Greiber S, O'Neill W C, Mitch W E
Division of Nephrology, Emory University School of Medicine, Atlanta, GA, USA.
J Am Soc Nephrol. 1995 Mar;5(9):1689-96. doi: 10.1681/ASN.V591689.
To examine how uremia changes sodium, potassium, and proton transport, thymocytes from chronic renal failure (CRF) rats were studied. If alterations in cation transport associated with chronic uremia (CRF) extend to intracellular pH regulation, the susceptibility to the catabolic effects of acidosis might be increased. To evaluate the influence of acidosis, cation transport in thymocytes from normal rats with NH4Cl-induced acidosis was also studied. Ouabain-sensitive 86Rb influx in thymocytes from acidotic CRF rats was 32% lower than in control cells (P < 0.05), but intracellular sodium concentration was unchanged. This may be related to a 47 +/- 22% reduction in 22Na influx. In thymocytes from nonuremic, acidotic rats, ouabain-sensitive 86Rb influx was decreased 39% (P < 0.025), similar to the change in CRF. In CRF thymocytes, Na(+)-H+ antiporter activity in response to cell acidification (7.13 +/- 0.8 versus 9.42 +/- 0.8 mmol of H+/L per min; CRF versus control), or to osmotic shrinkage (0.43 +/- 0.09 versus 0.82 +/- 0.11 mmol of H+/L per min; CRF versus control), was significantly (P < 0.01) reduced. Buffering capacity at resting and acidic intracellular pH was unchanged by uremia, but Na+/H+ antiporter activity in response to acid loading or osmotic shrinkage was unchanged in thymocytes of nonuremic rats with metabolic acidosis. Thus, CRF reduces both Na/K-ATPase and Na+/H+ antiporter activities in rat thymocytes. The former may be secondary to reduced sodium influx. Impaired Na+/H+ antiporter activity is not caused by metabolic acidosis alone, whereas reduced Na/K-ATPase activity is found in both acidosis and uremia.
为研究尿毒症如何改变钠、钾和质子转运,对慢性肾衰竭(CRF)大鼠的胸腺细胞进行了研究。如果与慢性尿毒症(CRF)相关的阳离子转运改变扩展至细胞内pH调节,那么对酸中毒分解代谢作用的易感性可能会增加。为评估酸中毒的影响,还对氯化铵诱导的酸中毒正常大鼠的胸腺细胞阳离子转运进行了研究。酸中毒CRF大鼠胸腺细胞中哇巴因敏感的⁸⁶Rb内流比对照细胞低32%(P<0.05),但细胞内钠浓度未变。这可能与²²Na内流减少47±22%有关。在非尿毒症酸中毒大鼠的胸腺细胞中,哇巴因敏感的⁸⁶Rb内流降低了39%(P<0.025),与CRF中的变化相似。在CRF胸腺细胞中,响应细胞酸化(7.13±0.8对9.42±0.8 mmol H⁺/L每分钟;CRF对对照)或渗透性收缩(0.43±0.09对0.82±0.11 mmol H⁺/L每分钟;CRF对对照)时,Na⁺-H⁺反向转运体活性显著降低(P<0.01)。尿毒症未改变静息和酸性细胞内pH时的缓冲能力,但在代谢性酸中毒的非尿毒症大鼠胸腺细胞中,响应酸负荷或渗透性收缩时的Na⁺/H⁺反向转运体活性未变。因此,CRF降低了大鼠胸腺细胞中Na/K-ATP酶和Na⁺/H⁺反向转运体的活性。前者可能继发于钠内流减少。Na⁺/H⁺反向转运体活性受损并非仅由代谢性酸中毒引起,而在酸中毒和尿毒症中均发现Na/K-ATP酶活性降低。