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大鼠肾盂水和溶质跨上皮交换的研究。

Examination of transepithelial exchange of water and solute in the rat renal pelvis.

作者信息

Bargman J, Leonard S L, McNeely E, Robertson C, Jamison R L

出版信息

J Clin Invest. 1984 Nov;74(5):1860-70. doi: 10.1172/JCI111605.

Abstract

Severance of the ureter beyond the renal papilla causes a fall in urinary osmolality, which suggests that exchange of water or solute between urine and renal parenchyma normally occurs in the intact renal pelvis. We examined water and solute flux in the renal pelvis with micropuncture and microcatheterization techniques. Four groups of antidiuretic rats were studied. Group I (n = 17) underwent micropuncture through the intact contracting ureter. Urine samples were obtained at the papillary tip, and in the pelvis beside the base of the extrarenal papilla. Urinary osmolality at the base, 880 +/- 97 mosmol/kg H2O (mean +/- SE), was less than that at the tip, 1,425 +/- 104 mosmol/kg H2O (P less than 0.005). In group II (n = 24), samples were analyzed for inulin and osmolality. In 15 rats (group IIA), comparison was made between base and tip samples. In the other nine animals (group IIB), comparisons were made among base, tip, and bladder samples and urea was also measured. In group II (A and B combined) urine-to-plasma (U/P) osmolality was lower at the base, 4.31 +/- 0.27, than at the tip, 6.08 +/- 0.23 (P less than 0.001), and U/P inulin was lower at the base, 192 +/- 25, than at the tip, 306 +/- 16 (P less than 0.001). In group IIB, the bladder urine had a lower U/P osmolality, 5.27 +/- 0.25, than the tip, 6.01 +/- 0.31 (P less than 0.02). The U/P urea was 59 +/- 10.6 (base), 98 +/- 9.4 (tip) (base vs. tip, P less than 0.05), and 81 +/- 6.5 (bladder, P less than 0.005, compared with tip). In group III (n = 8), samples were obtained by microcatheter from the fornices, the deepest intrarenal extensions of the pelvis, and compared with samples at the tip. Urinary osmolality was lower in the fornix, 646 +/- 106 mosmol/kg H2O, than at the tip, 1,296 +/- 99 mosmol/kg H2O (P less than 0.001). Similarly, U/P inulin was lower in the fornix, 48 +/- 14, than at the tip, 128 +/- 12 (P less than 0.001). The lower U/P inulin in the pelvic urine is the result of either the addition of fluid to the pelvis, or the backleak of inulin across the epithelium lining the pelvis. To verify that the pelvic epithelium was impermeable to inulin, in group IVA (n = 4) the left renal pelvis was superfused with a solution of chemical inulin. Cumulative absorption of inulin from the left kidney was 0.15 +/- 0.08% of that superfused. Using [14C]inulin in group IVB (n= 3), similar results were obtained (0.05 +/- 0.02%). These findings indicate that in the renal pelvis, fluid is added to urine after it emerges from the collecting ducts. We suggest that reflux of hyperosmotic urine over the renal papilla creates a transepithelial gradient for the flux of water into the pelvis. A model that incorporates diffusive and convective forces for water and solute transport is proposed to account for these findings.

摘要

在肾乳头以外切断输尿管会导致尿渗透压下降,这表明在完整的肾盂中,尿液与肾实质之间通常会发生水或溶质的交换。我们使用微穿刺和微导管技术研究了肾盂中的水和溶质通量。对四组抗利尿大鼠进行了研究。第一组(n = 17)通过完整收缩的输尿管进行微穿刺。在乳头尖端以及肾外乳头基部旁边的肾盂中获取尿液样本。基部的尿渗透压为880±97 mosmol/kg H₂O(均值±标准误),低于尖端的1425±104 mosmol/kg H₂O(P < 0.005)。在第二组(n = 24)中,对样本进行菊粉和渗透压分析。在15只大鼠(IIA组)中,比较了基部和尖端样本。在另外9只动物(IIB组)中,对基部、尖端和膀胱样本进行了比较,并且还测量了尿素。在第二组(A组和B组合并)中,基部的尿/血浆(U/P)渗透压为4.31±0.27,低于尖端的6.08±0.23(P < 0.001),基部的U/P菊粉为192±25,低于尖端的306±16(P < 0.001)。在IIB组中,膀胱尿液的U/P渗透压为5.27±0.25,低于尖端的6.01±0.31(P < 0.02)。U/P尿素在基部为59±10.6,在尖端为98±9.4(基部与尖端相比,P < 0.05),在膀胱为81±6.5(与尖端相比,P < 0.005)。在第三组(n = 8)中,通过微导管从肾盂穹窿(肾盂最深的肾内延伸部分)获取样本,并与尖端样本进行比较。穹窿处的尿渗透压为646±106 mosmol/kg H₂O,低于尖端的1296±99 mosmol/kg H₂O(P < 0.001)。同样,穹窿处的U/P菊粉为48±14,低于尖端的128±12(P < 0.001)。肾盂尿液中较低的U/P菊粉是由于向肾盂中添加了液体,或者是菊粉通过肾盂上皮的回漏所致。为了验证肾盂上皮对菊粉是不可渗透的,在IVA组(n = 4)中,用化学菊粉溶液对左肾盂进行灌流。左肾对菊粉的累积吸收量为灌流液的0.15±0.08%。在IVB组(n = 3)中使用[¹⁴C]菊粉,得到了类似的结果(0.05±0.02%)。这些发现表明,在肾盂中,液体在从集合管流出后会添加到尿液中。我们认为,高渗尿液在肾乳头上方的反流为水流入肾盂创造了跨上皮梯度。提出了一个包含水和溶质转运的扩散和对流力的模型来解释这些发现。

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