Proximal HCO3 Research Articles

Loss of Kir5.1 disturbs acid-base homeostasis in Dahl salt-sensitive rats

Renal basolateral inwardly-rectifying potassium (K ir ) channels contribute to the maintenance of the resting membrane potential and potassium homeostasis. Heteromeric K ir 4.1/K ir 5.1 channels are more sensitive to intracellular acidification than homomeric K ir 4.1 channels. Our previous study demonstrated that genetic mutation of Kcnj16 (the gene encodes K ir 5.1) causes chronic metabolic acidosis with lower blood pH and bicarbonate levels in Dalh salt-sensitive (SS) rats. Here, we aim to investigate the underlying mechanisms. We hypothesized that loss of K ir 5.1 disturbs acid-base homeostasis in SS rats by impairing ammoniagenesis in the proximal tubule and HCO3 - reabsorption in the distal convoluted tubule (DCT).12-week-old male SS WT and SS Kcnj16-/- rats were separated into two groups (N=5 per group). At the end of the experiment, kidneys were flushed and processed for blood pH and Western blot analysis.Western blot analysis indicated that knock out of K ir 5.1 causes lower expression of sodium-coupled neutral amino acid transporter 3 (SNAT3), which may indicate defective ammoniagenesis in the proximal tubule. On the other hand, increased expression of NBCe1 and NHE3 suggests enhanced HCO3 - reabsorption and H + excretion. Additionally, the expression of vacuolar ATPase (V-ATPase), which is a proton pump responsible for controlling the intracellular and extracellular pH of cells, remained the same. In the following experiments, we will further investigate the ammoniagensis in the proximal tubule as well as key bicarbonate transporters in DCT and collecting duct. Funding sources: National Institute of Health Grants R35 HL135749 (to AS), Department of Veterans Affairs grant I01 BX004024 (to AS). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Indirect evidence for cholinergic inhibition of intestinal bicarbonate absorption in humans

BACKGROUNDThe aim of the study was to test the hypothesis that in the fasting state, proximal intestinal HCO3− absorption, which depends on villus Na+/H+ exchanger activity, is tonically inhibited by...

Effect of acute increases in filtered [formula omitted] on renal hydrogen transporters: II. H+-ATPase

Adaptive increases in renal bicarbonate reabsorption occur in response to acute increases in filtered bicarbonate (FLHCO3). In a previous study, we showed that an increase in FLHCO3 induced by plasma volume expansion increased the Vmax for Na+/H+ exchange activity in renal cortical brush border membrane vesicles (BBMV), providing a potential mechanism for the adaptive increase in HCO3- reabsorption. The present studies were undertaken to determine whether the increase in FLHCO3 induced by plasma expansion also stimulates the other major H+ transporter in cortical BBMV, the H(+)-ATPase. H(+)-ATPase activity was assessed in BBMV obtained from hydropenic and plasma expanded Munich-Wistar rats, using a NADH-linked ATPase assay. H(+)-ATPase activity was measured as the ouabain and oligomycin-insensitive, bafilomycin A1-sensitive component of total ATPase activity. Acute plasma expansion doubled single nephron FLHCO3, and this change was associated with a 64% increase in the Vmax for H(+)-ATPase activity, with no change in apparent Km. The Vmax for H(+)-ATPase activity correlated directly with whole kidney GFR and FLHCO3 (r = 0.68 and 0.72, respectively), and with single nephron GFR and FLHCO3 (r = 0.76 and 0.80, respectively). Thus, the mechanism for the adaptive increase in proximal tubular HCO3- reabsorption that occurs in response to acute increases in FLHCO3 appears to be related to increased activity of both H(+)-ATPase and Na+/H+ exchange in the apical membrane of the proximal tubule epithelium.

Regulation of the renal Na-HCO3 cotransporter: V. Mechanism of the inhibitory effect of parathyroid hormone

PTH administration decreases proximal HCO3 reabsorption and inhibits the brush border Na-H antiporter. We studied the effect of PTH on the renal Na-HCO3 cotransporter and examined whether this effect is mediated through the adenylate cyclase/cyclic AMP system or through the phospholipase A pathway. We studied the effect of PTH [1-34] on the Na-HCO3 cotransporter activity in rabbit renal basolateral membranes incubated with 50 microM ATP by measuring the 22Na uptake in the presence of HCO3 and gluconate. Na-HCO3 cotransporter activity (expressed in nmol/mg protein/3 seconds) was taken as the difference in 22Na uptake in the presence of HCO3 and gluconate. PTH (10(-10) M) completely inhibited Na-HCO3 cotransporter activity from 1.23 +/- 0.14 to -0.58 +/- 0.23, P < 0.001. This effect of PTH to inhibit the Na-HCO3 cotransporter was prevented by the polyclonal antibody against G alpha s indicating that PTH acts through G alpha s protein. Because G alpha s stimulates adenylate cyclase/cyclic AMP system, we examined the effect of PTH in the presence and in the absence of the adenylate cyclase inhibitor, dideoxyadenosine (DDA). DDA alone (10(-4) M) stimulated the Na-HCO3 cotransporter activity. In the presence of DDA, the net inhibitory effect of PTH was the same magnitude as that of control, suggesting the existence of other pathways for the effect of PTH on the cotransporter. Calmodulin inhibition also partially prevented the effect of PTH. To determine whether the inhibitory effect of PTH is mediated at least in part, through phospholipase A, we first examined the effect of PTH on arachidonic acid release and then measured the Na-HCO3 cotransporter activity in presence and in absence of arachidonic acid or eicosatetraynoic acid (ETA), an inhibitor of arachidonic acid metabolism. PTH significantly increased the release of arachidonic acid by isolated proximal tubule cells and arachidonic acid inhibited the Na-HCO3 cotransporter in basolateral membranes. ETA (3 microM) partially prevented the inhibitory effect of PTH. In cultured proximal tubule cells, PTH inhibited the HCO3-dependent 22Na uptake and ethoxyresorufin, an inhibitor of cytochrome P-450, blocked the inhibitory effect of PTH on the cotransporter. These results demonstrate that PTH inhibits the renal Na-HCO3 cotransporter through multiple mechanisms, that are mediated through G proteins, G alpha s and GP, and CaM-KII.

Parathyroid hormone decreases HCO3 reabsorption in the rat proximal tubule by stimulating phosphatidylinositol metabolism and inhibiting base exit.

The mechanism of inhibition of HCO3 transport by parathyroid hormone (PTH) in the proximal tubule is not clearly defined. Previous studies in vitro have suggested that this effect is mediated via cAMP generation, which acts to inhibit Na/H exchange, resulting in cell acidification. To examine this question in vivo, intracellular pH (pHi) was measured in the superficial proximal tubule of the rat using the pH-sensitive fluoroprobes 4-methylumbelliferone (4MU) and 2',7'-bis(carboxyethyl)-(5, and 6)-carboxyfluorescein (BCECF). PTH was found to alkalinize the cell. This alkalinization suggested inhibition of basolateral base exit, which was confirmed by in situ microperfusion studies: lowering HCO3 in peritubular capillaries acidified the cell, an effect blunted by PTH. Removal of luminal Na promoted basolateral base entry, alkalinizing the cell. This response was also blunted by PTH. Readdition of luminal Na stimulated the luminal Na/H exchanger, causing an alkalinization overshoot that was partially inhibited by PTH. cAMP inhibited luminal H secretion but did not alkalinize the cell. Stimulation of phosphatidylinositol-bis-phosphate turnover by PTH was suggested by the effect to the hormone to increase cell Ca. Blocking the PTH-induced rise in cell Ca blunted the effect of the hormone to alkalinize the cell, as did inhibition of phosphatidylinositol breakdown. Furthermore, stimulation of protein kinase C by a phorbol ester and a diacylglycerol applied basolaterally alkalinized the cell and inhibited luminal H secretion. The findings indicate that both arms of the phosphatidylinositol-bis-phosphate cascade play a role in mediating the effect of PTH on the cell pH. The results are consistent with the view that PTH inhibits base exit in the proximal tubule by activation of the phosphatidylinositol cascade. The resulting alkalinization may contribute, with cAMP, to inhibit apical Na/H exchange and the PTH-induced depression of proximal HCO3 reabsorption.

Interaction of atrial natriuretic factor and angiotensin II in proximal HCO3- reabsorption.

Bicarbonate reabsorption was evaluated by the acidification kinetics technique in middle proximal tubule in Munich-Wistar rats. Atrial natriuretic factor (ANF) and angiotensin II (ANG II) were infused into the jugular vein (ANF, 0.5 microgram.min-1.kg-1 after a prime of 10 micrograms/kg; ANG II, 20 ng.min-1.kg-1) or added to luminal or peritubular perfusion fluid (10(-6) M ANF; 10(-12) M ANG II). In the presence of ANF, in each condition, no significant differences in net HCO3- reabsorption or in acidification half time were observed compared with the control group. In the presence of ANG II, a significant increase in HCO3- reabsorption was observed, expressed by a fall in acidification half time from a mean of 4.75 +/- 0.20 (n = 86) to 2.47 +/- 0.18 s (n = 32) in systemically infused rats or to 2.30 +/- 0.15 s (n = 35) in luminally perfused tubules and from 4.57 +/- 0.32 (n = 44) to 2.04 +/- 0.10 s (n = 50) during capillary perfusion. However, when ANG II was systemically infused or perfused in lumen or in peritubular capillaries, addition of ANF to lumen or capillaries by perfusion or systemic infusion abolished the effects observed with ANG II alone. These studies confirm that ANG II stimulates proximal HCO3- reabsorption and show that ANF alone does not affect this process, but impairs the stimulation caused by ANG II.

Delivery dependence of early proximal bicarbonate reabsorption in the rat in respiratory acidosis and alkalosis.

In the intact rat kidney, bicarbonate reabsorption in the early proximal tubule (EP) is strongly dependent on delivery. Independent of delivery, metabolic acidosis stimulates EP bicarbonate reabsorption. In this study, we investigated whether systemic pH changes induced by acute or chronic respiratory acid-base disorders also affect EP HCO3- reabsorption, independent of delivery (FLHCO3, filtered load of bicarbonate). Hypercapnia was induced in rats acutely (1-3 h) and chronically (4-5 d) by increasing inspired PCO2. Hypocapnia was induced acutely (1-3 h) by mechanical hyperventilation, and chronically (4-5 d) using hypoxemia to stimulate ventilation. When compared with normocapneic rats with similar FLHCO3, no stimulation of EP or overall proximal HCO3 reabsorption was found with either acute hypercapnia (PaCO2 = 74 mmHg, pH = 7.23) or chronic hypercapnia (PaCO2 = 84 mmHg, pH = 7.31). Acute hypocapnia (PaCO2 = 29 mmHg, pH = 7.56) did not suppress EP or overall HCO3 reabsorption. Chronic hypocapnia (PaCO2 = 26 mmHg, pH = 7.54) reduced proximal HCO3 reabsorption, but this effect was reversed when FLHCO3 was increased to levels comparable to euvolemic normocapneic rats. Thus, when delivery is accounted for, we could find no additional stimulation of proximal bicarbonate reabsorption in respiratory acidosis and, except at low delivery rates, no reduction in bicarbonate reabsorption in respiratory alkalosis.

Effects of Euvolemic and Hypervolemic Hyperbicarbonemia on Segmental Nephron HCO3 Reabsorption in the Newborn Dog1

Studies were undertaken to determine the effect of elevated plasma bicarbonate concentration (PHCO3) with and without volume expansion on segmental nephron HCO3 reabsorption in newborn and adult dogs using the technique of distal blockade. Reabsorption of bicarbonate per mL glomerular filtrate (RHCO3/GFR) in the proximal nephron was more suppressed in euvolemic newborns than euvolemic adults as PHCO3 was increased from baseline to 50-70 mM. Inasmuch as total nephron reabsorption has been shown to be essentially complete under these conditions in both newborns and adults, distal nephron HCO3 delivery and the fraction of the distal HCO3 load reabsorbed must have been greater in euvolemic newborns than adults when PHCO3 was elevated. Total nephron RHCO3/GFR was less suppressed by NaHCO3 volume expansion in the newborn than it was in the adult. However, proximal nephron RHCO3/GFR was similarly suppressed by NaHCO3 volume expansion in newborns and adults. Thus, the NaHCO3-expanded newborn must have reabsorbed a greater proportion of the increased distal HCO3 load than did the NaHCO3-expanded adult. Proximal nephron HCO3 reabsorption is a balance between reabsorption effected by active proton secretion and passive HCO3 back leak. Euvolemic increase in peritubular HCO3 concentration has been shown to suppress proximal tubular proton secretion; volume expansion increases proximal tubule HCO3 permeability and back leak.(ABSTRACT TRUNCATED AT 250 WORDS)

Parathyroid hormone directly inhibits tubular reabsorption of bicarbonate in normocalcaemic rats with chronic hyperparathyroidism.

The hypothesis that chronic metabolic acidosis encountered in some patients with primary hyperparathyroidism is due to inhibition of proximal HCO3 reabsorption has recently been challenged. Indeed, this action of parathyroid hormone (PTH) has only been observed in acute studies, whereas in animal models of chronic hyperparathyroidism a metabolic alkalosis has been induced, probably owing to the release of alkaline salts from bone tissue, and to the stimulation of tubular acid secretion by hypercalcaemia. Studies were, therefore, performed to determine the effect of PTH on the renal handling of HCO3 in an animal model in which changes in plasma calcium and phosphate, and nephrocalcinosis, all known to affect tubular acidification, did not occur. Thyroparathyroidectomized (TPTX) rats were infused with synthetic bovine hormone fragment bPTH 1-34 via Alzet minipumps at the rate of 0.7 U h-1 to simulate normal endogenous production of PTH (group I) and at the three-fold higher rate of 2.1 U h-1 (group II). In order to prevent changes in serum calcium and phosphate, and nephrocalcinosis, animals of group II were fed a Ca- and P-free diet prior to TPTX (compared with a regular diet for group I) and both groups were treated with dichloromethylene-diphosphonate (Cl2MDP, 10 mg kg-1 day-1) and a Ca-free diet during PTH infusion. During the course of PTH infusion both groups of animals had stable and normal levels of plasma calcium and phosphate.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic hypercapnia enhances Vmax of Na-H antiporter of renal brush-border membranes.

Chronic hypercapnia is associated with increased proximal HCO3 reabsorption that is thought to be mediated by a Na-H antiporter. We hypothesized that chronic hypercapnia would be associated either with increased Vmax or with decreased Km of the Na-H antiporter. To test this hypothesis we made rabbits hypercapnic for 48 h by exposure to 10% CO2. In both control and hypercapnic animals, cortical luminal membranes were enriched over the homogenate 16-fold in alkaline phosphatase and 10-fold in maltase activity. The kinetic activity of the Na-H antiporter was measured by the dissipation of the quenching of acridine orange by addition of different Na concentrations. Chronic hypercapnic rabbits had significantly higher Vmax of the Na-H antiporter of luminal membranes than controls (593 +/- 81 vs. 252 +/- 40 arbitrary fluorescence units X min-1 X 300 micrograms protein-1, P less than 0.01). The Km, however, was not different between control and hypercapnic rabbits. 22Na uptake in presence of an outwardly directed pH gradient was significantly higher in vesicles from hypercapnic rabbits than controls. Amiloride inhibited the Na-H antiporter (as assessed by acridine orange quenching or 22Na uptake) to the same degree in membranes from both control and hypercapnic rabbits, suggesting that the increase in Vmax is mediated by the electroneutral component of the Na-H antiporter. In addition, under voltage clamp conditions by K and valinomycin the Vmax was still increased in membranes from hypercapnic animals, again suggesting that the increase in Vmax is mediated by the electroneutral component of the Na-H antiporter. The uptake of D-[3H]glucose by luminal membranes was not different between control and hypercapnic rabbits, indicating a specific enhancement of the Na-H antiporter. Acute hypercapnia (4 h) failed to increase the Vmax of the Na-H antiporter despite comparable increase in PCO2. Thus chronic hypercapnia, but not acute hypercapnia, induces a selective and specific increase in the Vmax of Na-H antiporter, and this may mediate the adaptation to chronic hypercapnia.(ABSTRACT TRUNCATED AT 250 WORDS)

Load dependence of proximal tubular bicarbonate reabsorption in chronic metabolic alkalosis in the rat.

Studies were undertaken in Munich-Wistar rats to determine whether maintenance of chronic metabolic alkalosis (CMA) is associated with an increase in proximal HCO3- reabsorption, or whether a reduction in glomerular filtration rate (GFR) is required to sustain the elevated plasma HCO3- concentration. Superficial single nephron glomerular filtration rate (SNGFR), and absolute proximal HCO-3 (APRHCO3) and water (APRH2O) reabsorption were measured 20 +/- 3 d after the induction of CMA in eight rats and the results compared with seven age-matched control animals. Plasma [HCO3-] was 39.1 +/- 1.8 mM in CMA rats compared with 26.0 +/- 0.4 mM in controls (P less than 0.001). In the CMA rats, SNGFR was 44.8 +/- 1.1 vs. 38.2 +/- 2.1 nl/min in controls (P less than 0.025). As a result, the single nephron filtered load of HCO3- (FLHCO3) increased from 1,147 +/- 61 pmol/min in control to 2,040 +/- 108 pmol/min in CMA (P less than 0.001). APRHCO3 increased by greater than 65%, from 970 +/- 65 pmol/min in control to 1,624 +/- 86 pmol/min in CMA (P less than 0.001). APRH2O increased from 18.4 +/- 1.6 nl/min in control to 24.0 +/- 0.8 nl/min in CMA (P less than 0.005). Tubular hypertrophy resulted in an increase in the length of the proximal convoluted tubule from 5.6 +/- 0.2 to 6.5 +/- 0.2 mm (P less than 0.005). The pattern of HCO3- reabsorption along the length of the proximal convoluted tubule in CMA was indistinguishable from that found in normal rats in which FLHCO3 was varied acutely by altering SNGFR. The increase in tubular length accounted for only 30% of the increase in APRH2O and 15% of the increase in APRHCO3. We conclude that a sustained reduction in GFR is not required for maintenance of CMA in the rat. If GFR is chronically restored to normal levels, the alkalosis is maintained by an increase in APRHCO3. The increase in reabsorption is accounted for by tubular hypertrophy, a chronic adaptive response, and a load-dependent response that is indistinguishable from that seen in normal rats when FLHCO3 is increased acutely by increasing SNGFR.

Microperfusion study of proximal tubule bicarbonate transport in maleic acid-induced renal tubular acidosis.

Microperfusion studies were carried out in rats to examine the abnormality in proximal tubule HCO3- transport caused by maleic acid administration. Permeability of the proximal tubule to HCO-3 was measured by perfusing proximal tubules with a HCO3- -free low-buffer isotonic equilibrium solution containing acetazolamide after plasma [HCO3-] had been raised by intravenous NaHCO3 infusion. Insulin recovery in the collected perfusate was approximately 100% in control and maleic acid-treated rats. CO2 influx measured by microcalorimetry was not significantly different in control vs. maleic acid-treated rats. Thus maleic acid did not cause increased permeability of the proximal tubule to either inulin or HCO3-. In a second group of experiments, proximal tubule fluid and HCO3- efflux were measured in paired-reperfusion experiments before and after maleic acid administration. The perfusion fluid contained 25 mM HCO3- and 120 mM Cl-. HCO3- absorption was inhibited 25% (79 pmol/min), Na+ was inhibited 22% (164 pmol/min), and Cl- absorption (calculated as the anion gap) by 85 pmol/min. [HCO3-] in the collected perfusate rose significantly after maleic acid, presumably accompanied by a fall in [Cl-]. The observations indicate that proximal renal tubular acidosis (RTA) induced by maleic acid is characterized by impaired lumen-to-blood transport of sodium bicarbonate and chloride but not by increased backflux. Based on previously demonstrated effects of maleic acid on mitochondrial energy metabolism and cellular ATP levels, we postulate that the principal transport abnormality is impaired basolateral membrane active sodium transport, leading to a secondary reduction in brush border Na+-H+ exchange.(ABSTRACT TRUNCATED AT 250 WORDS)

Proximal HCO3- reabsorption and the determinants of tubular and capillary PCO2 in the rat.

Studies were carried out in Munich-Wistar rats to define the CO2 partial pressure (PCO2) profile in the surface tubules and capillaries of the kidney and to relate these measurements to proximal tubular HCO3- reabsorption, renal blood flow, and O2 consumption. In euvolemic rats, PCO2 in Bowman's space (BS) was 12.5 mmHg higher than in arterial blood, indicating CO2 addition to the arterial tree as it traverses the cortex. PCO2 further rose by 3.9 mmHg between the efferent arteriole (EA) and the peritubular capillaries (PC) (P less than 0.01) and by 4.9 mmHg between BS and the early proximal tubule (EP) (P less than 0.01). In studies with paired measurements, PCO2 in EP was 1.8 mmHg higher than in the adjacent PC (P less than 0.05). HCO3- reabsorption in EP (first 0.4-1.25 mm) was 579 pmol X min-1 X mm-1 (34.3 +/- 4.6% of the filtered load). By use of a model of facilitated diffusion of CO2 across the cell, the trans-epithelial PCO2 gradient in EP can be accounted for by the CO2 generated from HCO3- reabsorption, assuming an intracellular pH of 7.3. In the vascular compartment, roughly half the rise in PCO2 between the afferent arteriole (estimated to equal BS PCO2) and PC can be accounted for by metabolic CO2 production and half by titration of blood buffers by reabsorbed HCO3-.

Proximal tubular Na, Cl, and HCO3 reabsorption and renal oxygen consumption.

The majority of the oxygen consumed by the rat kidney appears to occur in the proximal tubule. Therefore changes in metabolically linked ion transport in this segment of the nephron should result in changes in renal oxygen consumption. To study the role of bicarbonate reabsorption in metabolically linked proximal tubular ion transport a series of micropuncture-clearance-extraction experiments were performed comparing the effects of the carbonic anhydrase inhibitor benzolamide and of hypertonic sodium bicarbonate infusion with control conditions in the rat. End-proximal tubular fluid and chloride reabsorption were measured. From these, the rates of sodium and bicarbonate reabsorption were estimated. Simultaneously with the tubular fluids, extraction collections were obtained for determination of renal oxygen consumption. Both benzolamide and hypertonic bicarbonate reduced proximal tubular fluid reabsorption while concomitantly reducing the transepithelial gradient for chloride. The mean rate of renal oxygen consumption did not differ from the control rate in either experimental group and could be dissociated from the calculated net rates of proximal tubular sodium, chloride, and bicarbonate reabsorption. We interpret these data as evidence that proximal tubular hydrogen ion secretion supporting bicarbonate reabsorption requires at most small amounts of oxidative energy, less than detectable by these techniques. The data, in contrast, support the conclusion that the chloride-bicarbonate transepithelial gradient appears to be an important passive driving force in vivo for proximal tubular fluid reabsorption.

Effects of acute alterations in PCO2 on proximal HCO-3, Cl-, and H2O reabsorption

The effect of acute changes in arterial PCO2 on absolute proximal reabsorption of bicarbonate, chloride, and water has not been systematically studied. In the present free-flow micropuncture studies in Munich-Wistar rats, arterial PCO2 was increased or decreased by 20 mmHg. Under conditions of stable SNGFR, proximal and whole kidney electrolyte reabsorption was measured. Acute hypocapnia decreased absolute proximal bicarbonate reabsorption by 23% (from 1,008 +/- 38 to 773 +/- 36 pmol/min). Proximal volume reabsorption also decreased. Although bicarbonate delivery out of the superficial proximal convoluted tubule did not exceed normal levels, bicarbonaturia developed, suggesting an additional suppression of acidification by distal and/or juxtamedullary nephron segments. Acute hypercapnia increased absolute proximal bicarbonate reabsorption by only 10% in chronically alkalotic animals (from 1,050 +/- 68 to 1,176 +/- 77 pmol/min). In acutely alkalotic animals, hypercapnia caused no significant increment in the higher basal level of absolute proximal bicarbonate reabsorption (from 1,158 +/- 120 to 1,234 +/- 97 pmol/min). Whole kidney bicarbonate reabsorption rose, again suggesting a distal and/or juxtamedullary effect. Hypercapnia inhibited proximal chloride reabsorption and caused a chloruresis. In conclusion, acute hypo- and hypercapnia caused alterations in proximal bicarbonate, chloride, and sodium transport that may participate, at least in part, in the changes in whole kidney electrolyte reabsorption observed in these conditions. Distal and/or juxtamedullary nephrons also appeared to contribute to the changes in renal acidification induced by alterations in systemic PCO2.

Studies of the urinary acidification defect induced by lithium

Experiments were carried out in rats and isolated turtle bladders to study the defect in H+ transport induced by LiCl. After 3-4 days of intraperitoneal LiCl, rats developed urinary findings of "distal" renal tubular acidosis. Proximal tubular fluid pH measured in situ by glass microelectrodes was higher in lithium-treated rats than in acidotic controls. Proximal fluid total CO2 [tCO2] was also higher, and the fraction of tCO2 leaving the proximal tubule was 14 vs. 7% (P less than 0.001). Impaired acidification was also apparent beyond distal convoluted tubules, as judged by normal distal tCO2 reabsorption but increased HCO3(-) in the urine. During NaHCO3 loading, the proximal defect was ameliorated but not the distal. Turtle bladder studies showed that mucosal lithium inhibits H+ secretion secondary to reducing transepithelial electrical potential, presumably by hyperpolarization of the luminal membrane. A similar mechanism may be responsible for lithium's effect on the distal nephron. Inhibition of proximal tubular HCO3(-) reabsorption is probably not attributable to electrical potential changes but might be due to interference of luminal membrane Na+ entry by Li+ and reduced (Na+ + Li+)-H+ exchange.

Dissociative effects of piretanide on proximal tubular PO4 and HCO3 transport.

The effect of piretanide on renal electrolyte transport was evaluated by simultaneous micropuncture and clearance studies. In chronically thyroparathyroidectomized (TPTX) dogs, the drug caused an increased percentage excretion (%E) of sodium (from 0.6 +/- 0.1 to 15.2 +/= 1.8%, P less than 0.01) as well as of calcium (from 1.0 +/- 0.2 to 17.8 +/- 1.7%, P less than 0.001) and bicarbonate (from 1.2 +/- 0.4 to 5.9 +/- 0.9, P less than 0.001), but there was no change in %E of phosphate (4.0 +/- 0.9 to 6.6 +/- 1.6, P less than 0.10). In the presence of a constant infusion of parathyroid hormone (PTH) the drug caused a greater degree of natriuresis, calciuria, and bicarbonaturia and a significant increase in %E of PO4 (from 7.4 +/- 1.6 to 20.0 +/- 2.1, P less than 0.05). Proximal fractional reabsorption (PFR) of PO4 was unaffected, but there was a significant decrease in PFR of sodium, calcium, and bicarbonate in the TPTX dogs. The presence of PTH did not alter the effects of piretanide on PFR of phosphate and bicarbonate. There was no change in urinary or tubular fluid pH in either group of dogs. These data indicate that piretanide dissociates proximal PO4 transport from that of sodium and bicarbonate. In the presence of PTH, the drug inhibits PO4 transport beyond the late proximal convoluted tubule. In addition, tubular (and urinary) pH appears to be an important regulator of PO4 transport, especially in the absence of PTH.

Effect of parathyroid hormone on urinary acidification.

The effect of parathyroid hormone (PTH) administration on urinary acidification was studied in intact and thyroparathyroidectomized dogs. PTH administration resulted in a significant increase in urine pH and HCO3 excretion. In dogs with maximally acid urine caused by Na2SO4 infusion PTH administration also led to a significant increase in urine pH and to a decrease in ammonium excretion. To examine the effect of PTH on H+ secretion in the distal nephron we measured the urine-blood (U-B) PCO2 gradient in dogs with maximally alkaline urine (urine pH greater than 7.8) before and after PTH administration. After infusion of the hormone, HCO3 excretion increased significantly but the U-B PCO2 gradient remained unchanged. The effects of PTH infusion on urinary acidification in animals with distal renal tubular acidosis caused by LiCl administration were also studied. PTH administration to these dogs increased HCO3 excretion to the same level seen in normal dogs. These data suggest that PTH does not inhibit distal H+ secretion but increases HCO3 excretion by depressing proximal HCO3 reabsorption.

Effect of chronic NH4Cl acidosis on proximal tubular H2O and HCO3 reabsorption.

Effect of chronic NH4Cl acidosis on proximal tubular H2O and HCO3 reabsorption.

Bicarbonate reabsorption along renal tubules.

SummaryUsing the stop flow technic in NaHCO3 loaded dogs under osmotic diuresis we find that bicarbonate and chloride are reabsorbed avidly in a far distal area coincident with sodium. Compared to values in free tlowing osmotic diuretic urine, concentration of bicarbonate developed in proximal tubules during stop flow remains low at the same point where chloride is relatively elevated. Reabsorption of proximal HCO3 alone does not account for Cl elevation. Cl secretion into and removal of other anions from the proximal fluid is considered.