Purkerson M L, Lubowitz H, White R W, Bricker N S
J Clin Invest. 1969 Sep;48(9):1754-60. doi: 10.1172/JCI106141.
Bicarbonate reabsorption is classically regarded as a rate-limited process characterized by saturation kinetics. The tubular maximum (Tm), however, varies with glomerular filtration rate. Thus bicarbonate reabsorption, in common with sodium reabsorption, is characterized by glomerulo-tubular balance. The examination of bicarbonate reabsorption is accomplished using the bicarbonate titration technique; however, this method in its traditional form leads to marked expansion of extracellular fluid (ECF) volume. The possibility exists, therefore, that glomerulo-tubular balance for bicarbonate is altered by the volume expansion and thus that the classic pattern of reabsorption may actually reflect inhibited bicarbonate reabsorptive capacity. The present studies were performed in rats to examine this possibility. Bicarbonate titration studies were performed in two groups of animals: (a) those in which ECF volume expansion was minimized; and (b) those in which ECF volume expansion was exaggerated. In the first group, no Tm for bicarbonate was observed either in the majority of individual rats studied or in a group plot for all rats studied despite the fact that plasma bicarbonate concentrations were increased to values in excess of 60 mEq/liter. In the second group, a clear Tm was demonstrated both in individual animals and in group data and there was a lowered threshold for the excretion of bicarbonate. The data thus lend support to the view that the "normal" Tm for bicarbonate may actually represent an inhibited level of bicarbonate reabsorption induced by ECF volume expansion.
传统上认为碳酸氢盐重吸收是一个具有饱和动力学特征的限速过程。然而,肾小管最大重吸收率(Tm)会随肾小球滤过率而变化。因此,与钠重吸收一样,碳酸氢盐重吸收具有球 - 管平衡的特征。碳酸氢盐重吸收的检测是通过碳酸氢盐滴定技术完成的;然而,这种传统形式的方法会导致细胞外液(ECF)容量显著增加。因此,存在这样一种可能性,即碳酸氢盐的球 - 管平衡会因容量扩张而改变,从而经典的重吸收模式可能实际上反映了碳酸氢盐重吸收能力受到抑制。本研究在大鼠中进行,以检验这种可能性。在两组动物中进行了碳酸氢盐滴定研究:(a)细胞外液容量扩张最小化的动物组;(b)细胞外液容量扩张过度的动物组。在第一组中,尽管血浆碳酸氢盐浓度升高至超过60 mEq/升的值,但在大多数个体大鼠以及所有研究大鼠的组图中均未观察到碳酸氢盐的Tm。在第二组中,无论是个体动物还是组数据中都显示出明显的Tm,并且碳酸氢盐排泄的阈值降低。因此,这些数据支持了这样一种观点,即碳酸氢盐的“正常”Tm实际上可能代表了由细胞外液容量扩张引起的碳酸氢盐重吸收的受抑制水平。