Wesson D E
Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas 77030.
Am J Physiol. 1990 Oct;259(4 Pt 2):F636-44. doi: 10.1152/ajprenal.1990.259.4.F636.
We investigated the relative contributions made by the proximal and distal tubule to the correction of Cl-deplete metabolic alkalosis induced by systemic administration of NaCl. Free-flow micropuncture was used to examine net bicarbonate reabsorption in superficial proximal and distal tubules of anesthetized Munich-Wistar rats during maintenance and correction of chronic furosemide-induced Cl-deplete metabolic alkalosis. The distal tubule of animals with correcting vs. maintained alkalosis had a lower fractional reabsorption of bicarbonate (38 vs. 75%, P less than 0.001) and a lower slope of the linear regression comparing absorption to delivered load (0.48 vs. 0.99, P less than 0.02). By contrast, proximal tubule of animals with correcting vs. maintained alkalosis had fractional reabsorption (85 vs. 90%, P = 0.07) and slopes of the regression comparing reabsorption to filtered load (1.09 vs. 0.98, P = 0.48) that were not different. The data indicate that correction of Cl-deplete metabolic alkalosis induced by NaCl administration involves a qualitative decreased in bicarbonate reabsorption in distal tubule with maintenance of the same load-dependent relationship for bicarbonate reabsorption in proximal tubule.
我们研究了近端小管和远端小管对全身性给予氯化钠所诱导的氯缺乏性代谢性碱中毒纠正的相对贡献。在维持和纠正慢性呋塞米诱导的氯缺乏性代谢性碱中毒期间,采用自由流微穿刺技术检测麻醉的慕尼黑-维斯塔大鼠浅表近端和远端小管中的净碳酸氢盐重吸收。与维持碱中毒的动物相比,纠正碱中毒的动物的远端小管碳酸氢盐重吸收率较低(38%对75%,P<0.001),并且将重吸收与输送负荷进行线性回归比较的斜率较低(0.48对0.99,P<0.02)。相比之下,与维持碱中毒的动物相比,纠正碱中毒的动物的近端小管重吸收率(85%对90%,P=0.07)以及将重吸收与滤过负荷进行回归比较的斜率(1.09对0.98,P=0.48)并无差异。数据表明,给予氯化钠所诱导的氯缺乏性代谢性碱中毒的纠正涉及远端小管中碳酸氢盐重吸收的质量性降低,而近端小管中碳酸氢盐重吸收的负荷依赖性关系保持不变。