DuBose T D, Pucacco L R, Seldin D W, Carter N W
J Clin Invest. 1978 Aug;62(2):338-48. doi: 10.1172/JCI109134.
The mechanism by which the kidney reabsorbs sodium bicarbonate could be a result of (a) H+ secretion, (b) direct HCO3- reabsorption, or (c) a combination of both processes. Most of the studies which have supported the H+ secretory theory have involved the assumption that tubular fluid and arterial PCO2 were equal. We have utilized a new PCO2 microelectrode to directly determine in situ PCO2 of tubular fluid and stellate vessel blood in the cortex of the rat kidney during control conditions and after alterations in acid-base status. In 21 control rats, proximal tubular fluid PCO2 exceeded systemic arterial PCO2 (deltaCO2) by 25.9 +/- 0.92 mm Hg (P less than 0.001). The values obtained for both distal tubular fluid and stellate vessel blood were not significantly different from proximal tubular PCO2. Evaluation of PCO2 in the proximal tubules of Munich-Wistar rats did not reveal evidence for a declining profile for PCO2 along the length of the nephron. When proximal bicarbonate reabsorption was increased or decreased acutely by alterations in acid-base status, deltaPCO2 changed in paralle. Furthermore, benzolamide administration significantly reduced deltaPCO2. We conclude: (a) that the PCO2 in tubular fluid is significantly greater than systemic arterial PCO2, (b) that there is no tendency for the observed PCO2 to fall along the proximal tubule, (c) the mean PCO2 in the proximal and distal tubules as well as the stellate vessle is not significantly different, thereby rendering the concept of a "diffusion barrier" for CO2 in the proximal tubule unlikely, and (d) the level of renal cortical PCO2 appears to vary directly with the magnitude of bicarbonate reabsorption.
(a)H⁺分泌;(b)直接重吸收HCO₃⁻;或(c)这两个过程的结合。大多数支持H⁺分泌理论的研究都假定肾小管液和动脉血PCO₂相等。我们使用一种新的PCO₂微电极,直接测定在对照条件下以及酸碱状态改变后大鼠肾皮质肾小管液和星状血管血液的原位PCO₂。在21只对照大鼠中,近端肾小管液PCO₂超过全身动脉血PCO₂(ΔCO₂)25.9±0.92 mmHg(P<0.001)。远端肾小管液和星状血管血液的测定值与近端肾小管PCO₂无显著差异。对慕尼黑-威斯塔大鼠近端小管PCO₂的评估未发现沿肾单位长度PCO₂呈下降趋势的证据。当通过酸碱状态改变急性增加或减少近端碳酸氢盐重吸收时,ΔPCO₂平行变化。此外,给予苯磺酰胺可显著降低ΔPCO₂。我们得出以下结论:(a)肾小管液中的PCO₂显著高于全身动脉血PCO₂;(b)观察到的PCO₂在近端小管中没有下降趋势;(c)近端和远端小管以及星状血管中的平均PCO₂无显著差异,因此近端小管中存在CO₂“扩散屏障”的概念不太可能成立;(d)肾皮质PCO₂水平似乎与碳酸氢盐重吸收的幅度直接相关。