Buerkert J, Martin D, Trigg D
J Clin Invest. 1982 Jul;70(1):1-12. doi: 10.1172/jci110581.
Papillary and surface micropuncture was used to assess the effects of a chronic metabolic acidosis on the renal tubular handling of ammonium by surface nephrons, juxtamedullary nephrons, and the terminal segment of collecting duct. Rats chronically fed ammonium chloride had an expected decline in arterial pH and bicarbonate concentration associated with a doubling in the amount of ammonium excreted and a decline in urine pH. The glomerular filtration rate and absolute delivery of water and sodium to micropuncture sites of surface and deep nephrons was not measurably altered. Ammonium delivery to the end of the proximal tubule increased from 853+/-102% to 1,197+/-142% (SE) of the filtered load of ammonium after the induction of metabolic acidosis. This increase was due to a rise in tubular fluid ammonium content from 2.31+/-0.23 to 4.06+/-0.28 mM/liter. After the induction of acidosis, absolute and fractional delivery of ammonium ion to the end of the distal tubule was less than to the end of the accessible portion of the proximal tubule. These findings indicate that ammonium is lost in the intervening segment.Ammonium handling by deep nephrons was profoundly affected by acid loading. Absolute delivery to the bend of the loop of Henle increased twofold while fractional delivery rose from 1,222+/-108% to 1,780+/-132% of the filtered ammonium. This was due to a marked increase in ammonia entry. During acidosis, ammonium delivery to the terminal segment of the collecting duct was doubled (709+/-137% in controls vs. 1,415+/-150% in acidosis, P < 0.005) but did not change between proximal and tip collecting duct sites. In both groups of animals delivery of ammonium to the terminal segment of the collecting duct was greater than to end distal tubular micropuncture sites suggesting that ammonia entry occurred between these two sites. The differences in delivery was greater after the induction of a metabolic acidosis (887+/-140% vs. 384+/-144%, P < 0.05). Thus, the present study indicates that deep nephrons contribute to the adaptive increase in ammonium excretion seen during the induction of metabolic acidosis. The data also suggest that ammonia leaves the nephrons at a site(s) along the loop of Henle to enter the collecting duct and that the induction of a metabolic acidosis enhances this reentry.
采用乳头及表面微穿刺法,评估慢性代谢性酸中毒对表层肾单位、近髓肾单位及集合管终末段肾小管铵处理的影响。长期喂食氯化铵的大鼠,动脉血pH值和碳酸氢盐浓度出现预期下降,同时铵排泄量翻倍,尿pH值下降。肾小球滤过率以及水和钠向表层及深层肾单位微穿刺部位的绝对输送量未出现可测量的改变。代谢性酸中毒诱导后,近端小管末端的铵输送量从滤过铵负荷的853±102%增加至1197±142%(标准误)。这种增加是由于肾小管液铵含量从2.31±0.23毫摩尔/升升至4.06±0.28毫摩尔/升。酸中毒诱导后,铵离子向远端小管末端的绝对输送量和分数输送量均低于向近端小管可及部分末端的输送量。这些发现表明,铵在中间段丢失。酸负荷对深层肾单位的铵处理有深远影响。向髓袢降支粗段的绝对输送量增加两倍,而分数输送量从滤过铵的1222±108%升至1780±132%。这是由于氨进入量显著增加。在酸中毒期间,向集合管终末段的铵输送量翻倍(对照组为709±137%,酸中毒组为1415±150%,P<0.005),但在近端集合管和集合管顶端部位之间没有变化。在两组动物中,向集合管终末段的铵输送量均大于向远端小管末端微穿刺部位的输送量,提示氨在这两个部位之间进入。代谢性酸中毒诱导后,输送量的差异更大(887±140%对384±144%,P<0.05)。因此,本研究表明,深层肾单位促成了代谢性酸中毒诱导期间铵排泄的适应性增加。数据还提示,氨在髓袢的某个部位离开肾单位进入集合管,且代谢性酸中毒的诱导增强了这种再进入。