Levine D Z, Nash L A, Chan T, Dubrovskis A H
J Clin Invest. 1976 Jun;57(6):1490-7. doi: 10.1172/JCI108419.
Several studies have clearly shown that extracellular volume expansion is associated with suppression of whole kidney bicarbonate reabsorption, although little is known concerning the single nephron correlates of this response. More recently, attention has also been focussed on bicarbonate transport in attempts to identify a possible role for this ion in enhancing the rate of net fluid efflux by proximal tubules. To further explore proximal tubular bicarbonate handling in the rat, we carried out recollection micropuncture studies to assess the effects of infusions of modified Ringer or salt-poor hyperoncotic human albumin. With stable levels of arterial PCO2, plasma [HCO3-] or plasma [K+], marked suppression of fractional HCO3- reabsorption occurred: during Ringer infusion fractional reabsorption fell by 31% (P less than 0.001) while during albumin infusion a decrease of 20% (P less than 0.001) was observed. Despite this, absolute net HCO3- reabsorptive rates did not change significantly. Simple and partial correlation analysis of single tubular responses revealed strong linkage effects between changes in absolute net reabsorptive rates for HCO3- and H2O in both types of infusion; the partial r was 0.91 (P less than 0.001) and 0.94 (P less than 0.001) during Ringer and albumin infusions, respectively. We conclude that under these free-flow conditions, Ringer and albumin infusions do not suppress absolute net HCO3- reabsorption by proximal tubules, and that strongly linked changes in absolute HCO3- and H2O fluxes are characteristic of both protocols.
多项研究已明确表明,细胞外液量扩张与全肾碳酸氢盐重吸收受抑制有关,尽管对于该反应单个肾单位的相关情况知之甚少。最近,人们也将注意力集中在碳酸氢盐转运上,试图确定该离子在提高近端小管净液体流出速率方面可能发挥的作用。为了进一步探究大鼠近端小管对碳酸氢盐的处理情况,我们进行了回收微穿刺研究,以评估输注改良林格液或低钠高渗人白蛋白的影响。在动脉血二氧化碳分压、血浆[HCO₃⁻]或血浆[K⁺]水平稳定的情况下,出现了显著的碳酸氢盐分数重吸收抑制:输注林格液期间,分数重吸收下降了31%(P<0.001),而输注白蛋白期间,观察到下降了20%(P<0.001)。尽管如此,绝对净碳酸氢盐重吸收率并未显著改变。对单个肾小管反应进行的简单和偏相关分析显示,在两种输注类型中,碳酸氢盐和水的绝对净重吸收率变化之间存在强烈的连锁效应;输注林格液和白蛋白期间,偏相关系数r分别为0.91(P<0.001)和0.94(P<0.001)。我们得出结论,在这些自由流动条件下,输注林格液和白蛋白不会抑制近端小管的绝对净碳酸氢盐重吸收,并且绝对碳酸氢盐和水通量的强烈相关变化是两种方案的特征。