Wilson D R, Honrath U
Can J Physiol Pharmacol. 1987 Jun;65(6):1200-4. doi: 10.1139/y87-189.
Microcatheterization was used to study the effect of cis-platinum nephrotoxicity on inner medullary collecting duct function in anaesthetized rats. Osmolality of collecting duct fluid increased from the beginning to the end (papillary tip) of the collecting duct by only 69 +/- 11 mosmol/kg in cis-platinum treated rats (at 5-6 days) compared with 306 +/- 75 mosmol/kg in sham controls (p less than 0.01). Tubular fluid to plasma inulin concentration ratio was reduced at the beginning and end of the collecting duct. Tubular fluid sodium, chloride, and potassium concentrations were lower at the papillary tip in cis-platinum treated rats (p less than 0.01). The results indicate that collecting duct water reabsorption is reduced, but electrolyte reabsorption is normal (or even increased) in cis-platinum nephrotoxicity. Papillary tissue sodium chloride concentration was reduced in cis-platinum treated rats. We conclude that the characteristic decrease in urine concentrating ability in cis-platinum nephrotoxicity is not primarily the result of an intrinsic abnormality in collecting duct function but is secondary to decreased papillary hypertonicity resulting from impaired function in more proximal nephron segments, presumably the pars recta of the proximal tubule and the loop of Henle where previous studies have demonstrated abnormal function.
采用微导管插入术研究顺铂肾毒性对麻醉大鼠髓质内集合管功能的影响。与假手术对照组相比，顺铂处理组大鼠（5 - 6天）集合管内液体的渗透压从集合管起始端到末端（乳头尖）仅增加69±11毫摩尔/千克，而假手术对照组为306±75毫摩尔/千克（P<0.01）。集合管起始端和末端的肾小管液与血浆菊粉浓度比值降低。顺铂处理组大鼠乳头尖处肾小管液中钠、氯和钾的浓度较低（P<0.01）。结果表明，在顺铂肾毒性中，集合管对水的重吸收减少，但电解质重吸收正常（甚至增加）。顺铂处理组大鼠乳头组织中氯化钠浓度降低。我们得出结论，顺铂肾毒性中尿浓缩能力的特征性降低并非主要源于集合管功能的内在异常，而是继发于近端肾单位节段（可能是近端小管直部和髓袢，此前研究已证明这些部位功能异常）功能受损导致的乳头高渗性降低。
