DuBose T D, Good D W
Department of Internal Medicine, University of Texas Medical Branch, Galveston 77550.
Am J Physiol. 1991 May;260(5 Pt 2):F680-7. doi: 10.1152/ajprenal.1991.260.5.F680.
Free-flow micropuncture experiments were performed to examine directly the effects of chronic hyperkalemia on renal ammonium production, urinary ammonium excretion, and proximal convoluted tubule ammonium transport in the rat in vivo. Munich-Wistar rats were pair-fed either a control or a high-K+ diet for 6-11 days. Chronic K+ loading was associated with an increase in plasma K+ concentration and significant systemic metabolic acidosis. Renal blood flow did not differ in control and high-K+ rats. In the hyperkalemic rats, urinary ammonium excretion was reduced by 40% and whole kidney ammonium production was reduced by 50% compared with controls. In contrast, chronic hyperkalemia had no significant effect on net ammonium transport by either the early or late segment of the proximal convoluted tubule. Chronic hyperkalemia also had no effect on the absolute rate of ammonium delivery to early or late proximal convoluted tubule sites. These results indicate that a change in renal ammonium production does not necessarily correlate with a change in proximal tubule ammonium transport and that reduced urinary ammonium excretion in chronic hyperkalemia is not due to impaired secretion of ammonium by the proximal convoluted tubule. Chronic hyperkalemia may reduce ammonium excretion by decreasing transfer of ammonium from proximal tubules to collecting ducts in the renal medulla.
进行自由流微穿刺实验以直接检测慢性高钾血症对大鼠体内肾铵生成、尿铵排泄及近端曲管铵转运的影响。将慕尼黑-威斯塔大鼠成对饲养,分别给予对照饮食或高钾饮食6至11天。慢性钾负荷与血浆钾浓度升高及明显的全身性代谢性酸中毒相关。对照大鼠和高钾大鼠的肾血流量无差异。与对照相比,高钾血症大鼠的尿铵排泄减少40%,全肾铵生成减少50%。相反,慢性高钾血症对近端曲管早期或晚期节段的净铵转运无显著影响。慢性高钾血症对铵输送至近端曲管早期或晚期部位的绝对速率也无影响。这些结果表明,肾铵生成的变化不一定与近端小管铵转运变化相关,且慢性高钾血症时尿铵排泄减少并非由于近端曲管铵分泌受损。慢性高钾血症可能通过减少铵从近端小管向肾髓质集合管的转运而降低铵排泄。