Beck L H, Senesky D, Goldberg M
J Clin Invest. 1973 Oct;52(10):2641-5. doi: 10.1172/JCI107456.
Prior studies of proximal tubule reabsorption have failed to distinguish conclusively between a separate active K+ transport system and K+ movement linked to Na+ reabsorption. To attempt to dissociate movement of K+ from Na+ and Ca++, recollection micropuncture experiments were performed in proximal tubules of intact and thyroparathyroidectomized (TPTX) dogs under two different conditions known to inhibit Na+ reabsorption: saline expansion to 5% body wt, and 5 mg/kg acetazolamide. A control hydropenic group was also studied. Tubular concentrations of K+, Na+, and Ca++ were measured by electron probe analysis. During initial collections, mean+/-SEM tubular fluid/plasma (TF/P)(K+) was 1.07 +/-0.05, 1.05+/-0.05, and 1.00+/-0.03 in intact hydropenic (n = 7), saline (n = 6), and acetazolamide (n = 8) groups; fractional reabsorption (FR) of K+ in proximal tubules was 0.35, 0.39, and 0.31 respectively. After saline, (TF/P)(Inul in) fell from 1.81 to 1.34 (P < 0.01); (TF/P)(K+), (TF/P)(Na+), and tubular fluid/ultrafiltrate, (TF/UF)(Ca++) did not change, so that FR of all three ions fell proportionately. After acetazolamide, however, despite a 24% inhibition of FR of Na+ and Ca++, (TF/P)(K+) fell to 0.85+/-0.04 (P < 0.005) so that FR of K+ was unchanged at 0.34. In three corresponding groups of TPTX dogs, similar results were obtained. Acetazolamide (n = 7) inhibited FR of Na+ and Ca++ by 41%, but (TF/P)(K+) fell from 1.03+/-0.03 to 0.89+/-0.04 (P < 0.005) so that FR of K+ was unchanged (0.36-0.34).A separate uphill transport system for K+ in proximal tubules is therefore unmasked by acetazolamide, a drug which selectively inhibits Na+ (and Ca++) reabsorption. Saline, on the other hand, inhibits net reabsorption of all three ions, probably by increasing passive backflux via intercellular channels.
以往关于近端小管重吸收的研究未能确凿地区分独立的主动钾离子转运系统与与钠离子重吸收相关的钾离子移动。为了尝试将钾离子的移动与钠离子和钙离子的移动分离,在完整和甲状旁腺切除(TPTX)的犬近端小管中,于两种已知可抑制钠离子重吸收的不同条件下进行了重吸收微穿刺实验:将生理盐水扩充至体重的5%,以及给予5mg/kg乙酰唑胺。还研究了一个对照限水组。通过电子探针分析测量钾离子、钠离子和钙离子的肾小管浓度。在最初的收集过程中,完整限水组(n = 7)、生理盐水组(n = 6)和乙酰唑胺组(n = 8)的肾小管液/血浆(TF/P)(钾离子)平均值±标准误分别为1.07±0.05、1.05±0.05和1.00±0.03;近端小管中钾离子的分数重吸收(FR)分别为0.35、0.39和0.31。给予生理盐水后,(TF/P)(菊粉)从1.81降至1.34(P < 0.01);(TF/P)(钾离子)、(TF/P)(钠离子)以及肾小管液/超滤液(TF/UF)(钙离子)均未改变,因此所有三种离子的FR均成比例下降。然而,给予乙酰唑胺后,尽管钠离子和钙离子的FR受到24%的抑制,但(TF/P)(钾离子)降至0.85±0.04(P < 0.005),使得钾离子的FR保持在0.34不变。在三组相应的TPTX犬中,获得了类似的结果。乙酰唑胺(n = 7)使钠离子和钙离子的FR抑制了41%,但(TF/P)(钾离子)从1.03±0.03降至0.89±0.04(P < 0.005),使得钾离子的FR保持不变(0.36 - 0.34)。因此,乙酰唑胺揭示了近端小管中一个独立的钾离子上坡转运系统,该药物选择性地抑制钠离子(和钙离子)重吸收。另一方面,生理盐水可能通过增加经细胞间通道的被动反流来抑制所有三种离子的净重吸收。