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低渗盐水负荷对水合状态下犬的影响:盐水诱导的远端肾小管钠转运极限的证据。

Effects of hypotonic saline loading in hydrated dog: evidence for a saline-induced limit on distal tubular sodium transport.

作者信息

Stein R M, Abramson R G, Kahn T, Levitt M F

出版信息

J Clin Invest. 1967 Jul;46(7):1205-14. doi: 10.1172/JCI105614.

Abstract

We performed studies on dogs under hydrated conditions, utilizing the rate of free water formation (C(H2O)) as an index of the rate of distal tubular sodium transport. Since C(H2O) could be progressively increased with no evidence of a maximal rate during loading with hypotonic (2.5%) mannitol, it was concluded that there is no limit on distal tubular sodium transport during mannitol loading. In contrast, during hypotonic (0.45%) saline loading C(H2O) rose initially, but as urine flow (V) exceeded 25% of the filtered load C(H2O) attained maximal levels (up to 20% of the filtered load) and remained stable as V increased to 50% of the filtered load. It was concluded that saline loading progressively inhibits proximal sodium reabsorption. Initially, the distal tubule absorbes a large fraction of the proximal rejectate and sodium excretion rises slightly. Eventually, an alteration in distal sodium transport appears which culminates in a maximal rate or transport limit. This distal transport limit provoked by saline loading could not be characterized by a classical Tm as seen with glucose and does not seem to be consequent to high rates of flow through the distal tubule. Regardless of the precise nature of this limit, the major increment in sodium excretion develops during saline loading only after saline alters the capacity of the distal tubule to transport sodium.

摘要

我们在水合状态下对犬进行了研究,利用自由水生成率(C(H₂O))作为远曲小管钠转运速率的指标。由于在输注低渗(2.5%)甘露醇期间,C(H₂O)可逐渐升高且无最大速率的证据,因此得出结论,在输注甘露醇期间远曲小管钠转运没有限制。相比之下,在输注低渗(0.45%)盐水期间,C(H₂O)最初升高,但当尿流率(V)超过滤过负荷的25%时,C(H₂O)达到最大水平(高达滤过负荷的20%),并在V增加至滤过负荷的50%时保持稳定。得出的结论是,输注盐水会逐渐抑制近端钠重吸收。最初,远曲小管吸收大部分近端排出物,钠排泄略有增加。最终,远曲小管钠转运出现改变,最终达到最大速率或转运极限。盐水输注引发的这种远曲小管转运极限不能用葡萄糖那样的经典Tm来描述,似乎也不是远曲小管高流速的结果。无论这种极限的确切性质如何,钠排泄的主要增加仅在盐水改变远曲小管转运钠的能力之后才在输注盐水期间出现。

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