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患有实验性肾病的犬的碳酸氢盐重吸收

Bicarbonate reabsorption in the dog with experimental renal disease.

作者信息

Schmidt R W, Bricker N S, Gavellas G

出版信息

Kidney Int. 1976 Oct;10(4):287-94. doi: 10.1038/ki.1976.111.

Abstract

Renal bicarbonate reabsorption (expressed per unit of glomerular filtration rate, GFR) has been reported to be diminished in uremic man and uremic rats. Both the increases in parathyroid hormone concentrations and in natriuretic forces have been considered to play a role in this change. The increased kaliuresis per nephron observed in chronic uremia could theoretically also contribute to inhibition of bicarbonate reabsorption. Despite the common use of normal dogs in studying bicarbonate reabsorption and of uremic dogs in studying alterations of renal function in disease, few studies of bicarbonate reabsorption in uremic dogs have been performed. In the present studies we have examined bicarbonate reabsorption in normal dogs and in dogs with experimental renal disease using a conventional bicarbonate titration technique. In unanesthetized normal dogs, the threshold for bicarbonaturia was 24.8 mEq/liter of GFR. A maximal reabsorptive rate (Tm/GFR) of 34.0 mEq/liter of GFR was obtained. In a second group of dogs, GFR was decreased to one-fifth normal. FENa was increased 16.9-fold over normal values: UKV/100 GFR and FEP were increased 5.8-fold and 10.9-fold, respectively. The threshold for bicarbonaturia in these dogs was increased to 30.5 mEq/liter of GFR and the maximal reabsorptive rate was increased to 41.2 mEq/liter of GFR. Thus, the capacity to reabsorb bicarbonate was increased despite the presence of high fractional excretion rates for sodium, potassium and phosphate. This increased reabsorptive capacity could not be accounted for by the effects of other known determinants of bicarbonate reabsorption.

摘要

据报道,尿毒症患者和尿毒症大鼠的肾脏重吸收碳酸氢盐(以单位肾小球滤过率,即GFR表示)减少。甲状旁腺激素浓度升高和利钠作用增强都被认为与这种变化有关。理论上,慢性尿毒症中每个肾单位的尿钾排泄增加也可能导致碳酸氢盐重吸收受到抑制。尽管在研究碳酸氢盐重吸收时常用正常狗,在研究疾病中肾功能改变时常用尿毒症狗,但对尿毒症狗的碳酸氢盐重吸收的研究却很少。在本研究中,我们使用传统的碳酸氢盐滴定技术检测了正常狗和实验性肾病狗的碳酸氢盐重吸收情况。在未麻醉的正常狗中,出现碳酸氢盐尿的阈值为每升GFR 24.8毫当量。获得的最大重吸收率(Tm/GFR)为每升GFR 34.0毫当量。在第二组狗中,GFR降至正常的五分之一。滤过钠排泄分数(FENa)比正常值增加了16.9倍;尿钾排泄量与100GFR的比值(UKV/100GFR)和滤过磷排泄分数(FEP)分别增加了5.8倍和10.9倍。这些狗出现碳酸氢盐尿的阈值增加到每升GFR 30.5毫当量,最大重吸收率增加到每升GFR 41.2毫当量。因此,尽管钠、钾和磷的排泄分数较高,但重吸收碳酸氢盐的能力仍有所增加。这种增加的重吸收能力无法用其他已知的碳酸氢盐重吸收决定因素的作用来解释。

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