Norman Bank

Effect of acute hypertension on sodium reabsorption by the proximal tubule

The effect of acute hypertension on sodium reabsorption by the proximal tubule was studied in rats by means of micropuncture methods. Hypertension was induced by bilateral carotid artery ligation and cervical vagotomy. Within a few minutes after blood pressure rose (30-60 mm Hg above control levels), a moderate natriuresis and diuresis began. Proximal sodium reabsorption, measured by two independent methods, was found to be markedly suppressed, both in absolute amount per unit length and per unit of tubular volume (C/pir(2)). The ratio between tubular volume and glomerular filtration rate (GFR) (pir(2)d/V(0)) was found to be increased. These observations indicate that the inhibition of proximal sodium reabsorption induced by hypertension cannot be explained by the tubular geometry hypothesis of sodium regulation. Several possible hormonal mechanisms were investigated. Intravenous d-aldosterone did not prevent the suppression of sodium transport due to acute hypertension, nor did chronic oral saline loading to reduce the renal content of renin. Constriction of the suprarenal aorta, with maintenance of a normal renal perfusion pressure, did prevent the inhibition of proximal transport during carotid artery occlusion, thus excluding an extrarenally produced natriuretic hormone as the mechanism. The observations are compatible with the view that sodium transport was inhibited either by an intrarenal natriuretic hormone or by an increase in the interstitial volume of the kidney produced by a transient hydrostatic pressure gradient across the peritubular capillaries. The latter seems more likely to us because of the rapidity of onset of the natriuresis, and because removing the renal capsule and releasing the surface interstitial fluid prevented the effect of hypertension on proximal sodium transport.

A Micropuncture Study of Postobstructive Diuresis in the Rat

In order to investigate the syndrome of postobstructive diuresis, clearance and micropuncture studies were carried out in rats after relief of 24 hr of bilateral (BUL) or unilateral (UUL) ureteral ligation. In rats with BUL, a striking diuresis and natriuresis occurred when the obstruction to one kidney (the experimental kidney) was relieved. The results were not influenced by administration of vasopressin or d-aldosterone. Whole kidney clearances of inulin and p-aminohippuric acid (PAH) in the experimental kidney were reduced to 10% and 20% of normal, respectively. Superficial nephron inulin and PAH clearances were also reduced, but only to 40% and 45%, respectively. These findings suggest a heterogeneity of nephron function in which deep nephrons were functioning poorly or not at all. To investigate the site of impaired tubular reabsorption in the surface nephrons, absolute and fractional water reabsorption was measured. Absolute reabsorption was found to be decreased all along the nephron. Fractional reabsorption in proximal tubules was normal, as indicated by an average endproximal tubular fluid per plasma inulin (TF/P(In)) of 2.16 vs. 2.30 in controls. TF/P(In) was markedly decreased in distal tubules (2.91 vs. 8.02) and final urine (5.56 vs. 263). These observations indicate that the major sites of impaired sodium reabsorption leading to the diuresis were beyond the proximal tubule.Rats with 24 hr of UUL did not demonstrate a comparable natriuresis or diuresis either spontaneously when the obstruction was relieved or after i.v. infusion of urea. A major difference between the BUL and UUL rats was that prerelease intrarenal hydrostatic pressure was markedly elevated (30.1 mm Hg) in the former but was below normal free-flow values (9.2 mm Hg) in the latter. Thus, elevation of intrarenal pressure during the period of obstruction may be causally related to the natriuresis and diuresis which occurs after the obstruction is relieved.

The effect of glutamine administration on urinary ammonium excretion in normal subjects and patients with renal disease

The effect of acute changes in the delivery rate of glutamine to the kidney on urinary ammonium excretion was studied in man. Healthy subjects and patients with intrinsic renal disease were studied under three different acid-base conditions: unaltered acid-base balance; NH(4)Cl-induced acidosis; and NaHCO(3)-induced alkalosis. Anhydrous L-glutamine was administered orally in a single dose of 260 mmoles during each of these three acid-base states. We found that endogenous venous plasma glutamine concentration fell during acidosis and rose during alkalosis in both healthy subjects and patients with renal disease. In healthy subjects, orally administered glutamine raised plasma glutamine concentration markedly over a 2-3 hr period. This was accompanied by an increase in urinary ammonium excretion and a rise in urine pH under normal acid-base conditions and during metabolic acidosis. No increase in ammonium excretion occurred when glutamine was administered during metabolic alkalosis in spite of an equivalent rise in plasma glutamine concentration. In patients with renal disease, endogenous venous plasma glutamine concentration was lower than in healthy subjects, perhaps as a result of mild metabolic acidosis. Acute oral glutamine loading failed to increase urinary ammonium excretion significantly during either unaltered acid-base conditions or after NH(4)Cl-induced acidosis, even though plasma glutamine rose as high as in healthy subjects. We conclude from these observations that glutamine delivery to the kidney is a rate-limiting factor for ammonium excretion in healthy subjects, both before and after cellular enzyme adaptation induced by metabolic acidosis. In contrast, in patients with renal disease, glutamine delivery is not rate-limiting for ammonium excretion. Presumably other factors, such as surviving renal mass and the activity of intracellular enzymes necessary for ammonia synthesis limit ammonium excretion in these patients.

A Micropuncture Study of Potassium Excretion by the Remnant Kidney

In order to study the mechanism of enhanced potassium excretion by the remaining nephrons of the remnant kidney, micropuncture and clearance experiments were carried out in rats after surgical ablation of 3/4 of the total renal mass. The potassium intake in all animals was approximately 5 meq/day. Animals were studied 24 h and 10-14 days after 3/4 nephrectomy. Balance measurements in the chronic animals before micropuncture study indicated that 24 h K(+) excretion by the remnant kidney was equal to that of the two kidneys before ablation of renal mass. Measurements of distal tubular inulin and potassium concentrations revealed progressive reabsorption of potassium in this segment of the nephron in both the 24-h and chronic 3/4-nephrectomized rats, as well as in normal control rats. A large increase in tubular fluid potassium content occurred between the end of the distal tubule and the final urine in the 3/4-nephrectomized rats, but not in the normal controls. These observations suggest that the segment of the nephron responsible for enhanced potassium excretion by remaining nephrons was the collecting duct. In additional experiments, potassium was completely eliminated from the diet of chronic 3/4-nephrectomized rats before micropuncture study. In these animals, no addition of K(+) occurred beyond the distal tubules. Normal rats infused with 0.15 M KCl to acutely elevate serum K(+) concentration, demonstrated reabsorption of K(+) in the distal tubule and a large addition of K(+) to the urine beyond the distal tubule. We conclude that the collecting duct is the major site of regulation of urinary potassium excretion in normal rats and is responsible for the adaptation to nephron loss by the remnant kidney.

A micropuncture study of renal salt and water retention in chronic bile duct obstruction.

The mechanism of sodium retention by the kidney in rats with ligation of the common bile duct was studied with micropuncture techniques. 10-14 days after bile duct ligation, rats showed positive sodium balance and ascites formation. Measurements of renal blood flow and glomerular filtration rate yielded values that were not different from those in normal control animals. Likewise, single nephron filtration rte of surface nephrons was the same in the experimental rats as in the controls. Sodium reabsorption, however, was markedly increased in the proximal convoluted tubule, as well as in segments beyond the proximal convolutions. Single nephron filtration fraction, calculated from measurements of efferent arteriolar and arterial hematocrits, was significantly elevated in the cortical nephrons, even though whole kidney filtration fraction was the same as in normal rats. The calculated protein concentration of cortical peritubular blood was higher in the bile duct-ligated rats than in the normal controls. The observations are consistent with the view that sodium retention is the result of enhanced reabsorption primarily by cortical nephrons. The enhanced reabsorption can be accounted for by relative cortical ischemia due to efferent arteriolar vasoconstriction with the consequent elevation of peritubular colloid oncotic pressure.

A Microperfusion Study of Phosphate Reabsorption by the Rat Proximal Renal Tubule EFFECT OF PARATHYROID HORMONE

To study the mechanism of phsophate reabsorption by the proximal tubule and the effect of parathyroid hormone (PTH), microperfusion experiments were carried out in rats. Segments of proximal tubule isolated by oil blocks were perfused in vivo with one of three solutions, each containing 152 meq/liter Na(+) and 2 mmol/liter phosphate, but otherwise differing in composition. The pH of solution 1 was 6.05-6.63, indicating that 60-85% of the phosphate was in the form of H(2)PO(4) (-). The pH of solution 2 was 7.56-7.85, and 85-92% of the phosphate was in the form of HPO(4) (=). Solution 3 contained HCO(3) (-) and glucose and had a pH of 7.50-7.65. When the proximal tubules were perfused with solution 1, the (32)P concentration in the collected perfusate was found to be consistently lower than in the initial perfusion solution. In sharp contrast, when the tubules were perfused with solutions 2 or 3, (32)P concentration usually rose above that in the initial solution. Water (and persumably Na(+)) reabsorption, as measured with [(3)H]inulin, was the same with the acid and alkaline solutions. Administration of partially purified PTH clearly prevented the fall in phosphate concentration with the acid solution, but had a less discernible effect on phosphate reabsorption with the two alkaline solutions. Measurements of pH within the perfused segments with antimony microelectrodes demonstrated that PTH enhanced alkalinization of the acid perfusion solution. The findings are consistent with the view that H(2)PO(4) (-) is reabsorbed preferentially over HPO(4) (=). This can be attributed to either an active transport mechanism for H(2)PO(4) (-) or selective membrane permeability to this anion. PTH appears to either inhibit an active transport process for H(2)PO(4) (-), or to interfere with passive diffusion of phosphate by alkalinizing the tubular lumen.

Effect of changes in renal perfusion pressure on the suppression of proximal tubular sodium reabsorption due to saline loading

Rapid intravenous infusion of saline is known to suppress reabsorption of sodium and water in the proximal tubule. It has previously been shown that this suppression is accompanied by two changes which in combination might account for the over-all decrease in reabsorption: a reduction in the intrinsic reabsorptive capacity of the tubular epithelium (C/pir(2)) and a reduction in the ratio between tubular volume and GFR (pir(2)d/V(o)). The present micropuncture experiments were carried out in order to study the possible role of altered peritubular physical forces (hydrostatic and colloid oncotic pressure) in mediating these two changes. Proximal tubular reabsorptive capacity, transit time, fractional reabsorption of sodium and water, pir(2)d/V(o), and intratubular hydrostatic pressure were measured in saline-loaded rats during acute changes in renal perfusion pressure induced by intermittent constriction of the abdominal aorta. We found that when renal perfusion pressure was lowered to 70-90 mm Hg, the usual effects of saline loading on C/pir(2), pir(2)d/V(o), and fractional reabsorption in the proximal tubule were greatly minimized. When the aortic clamp was released and renal perfusion pressure allowed to rise, C/pir(2), pir(2)d/V(o), and fractional reabsorption fell markedly to levels characteristically seen in saline diuresis. Reclamping of the aorta reversed all of these changes. In order to determine whether the changes in C/pir(2) accompanying changes in renal perfusion pressure were mediated by a circulating natriuretic hormone, we assayed in hydopenic rats the dialysate of plasma collected from saline-loaded rats during and after release of aortic constriction by the split oil drop method. No significant difference in reabsorptive half-time (t(1/2)) was found between the two dialysates, and t(1/2) with both dialysates was approximately the same as was found when isotonic saline was injected in the tubules of hydropenic control animals. These observations suggest that the large changes in C/pir(2) which occurred with changes in renal perfusion pressure in saline-loaded rats were not mediated by a circulating hormone. We suggest that the reduction in C/pir(2), pir(2)d/V(o), and fractional reabsorption which occurs in the proximal tubule during a saline diuresis is related to the rise in hydrostatic pressure within the kidney.

A microperfusion study of sucrose movement across the rat proximal tubule during renal vein constriction

Constriction of the renal vein has been shown to inhibit net sodium and water reabsorption by the rat proximal tubule. The mechanism is unknown but might be the result of inhibition of the active sodium pump induced by changes in the interstitial fluid compartment of the kidney, or to enhanced passive backflux of sodium and water into the cell or directly into the tubular lumen. Since passive movement of solutes across epithelial membranes is determined in part by the permeability characteristics of the epithelium, an increase in the permeability of the proximal tubule during venous constriction would suggest that enhanced passive flux is involved in the inhibition of reabsorption. In the present experiments, isolated segments of rat proximal convoluted tubules were microperfused in vivo with saline while the animals were receiving (14)C-labeled sucrose intravenously. In normal control animals, no sucrose was detected in the majority of the collected tubular perfusates. In rats with renal vein constriction (RVC), however, sucrose consistently appeared in the tubular perfusates. The rate of inflow of sucrose correlated with the length of the perfused segment, estimated by fractional water reabsorption. In another group of animals with renal vein constriction, inulin-(14)C was given intravenously and the proximal tubules similarly microperfused. Inulin did not appear in the majority of collected perfusates in these animals. These observations indicate that a physiological alteration in the permeability of the proximal tubule occurs during RVC. Such an increase in permeability is consistent with the view that enhanced passive extracellular back-flux plays a role in the reduction of net sodium and water reabsorption in this experimental condition.

A Microperfusion Study of Bicarbonate Accumulation in the Proximal Tubule of the Rat Kidney

In order to determine whether HCO(3) (-) gains access to the proximal tubular lumen from a source other than the glomerular filtrate, we carried out microperfusion experiments on isolated segments of rat proximal tubules in vivo. The perfusion fluid was essentially free of HCO(3) (-) and of a composition that prevented net absorption of sodium and water.It was found that when plasma HCO(3) (-) concentration and CO(2) tension (PCO(2)) were normal, the HCO(3) (-) concentration in the collected perfusate rose to about 3 mEq per L. Inhibition of renal carbonic anhydrase did not produce an appreciable change in this value in normal rats, but when the enzyme was inhibited in acutely alkalotic rats, a mean concentration of 15 mEq per L was recovered in the perfusate. Addition of HCO(3) (-) to the tubular lumen might occur by either intraluminal generation of HCO(3) (-) from CO(2) and OH(-) or by influx of ionic bicarbonate from the plasma or tubular cells. Because of the marked increase in HCO(3) (-) found when intraluminal carbonic anhydrase was inhibited, generation of new HCO(3) (-) from CO(2) and OH(-) seems unlikely. We conclude, therefore, that influx of ionic bicarbonate occurred, either across the luminal membrane or through extracellular aqueous channels. These observations suggest that the proximal epithelium has a finite degree of permeability to HCO(3) (-) and that influx of this ion may be a component of the over-all handling of HCO(3) (-) by the kidney.