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代谢性酸中毒和碱中毒对犬肾钠和钙转运的影响。

Effects of metabolic acidosis and alkalosis on sodium and calcium transport in the dog kidney.

作者信息

Sutton R A, Wong N L, Dirks J H

出版信息

Kidney Int. 1979 May;15(5):520-33. doi: 10.1038/ki.1979.67.

Abstract

Clearance and micropuncture studies have been performed in dogs to examine the effects of acute and chronic metabolic acidosis and acute alkalosis on tubular sodium and calcium transport. Acute metabolic acidosis, induced by the infusion of hydrochloric acid, decreased proximal fluid reabsorption and increased the fractional delivery of sodium and calcium to the distal tubule, but not to the final urine. In comparison with normal dogs, dogs with chronic metabolic acidosis (induced by feeding ammonium chloride) showed an increase in proximal fluid reabsorption and a dissociation of calcium from sodium reabsorption more distally, leading to an increased delivery of calcium relative to sodium at the distal tubule and in the final urine. The infusion of sodium bicarbonate to correct chronic metabolic acidosis, both in intact and thyroparathyroidectomized (TPTX) dogs, reduced proximal fluid reabsorption and caused a selective enhancement of calcium reabsorption relative to sodium in the more distal nephron, resulting in a reversal of the dissociation observed in acidosis, both at the distal tubule and in the final urine. By contrastin fusion of sodium chloride in parathyroid-intact acidotic dogs did not reduce proximal fluid reabsorption or enhance tubular calcium reabsorption. In nonacidotic dogs, both intact and TPTX, infusion of sodium bicarconate to induce acute alkalosis resulted in selhese data demonstrate the presence of a component of tubular calcium reabsorption situated beyond the proximal tubule, which is inhibited by chronic (but not acute) metabolic acidosis and enhanced by metabolic alkalosis (or bicarbonate infusion) independently of parathyroid hormone.

摘要

已经在犬类身上进行了清除率和微穿刺研究,以检查急性和慢性代谢性酸中毒以及急性碱中毒对肾小管钠和钙转运的影响。通过输注盐酸诱导的急性代谢性酸中毒,减少了近端液体重吸收,并增加了钠和钙向远端小管的分数输送,但未增加向终尿的输送。与正常犬相比,患有慢性代谢性酸中毒(通过喂食氯化铵诱导)的犬显示近端液体重吸收增加,并且在更远端钙与钠重吸收解离,导致在远端小管和终尿中钙相对于钠的输送增加。在完整和甲状旁腺切除(TPTX)的犬中,输注碳酸氢钠以纠正慢性代谢性酸中毒,减少了近端液体重吸收,并在更远端肾单位中导致相对于钠的钙重吸收选择性增强,导致在远端小管和终尿中观察到的酸中毒时的解离逆转。相比之下,在甲状旁腺完整的酸中毒犬中输注氯化钠并没有减少近端液体重吸收或增强肾小管钙重吸收。在非酸中毒犬中,无论是完整的还是TPTX的,输注碳酸氢钠以诱导急性碱中毒均导致……这些数据表明,在近端小管之外存在肾小管钙重吸收成分,其受到慢性(而非急性)代谢性酸中毒的抑制,并受到代谢性碱中毒(或输注碳酸氢盐)的增强,且与甲状旁腺激素无关。

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