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The effects of metabolic acidosis on renal function of fetal sheep.

机译:代谢性酸中毒对胎羊肾功能的影响。

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摘要

1. The effects of I.V. infusions of 6.7-19.3 mmol hydrochloric acid/kg on fetal renal function were studied in fourteen chronically catheterized fetal sheep aged 121-143 days. Infusion of acid caused arterial pH and plasma bicarbonate levels to fall (P less than 0.0005, P less than 0.001). These remained low for the next 3 h. Plasma chloride levels increased (P less than 0.0005). There were no other changes in plasma electrolytes nor in plasma osmolality. 2. Fetal glomerular filtration rate did not change; the fractional reabsorptions of sodium, chloride and phosphate all decreased (P less than 0.005). Initially urine volume did not change but urinary osmolality increased (P less than 0.0005). Fetal urinary pH fell abruptly, titratable acid excretion increased, urinary ammonium excretion increased (P less than 0.0005) but urinary bicarbonate excretion remained unchanged. Thus, net acid excretion increased significantly (P less than 0.0005). 3. Twenty-six hours after infusion of acid, fetal arterial pH, bicarbonate levels, urinary pH, titratable acid and ammonium excretion were no different from control. Net acid excretion was still increased (P less than 0.05), urine flow rate was less (P less than 0.01) and urinary osmolality still increased (P less than 0.05). 4. There were no differences in arterial blood gases nor in pH of four fetuses which died during or shortly after infusion of acid. However, prior to acid infusion they were already excreting significantly greater amounts of phosphate (P less than 0.01), ammonium and titratable acid (P less than 0.02). Thus the fetal kidney responds to a metabolic acidosis by excreting more acid and by generating more bicarbonate, but this response is limited.
机译:1. I.V.的影响在14只121-143日龄的经慢性导管插入的胎羊中研究了6.7-19.3 mmol盐酸/ kg输注对胎儿肾功能的影响。注入酸会导致动脉pH和血浆碳酸氢盐水平下降(P小于0.0005,P小于0.001)。这些在接下来的3小时内保持较低水平。血浆氯化物水平增加(P小于0.0005)。血浆电解质和血浆渗透压没有其他变化。 2.胎儿肾小球滤过率未改变;钠,氯和磷酸盐的部分重吸收均降低(P小于0.005)。最初尿量没有变化,但尿渗透压升高(P小于0.0005)。胎儿尿液pH值突然下降,可滴定酸排泄增加,尿铵排泄增加(P小于0.0005),但碳酸氢根排泄保持不变。因此,净酸排泄显着增加(P小于0.0005)。 3.输注酸后26小时,胎儿动脉pH,碳酸氢根水平,尿液pH,可滴定酸和铵排泄与对照组无差异。净酸排泄仍然增加(P小于0.05),尿流率较小(P小于0.01),尿渗透压仍增加(P小于0.05)。 4.在注入酸中或注入酸后不久死亡的四个胎儿的动脉血气和pH值均无差异。但是,在注入酸之前,它们已经排泄了大量的磷酸盐(P小于0.01),铵和可滴定酸(P小于0.02)。因此,胎儿肾脏通过排泄更多的酸并生成更多的碳酸氢盐来应对代谢性酸中毒,但是这种反应是有限的。

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