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关于犬肾单位减少时钾排泄的适应性变化

On the adaptation in potassium excretion associated with nephron reduction in the dog.

作者信息

Schultze R G, Taggart D D, Shapiro H, Pennell J P, Caglar S, Bricker N S

出版信息

J Clin Invest. 1971 May;50(5):1061-8. doi: 10.1172/JCI106577.

Abstract

An effort to examine certain aspects of the adaptation in potassium excretion associated with nephron reduction was made in dogs with unilateral remnant kidneys. A constant intake of potassium was maintained by tube feeding and studies were performed before and after removal of the intact control kidney. The removal of the intact kidney created the need for the remaining nephrons of the remnant kidney to increase their rate of potassium excretion markedly. Sodium intake was held constant either at a normal or a low level. Mineralocorticoid hormone activity was maintained either at a high level by the administration of 0.2 mg 9-alpha-fluorohydrocortisone daily or at a low level by performing bilateral adrenalectomy and administering a minimal maintenance dose of deoxycorticosterone acetate (DOCA) and cortisol. Potassium excretion per nephron increased strikingly within 18 hr of contralateral nephrectomy and by 7 days, excretion rates were 600% of control values for the remnant kidney. More potassium was excreted in the first 5 hr after administration of a test dose of potassium by the remnant kidney alone in the postnephrectomy state than by both the remnant and intact kidneys in the prenephrectomy state. 24 hr excretion of potassium by the remnant kidney postnephrectomy averaged 92% of the administered load of potassium. The adaptation in potassium excretion was independent of the concurrent rate of sodium excretion and of mineralocorticoid hormone activity and persisted during constriction of the renal artery, a stimulus which presumably decreased distal delivery of sodium. The adaptation and the continued modulation of potassium excretion could not be explained adequately by an increase in impermeant anion excretion per nephron. Finally, known changes in hydrogen ion excretion per nephron associated with nephron reduction are in a direction opposite to those which would explain the acquired kaliuresis per nephron.

摘要

我们对单侧残肾犬钾排泄适应性的某些方面进行了研究,以探讨与肾单位减少相关的情况。通过管饲维持钾的恒定摄入量,并在切除完整对照肾之前和之后进行研究。切除完整肾后,残肾的剩余肾单位需要显著提高其钾排泄率。钠摄入量保持在正常或低水平。通过每天给予0.2毫克9-α-氟氢化可的松将盐皮质激素活性维持在高水平,或通过双侧肾上腺切除术并给予最小维持剂量的醋酸脱氧皮质酮(DOCA)和皮质醇将其维持在低水平。对侧肾切除术后18小时内,每个肾单位的钾排泄量显著增加,到第7天时,排泄率是残肾对照值的600%。在肾切除术后状态下,仅残肾在给予试验剂量钾后的前5小时内排泄的钾比肾切除术前状态下残肾和完整肾排泄的钾更多。肾切除术后残肾24小时的钾排泄量平均为给予钾负荷量的92%。钾排泄的适应性与同时的钠排泄率和盐皮质激素活性无关,并且在肾动脉收缩期间持续存在,肾动脉收缩这一刺激大概会减少远端钠的输送。每个肾单位不可渗透阴离子排泄量的增加并不能充分解释钾排泄的适应性和持续调节。最后,已知与肾单位减少相关的每个肾单位氢离子排泄的变化方向与解释每个肾单位获得性尿钾增多的方向相反。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/147a/292028/4b28a69ce3f8/jcinvest00194-0111-a.jpg

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