV水平,硝酸钠研究中的碳酸氢盐重吸收分数更高,尿pH更低,尿钾排泄量(UKV)更高。因此,与氯化钠负荷相比,硝酸钠减少了远端肾单位中氯和钠的重吸收。硝酸钠研究中较高的氢和钾分泌可能是由于远端肾单位重吸收氯的能力下降所致。