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低钾血症家兔尿浓缩能力的体内及体外研究

In vivo and in vitro studies of urinary concentrating ability in potassium-depleted rabbits.

作者信息

Raymond K H, Davidson K K, McKinney T D

出版信息

J Clin Invest. 1985 Aug;76(2):561-6. doi: 10.1172/JCI112007.

DOI:10.1172/JCI112007
PMID:2993361
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC423861/
Abstract

The factors responsible for the urinary concentrating defect associated with the potassium-depleted (KD) state are uncertain. The present studies were designed to, first, determine whether a urinary concentrating defect exists in potassium-depleted rabbits and, second, to use the technique of in vitro perfusion to evaluate directly the antidiuretic hormone (ADH) responsiveness of cortical collecting tubules (CCT) in this setting. Feeding female New Zealand White rabbits a potassium-deficient diet for 2 wk caused a significant fall in plasma potassium levels in both the ad-libitum and controlled water intake groups (P less than 0.001). Muscle potassium content after 2 wk of potassium restriction fell from 45.6 +/- 0.9 to 29.0 +/- 1.2 meq/100 g fat-free dry solids (P less than 0.001). Renal papillary sodium content fell significantly from a control value of 234.6 +/- 8.0 to 182.46 +/- 10.0 meq/kg H2O after 2 wk of potassium restriction. Maximal urinary osmolality measured after 12 h of dehydration and 1.25 U pitressin IM was significantly decreased in rabbits after 2 wk of potassium restriction in both the ad-libitum and controlled water intake groups (P less than 0.001). The relationship between plasma potassium concentration and maximum urinary osmolality was significantly correlated in both the ad-libitum and controlled water intake groups, r = 0.73 and 0.68 (P less than 0.001), respectively. In addition, refeeding KD rabbits with normal chow for 1 wk resulted in normalization of both plasma potassium levels and urinary concentrating ability. CCT from control and KD rabbits were perfused in vitro at 25 degrees C. The hydraulic conductivity coefficient, Lp, was significantly reduced at all doses of ADH tested in tubules from KD rabbits when compared with control tubules. In addition, the maximal hydraulic conductivity in tubules from KD rabbits when tested with 200 microU/ml ADH at 37.5 degrees C was only 23% of control values (P less than 0.05). Furthermore, this reduced ADH responsiveness persisted when the bath potassium was elevated from 5 to 20 mM. The reflection coefficient for NaCl when compared with raffinose was 0.91 in tubules from KD animals. Thus, these data suggest that the ADH-resistant urinary concentrating defect associated with potassium depletion is due, at least in part, to a diminished responsiveness of the CCT to ADH. Therefore, further studies were designed to investigate the cellular steps involved in this abnormal response. There was no difference in the 8-para-chlorophenylthio cyclic AMP induced hydroosmotic response between CCT from KD and control rabbits. Since the cAMP-induced hydroosmotic response was similar between KD and control CCT, experiments were performed to evaluate the contribution of phosphodiesterase (PDIE) activity by using the potent PDIE inhibitor isobutylmethylxanthine (10(-4) and 10(-3)M) in the presence of ADH (200 U/ml). Although Lp was increased by PDIE inhibition in CCT from both control and KD animals, the overall hydroosmotic response in CCT from KD rabbits was still significantly reduced when compared with controls. The final experiments used forskolin to evaluate further the adenylate cyclase complex. The resulting hydroosmotic response in CCT from KD rabbits was almost identical to that obtained in controls. In conclusion, these data suggest that the decreased responsiveness of CCT from KD rabbits to ADH involves a step at or proximal to the stimulation of the catalytic subunit of adenylate cyclase, and that PDIE activity makes no contribution to this abnormal hydroosmotic response.

摘要

与低钾血症(KD)相关的尿浓缩功能缺陷的成因尚不确定。本研究旨在:其一,确定低钾血症兔是否存在尿浓缩功能缺陷;其二,运用体外灌注技术直接评估在此情况下皮质集合管(CCT)对抗利尿激素(ADH)的反应性。给雌性新西兰白兔喂食低钾饮食2周,无论自由饮水组还是限水组,血浆钾水平均显著下降(P<0.001)。低钾饮食2周后,肌肉钾含量从45.6±0.9降至29.0±1.2 meq/100 g无脂干固体(P<0.001)。低钾饮食2周后,肾乳头钠含量从对照值234.6±8.0显著降至182.46±10.0 meq/kg H2O。在自由饮水组和限水组中,低钾饮食2周后的兔子在脱水12小时并皮下注射1.25 U加压素后测得的最大尿渗透压均显著降低(P<0.001)。自由饮水组和限水组中,血浆钾浓度与最大尿渗透压之间均显著相关,相关系数r分别为0.73和0.68(P<0.001)。此外,用正常食物重新喂养低钾血症兔1周后,血浆钾水平和尿浓缩能力均恢复正常。将对照兔和低钾血症兔的CCT在25℃下进行体外灌注。与对照小管相比,在低钾血症兔的小管中,所有测试剂量的ADH作用下,水力传导系数Lp均显著降低。此外,在37.5℃下用200 μU/ml ADH测试时,低钾血症兔小管中的最大水力传导率仅为对照值的23%(P<0.05)。此外,当浴液钾浓度从5 mM升至20 mM时,这种ADH反应性降低仍然存在。与棉子糖相比,低钾血症动物小管中NaCl的反射系数为0.91。因此,这些数据表明,与低钾血症相关的抗ADH尿浓缩功能缺陷至少部分是由于CCT对ADH的反应性降低所致。因此,进一步的研究旨在探究参与这种异常反应的细胞步骤。低钾血症兔和对照兔的CCT在8-对氯苯硫基环磷酸腺苷诱导的水渗透反应方面没有差异。由于低钾血症兔和对照CCT之间的cAMP诱导的水渗透反应相似,因此进行实验以评估磷酸二酯酶(PDIE)活性的作用,方法是在ADH(200 U/ml)存在下使用强效PDIE抑制剂异丁基甲基黄嘌呤(10⁻⁴和10⁻³M)。尽管在对照动物和低钾血症动物的CCT中,PDIE抑制均使Lp增加,但与对照相比,低钾血症兔CCT中的总体水渗透反应仍显著降低。最后的实验使用福斯高林进一步评估腺苷酸环化酶复合物。低钾血症兔CCT产生的水渗透反应几乎与对照兔相同。总之,这些数据表明,低钾血症兔CCT对ADH反应性降低涉及腺苷酸环化酶催化亚基刺激处或其近端的一个步骤,并且PDIE活性对这种异常的水渗透反应没有作用。

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本文引用的文献

1
Water excrtion in potassium-deficient man.缺钾男性的水排泄
J Clin Invest. 1961 Dec;40(12):2215-24. doi: 10.1172/JCI104448.
2
On the mechanism of impairment of renal concentrating ability in potassium deficiency.论钾缺乏时肾浓缩能力受损的机制。
J Clin Invest. 1960 Apr;39(4):684-92. doi: 10.1172/JCI104084.
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Contributory role of extrarenal factors in the polyuria of potassium depletion.肾外因素在低钾血症性多尿中的作用。
N Engl J Med. 1959 Feb 5;260(6):268-71. doi: 10.1056/NEJM195902052600604.
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Defect in the renal tubular reabsorption of water associated with potassium depletion in rats.大鼠中与钾缺乏相关的肾小管对水重吸收的缺陷。
Am J Physiol. 1957 Jun;189(3):557-63. doi: 10.1152/ajplegacy.1957.189.3.557.
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Regulation of vasopressin action by prostaglandins. Evidence for prostaglandin synthesis in the rabbit cortical collecting tubule.前列腺素对血管加压素作用的调节。兔皮质集合管中前列腺素合成的证据。
J Clin Invest. 1982 Dec;70(6):1193-204. doi: 10.1172/jci110718.
6
Urinary concentrating ability and antidiuretic hormone responsiveness in the potassium-depleted dog.低钾血症犬的尿浓缩能力及抗利尿激素反应性
J Lab Clin Med. 1982 Jul;100(1):53-60.
7
In vivo evidence of impaired solute transport by the thick ascending limb in potassium-depleted rats.钾缺乏大鼠厚壁升支溶质转运受损的体内证据。
J Clin Invest. 1984 Apr;73(4):908-16. doi: 10.1172/JCI111314.
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Organization of nephron function.肾单位功能的组织
Am J Physiol. 1983 Jun;244(6):F579-89. doi: 10.1152/ajprenal.1983.244.6.F579.
9
Effect of potassium depletion on the vasopressin-sensitive cyclic AMP system in rat outer medullary tubules.钾缺乏对大鼠外髓质肾小管中血管加压素敏感的环磷酸腺苷系统的影响。
J Lab Clin Med. 1982 Jan;99(1):29-38.
10
Activation of adenylate cyclase by the diterpene forskolin does not require the guanine nucleotide regulatory protein.二萜类化合物毛喉素对腺苷酸环化酶的激活作用并不需要鸟嘌呤核苷酸调节蛋白。
J Biol Chem. 1981 Oct 10;256(19):9799-801.