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碳酸氢盐负荷期间的肾脏碳酸氢盐重吸收

Renal bicarbonate reabsorption during bicarbonate loading.

作者信息

Monclair T, Mathisen O, Kiil F

出版信息

Kidney Int. 1980 May;17(5):577-85. doi: 10.1038/ki.1980.68.

Abstract

To examine bicarbonate reabsorption at different GFR's, we varied the renal perfusion pressure in anesthetized dogs after inhibiting autoregulation by expanding extracellular volume and infusing ethacrynic acid. At a plasma bicarbonate concentration (PHCO3) of 28 +/- 1 mM, bicarbonate reabsorption varied in proportion to GFR (glomerulotubular balance). When PHCO3 was raised to 52 +/- 2 mM at constant PCO2 and hematocrit, bicarbonate reabsorption was reduced at all levels of filtered load. When plotted against GFR, different results were obtained dependent on the GFR level examined. At the control GFR,. bicarbonate loading reduced bicarbonate reabsorption by 30 +/- 5%. At a GFR level about 50% below the control GFR, bicarbonate loading increased reabsorption by about one third because the inhibitory effect of raising PHCO3 and extracellular pH was not sufficient to counteract the stimulatory effect of a higher filtered load. At intermediate levels of GFR, a rise in PHCO3 did not alter bicarbonate reabsorption. The finding that acetazolamide (30 mg/kg of body wt) at high PHCO3 failed to reduce bicarbonate reabsorption supports the hypothesis that the depressive effect of high extracellular pH on bicarbonate reabsorption may be attributed to reduced net tubular hydrogen ion secretion.

摘要

为了研究不同肾小球滤过率(GFR)下的碳酸氢盐重吸收情况,我们在麻醉犬身上通过扩充细胞外液量和输注依他尼酸抑制自身调节后,改变肾灌注压。在血浆碳酸氢盐浓度(PHCO3)为28±1 mM时,碳酸氢盐重吸收与GFR成比例变化(球管平衡)。当在恒定的PCO2和血细胞比容条件下将PHCO3提高到52±2 mM时,在所有滤过负荷水平下碳酸氢盐重吸收均降低。当以GFR为横坐标作图时,根据所检测的GFR水平获得了不同的结果。在对照GFR时,碳酸氢盐负荷使碳酸氢盐重吸收降低了30±5%。在比对照GFR低约50%的GFR水平时,碳酸氢盐负荷使重吸收增加了约三分之一,因为提高PHCO3和细胞外pH的抑制作用不足以抵消较高滤过负荷的刺激作用。在中等GFR水平时,PHCO3升高并未改变碳酸氢盐重吸收。在高PHCO3时乙酰唑胺(30 mg/kg体重)未能降低碳酸氢盐重吸收这一发现支持了以下假说,即细胞外高pH对碳酸氢盐重吸收的抑制作用可能归因于肾小管净氢离子分泌减少。

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