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氨基酸输注和肾衰竭对犬肾氨基酸摄取与释放的影响。

Effects of amino acid infusion and renal failure on the uptake and release of amino acids by the dog kidney.

作者信息

Kopple J D, Fukuda S

出版信息

Am J Clin Nutr. 1980 Jul;33(7):1363-72. doi: 10.1093/ajcn/33.7.1363.

Abstract

Net production and utilization (Qmet) of amino acids and ammonia were assessed in the left kidney of 11 normal and eight chronically uremic female dogs. Studies were conducted at the end of two 120-min infusions, first with half-normal saline and then with amino acids which increased plasma concentrations to postprandial levels. In the normal dogs, Qmet for a number of amino acids and ammonia was significantly positive (i.e., net production) or negative (i.e., net utilization). Qmet became more negative with the amino acid infusion. In the uremic dogs, Qmet for amino acids and ammonia was qualitatively similar to normal and tended to change in the same direction with the amino acid infusion. Although the absolute values for Qmet were usually less in the uremic dogs, with the amino acid infusion their mean fractional Qmet (Qmet/creatinine clearance) was often greater. A substantial proportion of the infused amino acids was removed by the kidney) in both groups of dogs. In the uremic dogs, there was evidence for preservation of glomerular-tubular balance between the filtered load of amino acids and tubular reabsorption. Data also suggest that the kidney may release sufficient quantities of certain amino acids into renal venous blood (e.g., serine) to affect the plasma levels. These findings indicate that the dog kidney may make an important contribution to total synthesis or metabolism of certain amino acids by the body and may also affect plasma concentrations of some amino acids. During amino acid infusion, the kidney plays a major role in removal of the added amino acids. In renal failure these functions are decreased, but compared to the fall in glomerular filtration rate, they are relatively well preerved.

摘要

在11只正常雌性犬和8只慢性尿毒症雌性犬的左肾中评估了氨基酸和氨的净生成及利用情况(Qmet)。研究在两次120分钟输注结束时进行,首先输注半生理盐水,然后输注氨基酸,使血浆浓度升至餐后水平。在正常犬中,多种氨基酸和氨的Qmet显著为正(即净生成)或为负(即净利用)。氨基酸输注后,Qmet变得更负。在尿毒症犬中,氨基酸和氨的Qmet在性质上与正常犬相似,且随着氨基酸输注往往朝相同方向变化。尽管尿毒症犬中Qmet的绝对值通常较小,但氨基酸输注后其平均分数Qmet(Qmet/肌酐清除率)往往更大。两组犬中,相当一部分输注的氨基酸被肾脏清除。在尿毒症犬中,有证据表明氨基酸滤过负荷与肾小管重吸收之间存在肾小球-肾小管平衡。数据还表明,肾脏可能向肾静脉血中释放足够量的某些氨基酸(如丝氨酸)以影响血浆水平。这些发现表明,犬肾可能对机体某些氨基酸的总合成或代谢做出重要贡献,也可能影响某些氨基酸的血浆浓度。在氨基酸输注期间,肾脏在清除额外氨基酸方面起主要作用。在肾衰竭时,这些功能会降低,但与肾小球滤过率的下降相比,它们相对保留较好。

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