Levy M, Lester R, Levinsky N G
J Clin Invest. 1968 Sep;47(9):2117-24. doi: 10.1172/JCI105897.
The renal excretion of urobilinogen was studied in dogs by standard clearance techniques. The use of radiochemically pure tritiated mesobilirubinogen as a representative urobilinogen afforded much greater analytical precision than can be obtained with the usual colorimetric and fluorimetric techniques which are only semiquantitative. With constant plasma levels of urobilinogen, raising urinary pH from 5 to 8 increased urobilinogen excretion from about 30% to up to 200% of the filtered load. When urinary pH was kept constant, changes in blood pH had no effect on urobilinogen excretion. Increases in urinary flow had no effect on urobilinogen excretion when the urine was alkaline but increased excretion markedly during aciduria. Probenecid did not influence urobilinogen excretion by the kidney. It is concluded that urobilinogen is excreted by a three-component system of glomerular filtration, active secretion, and pH-dependent nonionic diffusion in the distal nephron. Urobilinogen is a weak acid, and this mode of excretion is similar to that of other weak, organic acids, such as salicylates. These results indicate that urinary pH and flow must be considered in the clinical interpretation of measurements of urinary urobilinogen.
采用标准清除技术对犬的尿胆原肾排泄进行了研究。使用放射化学纯的氚标记中胆素原作为代表性尿胆原,比常用的仅为半定量的比色法和荧光法具有更高的分析精度。在尿胆原血浆水平恒定的情况下,将尿液pH从5提高到8,尿胆原排泄量从滤过量的约30%增加到高达200%。当尿液pH保持恒定时,血液pH的变化对尿胆原排泄没有影响。当尿液呈碱性时,尿量增加对尿胆原排泄没有影响,但在酸性尿期间排泄量显著增加。丙磺舒不影响肾脏对尿胆原的排泄。得出的结论是,尿胆原通过肾小球滤过、主动分泌和远曲小管中pH依赖性非离子扩散的三组分系统排泄。尿胆原是一种弱酸,这种排泄方式与其他弱酸(如水杨酸盐)的排泄方式相似。这些结果表明,在对尿胆原测量结果进行临床解释时,必须考虑尿液pH和尿量。