Stein J H, Osgood R W, Kunau R T
J Clin Invest. 1976 Oct;58(4):767-73. doi: 10.1172/JCI108527.
It has been suggested that collecting duct sodium transport was inhibited by extracellular volume expansion. To directly evaluate this possibility, micropuncture of the papillary collecting duct of young rats was performed during hydropenia and Ringer loading. The possibility of heterogeneity of nephron function was evaluated during Ringer and hyperoncotic albumin loading by comparing the delivery of sodium to the end of the distal tubule of superficial nephrons with papillary base delivery. During hydropenia (n = 14), sodium delivery to the base averaged 0.95% of the filtered sodium load and reabsorption along the collecting duct was noted from base to tip in each collection pair averaging 0.80% of the filtered load. During Ringer loading, sodium delivery to the base was markedly greater than in hydropenia, 11.8 vs. 0.95% of the filtered load (P less than 0.001). Yet, sodium reabsorption was also much greater, 6 vs. 0.8% (P less than 0.001). In 13 paired collections, during Ringer loading, sodium delivery to the papillary base, 12.2% of the filtered load, was consistently greater than late distal tubular delivery from superficial nephrons. 8% (P less than 0.005). In contrast, reabsorption of sodium from late distal tubule to papillary base was found during albumin infusion, 6.2 vs. 3.1% (P less than 0.001). Therefore, these studies demonstrate that: (a) the delivery of sodium to and reabsorption along the papillary collecting duct were markedly greater during Ringer loading than in hydropenia; (b) the amount of sodium delivered to the papillary base was greater than the delivery to the end of the distal tubule of superficial nephrons during Ringer loading, suggesting that deeper nephrons deliver more sodium to the collecting duct in this setting; and (c) the difference in sodium excretion between Ringer loading and hyperoncotic albumin infusion is due to events occurring between the late distal tubule of superficial nephrons and the base of the papillary collecting duct.
有人提出,细胞外液量扩张会抑制集合管钠转运。为了直接评估这种可能性,在缺水和输注林格液期间对幼鼠乳头集合管进行了微穿刺。通过比较浅表肾单位远端小管末端的钠输送量与乳头基部的钠输送量,评估了在输注林格液和高渗白蛋白期间肾单位功能异质性的可能性。在缺水期间(n = 14),输送到乳头基部的钠平均为滤过钠负荷的0.95%,并且在每个收集对中,沿集合管从基部到尖端的重吸收量平均为滤过负荷的0.80%。在输注林格液期间,输送到乳头基部的钠明显高于缺水时,分别为滤过负荷的11.8%和0.95%(P < 0.001)。然而,钠重吸收也明显增加,分别为6%和0.8%(P < 0.001)。在13对收集样本中,在输注林格液期间,输送到乳头基部的钠为滤过负荷的12.2%,始终高于浅表肾单位远端小管后期的输送量,即8%(P < 0.005)。相反,在输注白蛋白期间,发现从远端小管后期到乳头基部有钠重吸收,分别为6.2%和3.1%(P < 0.001)。因此,这些研究表明:(a)在输注林格液期间,输送到乳头集合管并沿其重吸收的钠明显多于缺水时;(b)在输注林格液期间,输送到乳头基部的钠量大于浅表肾单位远端小管末端的输送量,这表明在这种情况下,更深层的肾单位向集合管输送更多的钠;(c)输注林格液和高渗白蛋白之间钠排泄的差异是由于浅表肾单位远端小管后期与乳头集合管基部之间发生的事件所致。