Simon E E, Merli C, Fry B, Buerkert J
Department of Medicine, Jewish Hospital of St. Louis, Washington University, Missouri.
Kidney Int. 1989 Oct;36(4):601-8. doi: 10.1038/ki.1989.236.
The present study examined the contribution of individual superficial nephron segments to sodium excretion in antiglomerular basement membrane nephritis in the rat by sampling the same nephron successively from the end and beginning of the distal tubule and end of the proximal tubule. Whole kidney GFR in glomerulonephritic rats was reduced by approximately 40% from controls; absolute sodium excretion was about 25% of normal. Metabolic balance studies in the awake state had suggested that the animals were in sodium balance. Plasma renin levels before and during micropuncture were similar to controls. These findings suggest that the defect in sodium handling is intrinsic to the kidney. Glomerulotubular balance was maintained along the proximal tubule. Sodium reabsorption in the loop of Henle was reduced in absolute terms but was proportional to the load delivered. Due to the decreased absolute sodium reabsorption in the preceding segments, sodium delivery to the beginning of the distal tubule was comparable in the two groups of animals. Along the distal tubule sodium reabsorption was comparable to control animals. Therefore, the avid urinary sodium retention seen during micropuncture was due to increased sodium reabsorption by segments past the superficial proximal tubule and/or by deep nephrons.
本研究通过从大鼠远端小管末端和起始端以及近端小管末端连续采集同一肾单位样本,探讨了大鼠抗肾小球基底膜肾炎中单个浅表肾单位节段对钠排泄的贡献。肾小球肾炎大鼠的全肾肾小球滤过率(GFR)较对照组降低了约40%;绝对钠排泄量约为正常水平的25%。清醒状态下的代谢平衡研究表明动物处于钠平衡状态。微穿刺前后的血浆肾素水平与对照组相似。这些发现提示钠处理缺陷是肾脏固有的。近端小管维持了球管平衡。亨利氏袢中的钠重吸收绝对值降低,但与输送的负荷成比例。由于前段钠重吸收绝对值降低,两组动物输送到远端小管起始端的钠量相当。沿远端小管的钠重吸收与对照动物相当。因此,微穿刺期间观察到的大量尿钠潴留是由于浅表近端小管之后的节段和/或深部肾单位钠重吸收增加所致。