Anaizi N H, Cohen J J, Black A J, Wertheim S J
Am J Physiol. 1986 Sep;251(3 Pt 2):F547-61. doi: 10.1152/ajprenal.1986.251.3.F547.
During alkalosis in vivo, renal tissue [citrate] [( citrate]t) increases and citrate reabsorption (Tcit) and utilization (Qcit) simultaneously decrease. The decrease in Qcit is interpreted to cause the increased [citrate]t, which in turn decreases Tcit X Renal citrate handling and [citrate]t could be regulated by other mechanisms, since alkalosis changes [substrate] and [H+] in extracellular (ECF) and intracellular (ICF) fluid. Also, since high plasma [citrate] decreases ionized [Ca2+] (Cai), it is not possible to determine in vivo whether there is a maximum for Tcit or Qcit and whether change in extracellular fluid (delta ECF) pH affects these maxima. We perfused the substrate-limited isolated rat kidney for either 110 (n = 36) or 50 min (n = 44) at pH 7.2, 7.4, or 7.6; pH was changed by varying [HCO3-]; Cai was held constant at approximately 2.5 meq/liter. When citrate was the only substrate available in a Krebs-Ringer-HCO3 perfusate containing 6% substrate-free albumin, both Qcit and Tcit had maximal rates: Qcit much greater than Tcit; at pH 7.6, Qcit and Tcit were significantly reduced below their values at pH 7.2 or 7.4. In contrast to in vivo observations, [citrate]t was not significantly increased at high ECF pH. To test whether [citrate]t in the perfused kidney can increase in alkalosis, 11 additional perfusions were done in the presence of glucose plus lactate plus malate but without added citrate: [citrate]t = 0.6 mumol X g-1 at pH 7.6 and 0.3 mumol X g-1 at pH 7.2 (P less than 0.01); no citrate was detectable in the perfusate, and urinary citrate excretion was negligible. Thus, in the isolated rat kidney, an increase in [citrate]t occurred in alkalosis and was derived from precursors and not from citrate in the ECF. Overall, when only citrate was available to the isolated kidney during alkalosis, a significant rise in [citrate]t did not occur, although Vmax for Tcit and Qcit decreased. These effects of alkalosis on Tcit are consistent with observations in brush-border vesicles, where divalent citrate is the preferential substrate for luminal Na+-coupled transport; by contrast, high ECF pH and [HCO-3] apparently decrease Qcit by a direct effect on the utilization of citrate.
在体内碱中毒期间,肾组织中柠檬酸盐增加,而柠檬酸盐重吸收(Tcit)和利用(Qcit)同时减少。Qcit的减少被认为会导致[柠檬酸盐]t升高,进而使Tcit降低。肾对柠檬酸盐的处理和[柠檬酸盐]t可能受其他机制调节,因为碱中毒会改变细胞外液(ECF)和细胞内液(ICF)中的[底物]和[H⁺]。此外,由于高血浆[柠檬酸盐]会降低离子化Ca²⁺,所以无法在体内确定Tcit或Qcit是否存在最大值,以及细胞外液(delta ECF)pH值的变化是否会影响这些最大值。我们在pH值为7.2、7.4或7.6的条件下,对底物受限的离体大鼠肾脏进行了110分钟(n = 36)或50分钟(n = 44)的灌注;通过改变[HCO₃⁻]来改变pH值;Cai保持在约2.5 meq/升恒定。当柠檬酸盐是含有6%无底物白蛋白的 Krebs-Ringer-HCO₃灌注液中唯一可用的底物时,Qcit和Tcit都有最大速率:Qcit远大于Tcit;在pH 7.6时,Qcit和Tcit显著低于它们在pH 7.2或7.4时的值。与体内观察结果相反,在高ECF pH值时[柠檬酸盐]t没有显著增加。为了测试灌注肾脏中的[柠檬酸盐]t在碱中毒时是否会增加,在有葡萄糖加乳酸加苹果酸但不添加柠檬酸盐的情况下又进行了11次灌注:在pH 7.6时[柠檬酸盐]t = 0.6 μmol·g⁻¹,在pH 7.2时为0.3 μmol·g⁻¹(P < 0.01);灌注液中未检测到柠檬酸盐,尿柠檬酸盐排泄可忽略不计。因此,在离体大鼠肾脏中,碱中毒时[柠檬酸盐]t增加,且来源于前体而非ECF中的柠檬酸盐。总体而言,当碱中毒期间离体肾脏仅能利用柠檬酸盐时,尽管Tcit和Qcit的Vmax降低,但[柠檬酸盐]t并未显著升高。碱中毒对Tcit的这些影响与在刷状缘小泡中的观察结果一致,在刷状缘小泡中,二价柠檬酸盐是腔内Na⁺偶联转运的优先底物;相比之下,高ECF pH值和[HCO₃⁻]显然通过直接影响柠檬酸盐的利用而降低Qcit。