Vandorpe D H, Levine D Z
Department of Physiology, University of Ottawa, Ontario.
Clin Invest Med. 1989 Aug;12(4):224-9.
NH4Cl acidosis--a common experimental model of hyperchloremic metabolic acidosis--elicits complex intrarenal responses whereby the fall in plasma bicarbonate concentration can be restored to normal after the initial acid load. Using the technique of in vivo micropuncture of surface distal tubules of the rat kidney, we attempted to further define controlling mechanisms underlying the enhanced bicarbonate reabsorption in this setting. Specifically, we wished to determine the dependence of distal tubule bicarbonate reabsorption (JtCO2) on sodium transport, water reabsorption, and carbonic anhydrase activity. Surface distal tubules of Sprague-Dawley rats made acidotic by ammonium chloride gavage (arterial blood pH: 7.15 +/- 0.01, [HCO3]: 14.8 +/- 0.5 mM) were perfused in vivo at 8 and 24 nL/min with 4 different isoosmotic, 25 mM bicarbonate solutions: Group 1 was perfused with 60 mM Na, Group 2 with 60 mM choline, Group 3 with 60 mM choline + 3 x 10(-4) M amiloride, and Group 4 with 60 mM Na + 10(-3) M acetazolamide. At 8 nL/min, significant bicarbonate reabsorption occurred with all perfusates. JtCO2 was 65 +/- 4, 59 +/- 5, 58 +/- 6, and 40 +/- 4 pmol.min-1.mm-1, in Groups 1, 2, 3, and 4, respectively. However, JtCO2 in Group 4 was significantly less than that in Groups 1 and 2 (p less than 0.01 and p less than 0.05, respectively). Amiloride added to the low sodium perfusate did not reduce bicarbonate reabsorption. We conclude that bicarbonate reabsorption in distal tubules of acidotic rats is acetazolamide-sensitive and is not significantly sustained by sodium or water movements.
氯化铵酸中毒——一种常见的高氯性代谢性酸中毒实验模型——引发复杂的肾内反应,通过该反应,初始酸负荷后血浆碳酸氢盐浓度的下降可恢复正常。我们运用大鼠肾脏表面远曲小管的体内微穿刺技术,试图进一步明确在此情况下增强的碳酸氢盐重吸收的控制机制。具体而言,我们希望确定远曲小管碳酸氢盐重吸收(JtCO2)对钠转运、水重吸收和碳酸酐酶活性的依赖性。通过氯化铵灌胃使Sprague-Dawley大鼠发生酸中毒(动脉血pH:7.15±0.01,[HCO3]:14.8±0.5 mM),然后以8和24 nL/分钟的流速在体内用4种不同的等渗、25 mM碳酸氢盐溶液灌注其表面远曲小管:第1组用60 mM钠灌注,第2组用60 mM胆碱灌注,第3组用60 mM胆碱 + 3×10⁻⁴ M氨氯吡咪灌注,第4组用60 mM钠 + 10⁻³ M乙酰唑胺灌注。在8 nL/分钟时,所有灌注液均发生显著的碳酸氢盐重吸收。第1、2、3和4组的JtCO2分别为65±4、59±5、58±6和40±4 pmol·min⁻¹·mm⁻¹。然而,第4组的JtCO2显著低于第1组和第2组(分别为p<0.01和p<0.05)。添加到低钠灌注液中的氨氯吡咪并未降低碳酸氢盐重吸收。我们得出结论,酸中毒大鼠远曲小管中的碳酸氢盐重吸收对乙酰唑胺敏感,且不受钠或水转运的显著维持。