Adler S, Zett B, Anderson B, Fraley D S
J Clin Invest. 1975 Aug;56(2):391-400. doi: 10.1172/JCI108104.
When rats with desoxycorticosterone acetate (DOCA)-induced potassium chloride deficiency are given sodium chloride there is simultaneously a partial correction of metabolic alkalosis and a marked reduction in urinary citrate excretion and renal citrate content. To examine DOCA's role in this phenomenon and to determine how sodium chloride alters renal metabolism, rats were made KC1 deficient using furosemide and a KC1-deficient diet. Renal citrate and ammonia metabolism were then studied after chronic oral sodium chloride administration or acute volume expansion with isotonic mannitol. Although both maneuvers partially corrected metabolic alkalosis, sodium chloride raised serum chloride concentration while mannitol significantly decreased it. Urinary citrate excretion decreased to 10% of control in rats given NaCl and to 50% of control in rats infused with mannitol. The filtered load of citrate was constant or increased indicating increased tubular citrate reabsorption. Renal cortical citrate content also decreased approximately 50%. Renal cortical slices from KCl-deficient rats incubated in low or normal chloride media produced equal amounts of 14CO2 from (1, 5-14C) citrate. In addition, urinary ammonia excretion increased by over 300% in both groups. This occurred in the mannitol group despite increased urinary pH and flow rate indicating a rise in renal ammonia production. It seems that neither DOCA nor an increase in serum chloride concentration explains the experimental results. Rather, it appears that volume expansion is responsible for increased renal tubular citrate reabsorption and renal ammonia production. As these renal metabolic responses ordinarily occur in response to acidosis, the data are consistent with the hypothesis that volume expansion reduces renal cell pH in 3KCl-deficient rats.
给醋酸脱氧皮质酮(DOCA)诱导的氯化钾缺乏大鼠喂食氯化钠时,代谢性碱中毒会得到部分纠正,同时尿枸橼酸盐排泄和肾枸橼酸盐含量会显著降低。为了研究DOCA在这一现象中的作用,并确定氯化钠如何改变肾脏代谢,使用速尿和低钾饮食使大鼠出现氯化钾缺乏。然后在长期口服氯化钠或用等渗甘露醇进行急性容量扩张后,研究肾脏枸橼酸盐和氨的代谢。虽然这两种操作都能部分纠正代谢性碱中毒,但氯化钠会提高血清氯浓度,而甘露醇则会使其显著降低。给予氯化钠的大鼠尿枸橼酸盐排泄降至对照组的10%,输注甘露醇的大鼠降至对照组的50%。枸橼酸盐的滤过负荷保持不变或增加,表明肾小管对枸橼酸盐的重吸收增加。肾皮质枸橼酸盐含量也下降了约50%。在低氯或正常氯培养基中孵育的氯化钾缺乏大鼠的肾皮质切片,从(1,5-14C)枸橼酸盐产生等量的14CO2。此外,两组的尿氨排泄均增加了300%以上。在甘露醇组中,尽管尿pH值和流速增加,但仍出现这种情况,表明肾脏氨生成增加。似乎DOCA和血清氯浓度的增加都不能解释实验结果。相反,似乎是容量扩张导致肾小管对枸橼酸盐的重吸收增加和肾脏氨生成增加。由于这些肾脏代谢反应通常是对酸中毒的反应,这些数据与容量扩张降低3KCl缺乏大鼠肾细胞pH值的假设一致。