Martin R S, Hayslett J P
Pflugers Arch. 1986 Jul;407(1):76-81. doi: 10.1007/BF00580724.
Chronic potassium loading results in an adaptive change in renal tubular epithelium which increases the capacity for potassium excretion. The present study was performed to evaluate the role of aldosterone in renal potassium adaptation, since hyperaldosteronism stimulates potassium secretion, and potassium loading increases the production of aldosterone. Experiments were performed in animals with intact adrenal glands, and in adrenalectomized animals (Adx) replaced with basal physiologic amounts of corticosterone, which were not replaced with aldosterone, or were chronically infused with aldosterone to achieve either basal plasma levels or elevated levels. Chronic potassium loading in adrenal intact animals was associated with a statistically significant higher rate of urinary potassium excretion (3.57 +/- 0.30 microEq/min/100 g BW) compared to the control rate (2.54 +/- 0.25 microEq/min/100 g BW, p less than 0.05), during acute infusion of KCl. In potassium loaded Adx animals, with selective replacement of adrenal hormones, the maximum rate of potassium excretion was blunted in the absence of aldosterone, compared to potassium loaded animals with intact adrenal glands. In contrast, when Adx animals were infused chronically with aldosterone, to achieve basal or elevated plasma levels, the maximum rate of potassium excretion was not blunted, although at basal aldosterone levels increased potassium excretion was due, at least in part, to hyperkalemia. These results indicate that the induction of renal potassium adaptation after a week or more of chronic potassium loading is dependent on the action of hyperaldosteronism on renal tubular epithelium.
慢性钾负荷会导致肾小管上皮细胞发生适应性变化,从而增加钾排泄能力。由于醛固酮增多症会刺激钾分泌,且钾负荷会增加醛固酮的生成,因此本研究旨在评估醛固酮在肾脏钾适应性中的作用。实验在肾上腺完整的动物以及肾上腺切除(Adx)的动物中进行,肾上腺切除动物用基础生理量的皮质酮替代,未用醛固酮替代,或长期输注醛固酮以达到基础血浆水平或升高水平。与对照组速率(2.54±0.25微当量/分钟/100克体重,p<0.05)相比,在急性输注氯化钾期间,肾上腺完整动物的慢性钾负荷与尿钾排泄率在统计学上显著更高(3.57±0.30微当量/分钟/100克体重)。在钾负荷的肾上腺切除动物中,在选择性替代肾上腺激素时,与肾上腺完整的钾负荷动物相比,在无醛固酮的情况下钾排泄的最大速率受到抑制。相反,当肾上腺切除动物长期输注醛固酮以达到基础或升高的血浆水平时,钾排泄的最大速率未受到抑制,尽管在基础醛固酮水平时钾排泄增加至少部分归因于高钾血症。这些结果表明,经过一周或更长时间的慢性钾负荷后肾脏钾适应性的诱导依赖于醛固酮增多症对肾小管上皮的作用。