Hropot M, Fowler N, Karlmark B, Giebisch G
Kidney Int. 1985 Sep;28(3):477-89. doi: 10.1038/ki.1985.154.
We used clearance and free-flow micropuncture techniques to evaluate the influence of several diuretic agents, given both individually and in various combinations, on transport of sodium, potassium, and fluid, and on acidification and ammonium transport, within the distal tubule of the rat kidney. The loop diuretics, furosemide and piretanide, sharply increased fractional delivery of fluid, sodium, and potassium into the distal tubule, and, as a result, sodium reabsorption and potassium secretion were enhanced in this nephron segment. These two drugs also stimulated urinary acidification and increased urinary phosphate, titratable acid, and ammonium excretion. These effects took place both within the loop of Henle and along the distal tubule. Amiloride and triamterene alone inhibited distal tubular sodium reabsorption and potassium secretion, and, when given with one of the loop diuretics, suppressed both the kaliuresis and the increased acid and ammonium excretion induced by the latter agents. Hydrochlorothiazide and tizolemide inhibited sodium reabsorption within the distal tubule, and were associated with a stimulation of potassium secretion within this segment. Addition of one of these two latter distally acting agents to either of the loop diuretics led to a further augmentation of sodium excretion, but to a reduction of potassium excretion, compared to the responses seen after the loop diuretics alone.
我们采用清除率和自由流动微穿刺技术，评估了几种利尿剂单独使用及多种组合使用时，对大鼠肾脏远曲小管内钠、钾和液体转运以及酸化和铵转运的影响。袢利尿剂呋塞米和吡咯他尼显著增加了液体、钠和钾进入远曲小管的分数输送量，结果，该肾单位节段的钠重吸收和钾分泌增强。这两种药物还刺激了尿液酸化，并增加了尿磷酸盐、可滴定酸和铵的排泄。这些作用在髓袢和远曲小管均有发生。单独使用氨氯地平和氨苯蝶啶可抑制远曲小管的钠重吸收和钾分泌，当与一种袢利尿剂合用时，可抑制后者诱导的尿钾增多以及酸和铵排泄增加。氢氯噻嗪和替唑米德抑制远曲小管内的钠重吸收，并伴有该节段钾分泌的刺激。与单独使用袢利尿剂后的反应相比，将这两种远曲小管作用药物之一添加到任何一种袢利尿剂中，都会导致钠排泄进一步增加，但钾排泄减少。
