Kaufman A M, Kahn T
Department of Medicine, Bronx Veterans Administration Medical Center, New York 10468.
Am J Physiol. 1988 Oct;255(4 Pt 2):F763-70. doi: 10.1152/ajprenal.1988.255.4.F763.
Studies were performed to investigate the role of concomitant chloride depletion in potassium-depletion alkalosis in the rat and the relationship between potassium depletion, plasma bicarbonate (PHCO3), and net acid excretion. 1) Selective potassium depletion (K-DEPL), potassium plus chloride depletion (KCl-DEPL), or selective chloride depletion (Cl-DEPL) was produced by administering a selectively potassium-, potassium and chloride-, or selectively chloride-deficient diet. In K-DEPL and KCl-DEPL rat, PHCO3 increased progressively and similarly during a 38-day period of restriction, whereas net acid excretion was similar and not elevated in either group. Cl-DEPL did not result in alkalosis. Chloride administration without potassium in alkalotic KCl-DEPL rats did not result in a sustained significant decrease in PHCO3. Potassium administration without chloride in alkalotic KCl-DEPL rats decreased PHCO3. Thus concomitant chloride depletion plays a minimal role in the alkalosis produced by dietary-induced potassium depletion. 2) Administration of a chronic acid load to alkalotic K-DEPL rats did not decrease PHCO3, and net acid excretion increased similarly as in normals. In K-DEPL rats after PHCO3 was reduced toward normal levels with acetazolamide, net acid excretion increased sharply above base-line values and PHCO3 increased markedly. Thus the alkalotic K-DEPL rat maintains the ability to excrete a chronic acid load, and a reduction in PHCO3 elicits an increase in acid excretion to restore the initial acid-base condition. These studies suggest that potassium depletion alters the set-point at which the kidney maintains PHCO3.
开展了多项研究,以调查伴随的氯缺乏在大鼠钾缺乏性碱中毒中的作用,以及钾缺乏、血浆碳酸氢盐(PHCO3)和净酸排泄之间的关系。1)通过给予选择性低钾、低钾和低氯或选择性低氯饮食,造成选择性钾缺乏(K-DEPL)、钾加氯缺乏(KCl-DEPL)或选择性氯缺乏(Cl-DEPL)。在K-DEPL和KCl-DEPL大鼠中,在38天的限制期内,PHCO3逐渐且相似地升高,而两组的净酸排泄相似且未升高。Cl-DEPL未导致碱中毒。在碱中毒的KCl-DEPL大鼠中,无钾给予氯不会导致PHCO3持续显著下降。在碱中毒的KCl-DEPL大鼠中,无氯给予钾会降低PHCO3。因此,伴随的氯缺乏在饮食诱导的钾缺乏所产生的碱中毒中作用极小。2)向碱中毒的K-DEPL大鼠给予慢性酸负荷不会降低PHCO3,且净酸排泄与正常大鼠相似地增加。在用乙酰唑胺使K-DEPL大鼠的PHCO3降至正常水平后,净酸排泄急剧高于基线值增加,且PHCO3显著升高。因此,碱中毒的K-DEPL大鼠保持排泄慢性酸负荷的能力,且PHCO3的降低会引起酸排泄增加以恢复初始酸碱状态。这些研究表明,钾缺乏改变了肾脏维持PHCO3的设定点。