Hulter H N, Toto R D, Bonner E L, Ilnicki L P, Sebastian A
Am J Physiol. 1981 Nov;241(5):F495-501. doi: 10.1152/ajprenal.1981.241.5.F495.
MEtabolic alkalosis has been reported in patients with chronic hypoparathyroidism under conditions of uncontrolled diet and medication intake. Hypoparathyroidism has also been reported to result in increased renal bicarbonate reabsorptive capacity in acutely bicarbonate-loaded dogs. However, the acid-base effects of experimentally induced chronic hypoparathyroidism have not been investigated in any species. Accordingly, we investigated the chronic effects of hypoparathyroidism by thyroparathyroidectomy (TPTX) plus thyroxine replacement on renal regulation of plasma acid-base composition under metabolic balance conditions of normal dietary acid load (group I) and alkali load (group II, 9.0 meq/kg HCO3(-) daily) in dogs ingesting a normal Cl-, high Ca2+ diet throughout study. For groups I and II pre-TPTX: [HCO3(-)]p, 19.7 +/- 1.0, 20.1 +/- 0.9 meq/liter. Plasma acid-base composition (days 5-10) was unchanged by TPTX: delta [HCO3(-)]p, -0.7 +/- 0.4, 0.0 +/- 0.2 meq/liter; delta [H+]p, 0 +/- 1, -1 +/- 0 neq/liter, NS from control. A reduction in plasma total calcium concentration ([CaT]p) occurred and persisted (group I: [CaT]p, -1.6 +/- 0.2 mg/100 ml, P less than 0.01, day 1 and -1.2 +/- 0.9, days 5-10; group II: -1.4 +/- 0.3 mg/100 ml, P less than 0.01, day 1 and -2.3 +/- 0.4, days 5-10). No significant change in net acid or Cl- excretion occurred following TPTX. Thus, chronic hypoparathyroidism characterized by a chronic reduction in [CaT]p does not result in significant alterations in renal regulation of plasma acid-base composition in the dog.
据报道,在饮食和药物摄入不受控制的情况下,慢性甲状旁腺功能减退患者会出现代谢性碱中毒。据报道,甲状旁腺功能减退还会导致急性碳酸氢盐负荷的犬类肾脏对碳酸氢盐的重吸收能力增强。然而,尚未在任何物种中研究实验性诱导的慢性甲状旁腺功能减退对酸碱平衡的影响。因此,我们通过甲状旁腺切除术(TPTX)加甲状腺素替代疗法,研究了慢性甲状旁腺功能减退对正常饮食酸负荷(第一组)和碱负荷(第二组,每日9.0 meq/kg HCO3(-))代谢平衡条件下犬类血浆酸碱组成肾脏调节的慢性影响。在整个研究过程中,两组犬均摄入正常Cl-、高Ca2+饮食。对于第一组和第二组TPTX前:[HCO3(-)]p,19.7±1.0,20.1±0.9 meq/升。TPTX后血浆酸碱组成(第5 - 10天)无变化:δ[HCO3(-)]p,-0.7±0.4,0.0±0.2 meq/升;δ[H+]p,0±1,-1±0 neq/升,与对照组相比无统计学意义。血浆总钙浓度([CaT]p)降低并持续存在(第一组:[CaT]p,-1.6±0.2 mg/100 ml,第1天P<0.01,第5 - 10天为-1.2±0.9;第二组:-1.4±0.3 mg/100 ml,第1天P<0.01,第5 - 10天为-2.3±0.4)。TPTX后净酸或Cl-排泄无显著变化。因此,以[CaT]p慢性降低为特征的慢性甲状旁腺功能减退不会导致犬类血浆酸碱组成肾脏调节的显著改变。