Fine A
Department of Medicine, St. Boniface General Hospital, Winnipeg, Man., Canada.
Can J Physiol Pharmacol. 1989 Jun;67(6):641-4. doi: 10.1139/y89-102.
Acid-base status is considered the major factor controlling renal NH4+ production from glutamine, with maximal values found in chronic acidosis. However, metabolic inhibitors have been shown to increase NH4+ production without acid-base change; the mechanism for this increase is unclear. Fluorocitrate was administered to dogs with chronic metabolic alkalosis. Following fluorocitrate total renal NH4+ production rose from 32 +/- 5 to 104 +/- 15 mumol/(min.100 mL glomerular filtration rate (GFR] (p less than 0.01) and glutamine extraction rose from 26 +/- 8 to 65 +/- 8 mumol/(min.100 mL GFR) (p less than 0.01). These values approximate maximal values found in chronic acidosis. Lactate utilization fell from 165 +/- 19 to 99 +/- 7 mumol/(min.100 mL GFR) following fluorocitrate (p less than 0.01). Citrate extraction fell to zero and alanine production rose from 27 +/- 4 to 46 +/- 7 mumol/(min.100 mL GFR) (p less than 0.01). Oxygen consumption remained unchanged following fluorocitrate, 584 +/- 29 vs. 549 +/- 29 mumol/(min.100 mL GFR). These results demonstrate that in the presence of metabolic inhibition in the kidney, ATP production remains constant. This is achieved by increased utilization of one substrate, glutamine, when the ATP production from other substrates is reduced. Thus the necessity to maintain constant ATP production appears to modulate renal NH4+ production.
酸碱状态被认为是控制肾脏从谷氨酰胺产生NH4+的主要因素,在慢性酸中毒时可达到最大值。然而,代谢抑制剂已被证明可在不改变酸碱状态的情况下增加NH4+的产生;这种增加的机制尚不清楚。将氟柠檬酸给予患有慢性代谢性碱中毒的狗。给予氟柠檬酸后,肾脏总NH4+产生量从32±5上升至104±15μmol/(min·100 mL肾小球滤过率(GFR))(p<0.01),谷氨酰胺摄取量从26±8上升至65±8μmol/(min·100 mL GFR)(p<0.01)。这些值接近慢性酸中毒时的最大值。给予氟柠檬酸后,乳酸利用率从165±19降至99±7μmol/(min·100 mL GFR)(p<0.01)。柠檬酸摄取量降至零,丙氨酸产生量从27±4上升至46±7μmol/(min·100 mL GFR)(p<0.01)。给予氟柠檬酸后氧消耗量保持不变,分别为584±29和549±29μmol/(min·100 mL GFR)。这些结果表明,在肾脏存在代谢抑制的情况下,ATP产生量保持恒定。当其他底物的ATP产生减少时,通过增加一种底物谷氨酰胺的利用来实现这一点。因此,维持恒定ATP产生的必要性似乎调节了肾脏NH4+的产生。