Determinants of Brushite Stone Formation: A Case-Control Study

Purpose

The occurrence of brushite stones has increased during recent years. However, the pathogenic factors driving the development of brushite stones remain unclear.

Methods

Twenty-eight brushite stone formers and 28 age-, sex- and BMI-matched healthy individuals were enrolled in this case-control study. Anthropometric, clinical, 24 h urinary parameters and dietary intake from 7-day weighed food records were assessed.

Results

Pure brushite stones were present in 46% of patients, while calcium oxalate was the major secondary stone component. Urinary pH and oxalate excretion were significantly higher, whereas urinary citrate was lower in patients as compared to healthy controls. Despite lower dietary intake, urinary calcium excretion was significantly higher in brushite stone patients. Binary logistic regression analysis revealed pH>6.50 (OR 7.296; p = 0.035), calcium>6.40 mmol/24 h (OR 25.213; p = 0.001) and citrate excretion <2.600 mmol/24 h (OR 15.352; p = 0.005) as urinary risk factors for brushite stone formation. A total of 56% of patients exhibited distal renal tubular acidosis (dRTA). Urinary pH, calcium and citrate excretion did not significantly differ between patients with or without dRTA.

Conclusions

Hypercalciuria, a diminished citrate excretion and an elevated pH turned out to be the major urinary determinants of brushite stone formation. Interestingly, urinary phosphate was not associated with urolithiasis. The increased urinary oxalate excretion, possibly due to decreased calcium intake, promotes the risk of mixed stone formation with calcium oxalate. Neither dietary factors nor dRTA can account as cause for hypercalciuria, higher urinary pH and diminished citrate excretion. Further research is needed to define the role of dRTA in brushite stone formation and to evaluate the hypothesis of an acquired acidification defect.     

Arginine-induced pancreatic hormone secretion during exercise in rats

Trabelsi, Fethi, and Jean-Marc Lavoie. Arginine-inducedpancreatic hormone secretion during exercise in rats.J. Appl. Physiol. 81(6):2528-2533, 1996.The aim of the present investigation was to1) determine whetherarginine-induced pancreatic hormone secretion can be modified during anexercise bout, and 2) verify whetherthe sectioning of the hepatic branch of the vagus nerve can alter thearginine-induced insulin and glucagon secretion during exercise inrats. To this end, we studied the effects of an intraperitonealinjection of arginine (1 g/kg body mass) during an exercise bout (30 min, 26 m/min, 0% grade) on the pancreatic hormone responses. Theseeffects were determined in one group of sham-operated exercising ratsand compared with three control groups: one group of resting rats, onegroup of saline-injected exercising rats, and one group ofhepatic-vagotomized exercising rats. Five minutes after the injectionof arginine, significant (P < 0.05)increases in insulin, glucagon, and C-peptide concentrations wereobserved in exercising as well as in resting rats. These responses werenot, however, altered by the hepatic vagotomy and/or by theexercise bout. It is concluded that arginine is a potent stimulus ofpancreatic hormone secretion during exercise, even though thesympathoadrenal system is activated. These results also indicate that ahepatic vagotomy does not seem to influence arginine-inducedhormonal pancreatic responses and question the role of the putativehepatic arginoreceptors in the control of the pancreatic hormonesecretion during exercise.

     

Pseudoephedrine is without ergogenic effects during prolonged exercise

Gillies, Hunter, Wayne E. Derman, Timothy D. Noakes, Peter Smith, Alicia Evans, and Gary Gabriels.Pseudoephedrine is without ergogenic effects during prolongedexercise. J. Appl. Physiol. 81(6): 2611-2617, 1996.This study was designed to measure whether a single dose of 120 mg pseudoephedrine ingested 120 min before exercise influencesperformance during 1 h of high-intensity exercise. The effects ofexercise on urinary excretion of the drug were also studied. Tenhealthy male cyclists were tested on two occasions, separated by atleast 7 days, by using a randomly assigned, double-blind,placebo-controlled, crossover design. Exercise performance was testedduring a 40-km trial on a laboratory cycle ergometer, and skeletalmuscle function was measured during isometric contractions. On a thirdoccasion, subjects ingested 120 mg pseudoephedrine but did not exercise[control (C)]. Pseudoephedrine did not influence eithertime trial performance [drug (D) vs. placebo: 58.1 ± 1.4 (SE) vs. 58.7 ± 1.5 min] or isometric muscle function. Urinary pseudoephedrine concentrations were significantly increased 1 h after exercise (D vs. C: 114.3 ± 27.2 vs. 35.4 ± 13.1 µg/ml; P < 0.05). Peak plasma pseudoephedrineconcentrations (P < 0.05) but not time taken to reach peakplasma concentrations or the area under the plasma pseudoephedrineconcentration vs. time curve was significantly increased in the totalgroup with exercise (D vs. C). In three subjects, plasmapseudoephedrine concentrations were not influenced by exercise. Onlythese subjects showed increased urinary pseudoephedrine excretionduring exercise. We conclude that a single therapeutic dose ofpseudoephedrine did not have a measurable ergogenic effect duringhigh-intensity exercise of 1-h duration, but plasma drug concentrationsand urinary excretion were altered by exercise. These findings havepractical relevance to doping control regulations in internationalsporting competitions.

     

Normal forces and myofibrillar disruption after repeated eccentric exercise

Hortobágyi, Tibor, Joseph Houmard, David Fraser,Ronald Dudek, Jean Lambert, and James Tracy. Normalforces and myofibrillar disruption after repeated eccentric exercise.J. Appl. Physiol. 84(2): 492-498, 1998.To investigate the "rapid-adaptation" phenomenon, weexamined force, neural, and morphological adaptations in 12 subjectswho performed 100 eccentric contractions with the quadriceps muscle(bout 1) and repeated the sameexercise after a 2-wk hiatus (bout2). Two days after bout1, quadriceps muscle strength and surfaceelectromyographic (EMG) activity declined ~37 and 28%, respectively,in the control group (n = 6). Atday 2 after bout 1, significant increases occurred in patellar tendonreflex amplitude (~25%), muscle soreness (fivefold), and serumcreatine kinase (220%), and 65 ± 12% of the total number of pixelsin the EMG indicated myofibrillar disruption. At day7 after bout 1, all variables returned to normal. At day 2 after bout 2, no significant changesoccurred in force, EMG, creatine kinase, or soreness, but reflexamplitude increased, and 23 ± 4% of the total number of pixels inthe EMG still indicated myofibrillar disruption. The results suggestthat the rapid force recovery following eccentric exercise is mediatedat least in part by neural factors and that this recovery may occurindependently of cell disruption.

     

Effect of glucose supplement timing on protein metabolism after resistance training

Roy, B. D., M. A. Tarnopolsky, J. D. MacDougall, J. Fowles,and K. E. Yarasheski. Effect of glucose supplement timing onprotein metabolism after resistance training. J. Appl.Physiol. 82(6): 1882-1888, 1997.We determinedthe effect of the timing of glucose supplementation on fractionalmuscle protein synthetic rate (FSR), urinary urea excretion, and wholebody and myofibrillar protein degradation after resistance exercise.Eight healthy men performed unilateral knee extensor exercise (8 sets/~10 repetitions/~85% of 1 single maximal repetition). Theyreceived a carbohydrate (CHO) supplement (1 g/kg) or placebo (Pl)immediately (t = 0 h) and 1 h(t = +1 h) postexercise. FSR wasdetermined for exercised (Ex) and control (Con) limbs by incrementalL-[1-¹³C]leucineenrichment into the vastus lateralis over ~10 h postexercise. Insulinwas greater (P < 0.01) at 0.5, 0.75, 1.25, 1.5, 1.75, and 2 h, and glucose was greater(P < 0.05) at 0.5 and 0.75 h for CHO compared with Pl condition. FSR was 36.1% greater in the CHO/Ex leg than in the CHO/Con leg(P = not significant) and6.3% greater in the Pl/Ex leg than in the Pl/Con leg(P = not significant). 3-Methylhistidine excretion was lower in the CHO (110.43 ± 3.62 µmol/g creatinine) than Pl condition (120.14 ± 5.82, P < 0.05) as was urinary ureanitrogen (8.60 ± 0.66 vs. 12.28 ± 1.84 g/g creatinine,P < 0.05). This suggests that CHOsupplementation (1 g/kg) immediately and 1 h after resistance exercisecan decrease myofibrillar protein breakdown and urinary urea excretion,resulting in a more positive body protein balance.

     

Molecular Pathophysiology of Renal Tubular Acidosis

Renal tubular acidosis (RTA) is characterized by metabolic acidosis due to renal impaired acid excretion. Hyperchloremic acidosis with normal anion gap and normal or minimally affected glomerular filtration rate defines this disorder. RTA can also present with hypokalemia, medullary nephrocalcinosis and nephrolitiasis, as well as growth retardation and rickets in children, or short stature and osteomalacia in adults. In the past decade, remarkable progress has been made in our understanding of the molecular pathogenesis of RTA and the fundamental molecular physiology of renal tubular transport processes. This review summarizes hereditary diseases caused by mutations in genes encoding transporter or channel proteins operating along the renal tubule. Review of the molecular basis of hereditary tubulopathies reveals various loss-of-function or gain-of-function mutations in genes encoding cotransporter, exchanger, or channel proteins, which are located in the luminal, basolateral, or endosomal membranes of the tubular cell or in paracellular tight junctions. These gene mutations result in a variety of functional defects in transporter/channel proteins, including decreased activity, impaired gating, defective trafficking, impaired endocytosis and degradation, or defective assembly of channel subunits. Further molecular studies of inherited tubular transport disorders may shed more light on the molecular pathophysiology of these diseases and may significantly improve our understanding of the mechanisms underlying renal salt homeostasis, urinary mineral excretion, and blood pressure regulation in health and disease. The identification of the molecular defects in inherited tubulopathies may provide a basis for future design of targeted therapeutic interventions and, possibly, strategies for gene therapy of these complex disorders.Key Words: Renal tubular acidosis, acid-base homeostasis, molecular physiology, tubular transport, gene mutations.     

Mathematical Model of Ammonia Handling in the Rat Renal Medulla

The kidney is one of the main organs that produces ammonia and release it into the circulation. Under normal conditions, between 30 and 50% of the ammonia produced in the kidney is excreted in the urine, the rest being absorbed into the systemic circulation via the renal vein. In acidosis and in some pathological conditions, the proportion of urinary excretion can increase to 70% of the ammonia produced in the kidney. Mechanisms regulating the balance between urinary excretion and renal vein release are not fully understood. We developed a mathematical model that reflects current thinking about renal ammonia handling in order to investigate the role of each tubular segment and identify some of the components which might control this balance. The model treats the movements of water, sodium chloride, urea, NH₃ and NH4+, and non-reabsorbable solute in an idealized renal medulla of the rat at steady state. A parameter study was performed to identify the transport parameters and microenvironmental conditions that most affect the rate of urinary ammonia excretion. Our results suggest that urinary ammonia excretion is mainly determined by those parameters that affect ammonia recycling in the loops of Henle. In particular, our results suggest a critical role for interstitial pH in the outer medulla and for luminal pH along the inner medullary collecting ducts.     

Zinc bone loss in chronic renal failure and chronic metabolic acidosis

The effects of chronic metabolic acidosis (CMA) on zinc (Zn) bone content and urinary excretion were examined in the presence of normal or reduced renal function together with some aspects of calcium (Ca) metabolism. Four groups of rats were compared. All were fed a 30% protein and 9 mg Zn/100 g diet. Two were uremic (U): The first developed acidosis (UA), which was suppressed in the other (UNA) by NaHCO₃ supplement. Two other groups had normal renal function: One was normal (CNA), and the other had NH₄Cl in the drinking water and acidosis (CA). Femur total Zn and Ca content was markedly reduced by CMA and was not affected by uremia. Zn urinary excretion was increased by CMA and unaltered by uremia. Ca urinary excretion was markedly reduced in uremic rats, but was enhanced in both acidotic conditions. Urinary Ca and Zn showed a strong correlation in uremic and in control rats. Plasma parathormone and 1,25(OH)₂D₃ were unchanged by CMA. These data are in agreement with a direct primary effect of CMA on bone in releasing buffers. CMA induces bone resorption and a parallel decrease of mineral bone components, such as Ca and Zn, with little or no role of PTH, 1,25(OH)₂D₃ and of uremia itself.     

Physiological studies in heterozygous calcium sensing receptor (CaSR) gene-ablated mice confirm that the CaSR regulates calcitonin release <Emphasis Type="Italic">in vivo</Emphasis>

Background  

The calcium sensing receptor (CaSR) regulates serum calcium by suppressing secretion of parathyroid hormone; it also regulates renal tubular calcium excretion. Inactivating mutations of CaSR raise serum calcium and reduce urine calcium excretion. Thyroid C-cells (which make calcitonin) express CaSR and may, therefore, be regulated by it. Since calcium stimulates release of calcitonin, the higher blood calcium caused by inactivation of CaSR should increase serum calcitonin, unless CaSR mutations alter the responsiveness of calcitonin to calcium.     

Acute and chronic effects of exercise on leptin levels in humans

Pérusse, Louis, Gregory Collier, Jacques Gagnon,Arthur S. Leon, D. C. Rao, James S. Skinner, Jack H. Wilmore,André Nadeau, Paul Z. Zimmet, and Claude Bouchard. Acute andchronic effects of exercise on leptin levels in humans.J. Appl. Physiol. 83(1): 5-10, 1997.The acute (single bout of exercise) and chronic (exercisetraining) effects of exercise on plasma leptin were investigated in 97 sedentary adult men (n = 51) and women(n = 46) participating in the HERITAGEFamily Study. Exercise training consisted of a standardized 20-wkendurance training program performed in the laboratory on acomputer-controlled cycle ergometer. Maximal oxygen uptake, bodycomposition assessed by hydrostatic weighing, and fasting insulin levelwere also measured before and after training. Pre- and posttrainingblood samples were obtained before and after completion of a maximalexercise test on the cycle ergometer. Exercise training resulted insignificant changes in maximal oxygen uptake (increase in both genders)and body compostion (reduction of fat mass in men and increase infat-free mass in women). There were considerable interindividualdifferences in the leptin response to acute and chronic effects ofexercise, some individuals showing either increase or reduction inleptin, others showing almost no change. On average, leptin levels werenot acutely affected by exercise. After endurance training wascompleted, leptin levels decreased significantly in men (from 4.6 to3.9 ng/ml; P = 0.004) but not inwomen. However, after the training-induced changes in body fat masswere accounted for, the effects of exercise training were no longersignificant. Most of the variation observed in leptin levels afteracute exercise or endurance training appears to be within theconfidence intervals of the leptin assay. We conclude that there are nomeaningful acute or chronic effects of exercise, independent of theamount of body fat, on leptin levels in humans.

     

Renal tubular acidosis: developments in our understanding of the molecular basis

Renal tubular acidosis is a metabolic acidosis due to impaired acid excretion by the kidney. Hyperchloraemic acidosis with a normal anion gap and normal (or near normal) glomerular filtration rate, and in the absence of diarrhoea, defines this disorder. However, systemic acidosis is not always evident and renal tubular acidosis can present with hypokalaemia, medullary nephrocalcinosis and recurrent calcium phosphate stone disease, as well as growth retardation and rickets in children, or short stature and osteomalacia in adults. Renal dysfunction in renal tubular acidosis is not always confined to acid excretion and can be part of a more generalised renal tubule defect, as in the renal Fanconi syndrome. Isolated renal tubular acidosis is more usually acquired, due to drugs, autoimmune disease, post-obstructive uropathy or any cause of medullary nephrocalcinosis. Less commonly, it is inherited and may be associated with deafness, osteopetrosis or ocular abnormalities. The clinical classification of renal tubular acidosis has been correlated with our current physiological model of how the nephron excretes acid, and this has facilitated genetic studies that have identified mutations in several genes encoding acid and base ion transporters. In vitro functional studies of these mutant proteins in cell expression systems have helped to elucidate the molecular mechanisms underlying renal tubular acidosis, which ultimately may lead to new therapeutic options in what is still treatment only by giving an oral alkali.     

Long-Term Responses to Loss of Renal Mass: Tubular Changes: A Micropuncture Study of HCO3 Reabsorption by the Hypertrophied Proximal Tubule

In rats with renal failure produced by excision of one kidney and infarction of large portions of the other kidney, given a low calcium, high phosphorus diet for 2-3 weeks, GFR was reduced by 80 percent, the fractional excretion of sodium increased from 7 to 23 percent, that of bicarbonate from 16 to 23 percent and that of water from 4 to 13 percent. Single nephron GFR in the remaining nephrons was nearly doubled and end-proximal TF/P_In was depressed from 2.3 to 1.8, and proximal TF/P_HCO3 from 0.52 to 0.35, the latter figure corresponding to an increase of absolute proximal HCO₃ reabsorption from 1.7 to 3.5 nEq/min or from 2.8 to 3.2 Eq/L of single nephron glomerular filtrate. Acute parathyroidectomy had no influence on the fall of GFR or the rise of SNGFR in the remaining nephrons and failed to cause any significant changes in proximal tubular bicarbonate reabsorption. Parathyroidectomy, on the other hand, practically prevented the rise of the fractional excretion of sodium and of water and inverted the rise of the fractional excretion of bicarbonate to a fall. The data are interpreted to indicate that secondary hyperparathyroidism in renal failure impairs distal nephron bicarbonate and sodium reabsorption and, thus, contributes to the maintenance of sodium balance, but could possibly aggravate acidosis.     

A high salt diet induces tubular damage associated with a pro-inflammatory and pro-fibrotic response in a hypertension-independent manner

High salt diet (HSD), considered a public health problem worldwide, is associated with chronic degenerative diseases including renal diseases. However, little is known about the effects of HSD on renal function independently of the development of hypertension. To address the hypothesis that HSD induces renal injuries even without changes in blood pressure, BALB/c mice were fed for 7 days with chow with a high salt content (0.3–8%). Blood pressure did not change and there was a decrease in cortical (Na⁺ + K⁺)ATPase and NHE3 exchanger and an increase in renal fractional excretion of sodium. Positive correlations between Na⁺ intake or urinary sodium excretion with proteinuria were found. HSD did not change glomerular function and structure, but induced tubule-interstitial injury measured by an increase in collagen deposition, interstitial space and γ-GT activity, a marker of tubular injury. These effects were associated with a decrease in cortical albumin reabsorption and megalin expression. Similarly, the addition of NaCl 20 mM to the incubation medium of LLC-PK1 cells reduced megalin expression and albumin endocytosis indicating that HSD could have a direct effect on proximal tubule cells. Furthermore, tubule-interstitial injury was associated with pro-inflammatory and pro-fibrotic phenotypes with an increase in Th1 and Th17 phenotypes and a decrease in Tregs followed by increases in IL-6, -17, -10, TNF-α, IFN-γ and TGF-β. Our results reveal a complex network involved in renal injuries induced by HSD independently of changes in blood pressure. These findings strengthen the importance of restriction of salt intake for the general population even for salt-resistant individuals.     

Is urodilatin the missing link in exercise-dependent renal sodium retention?

Schmidt, W., A. Bub, M. Meyer, T. Weiss, D. Schneider, N. Maassen, and W. G. Forssmann. Is urodilatin the missing link inexercise-dependent renal sodium retention? J. Appl.Physiol. 84(1): 123-128, 1998.The purpose of thepresent study was to investigate the behavior of plasma atrialnatriuretic peptide [ANP-(99126)] concentration([ANP]) and renal urodilatin [Uro; ANP-(95126)] excretion during and after exercise and theirpossible effects on renal Na⁺retention. Ten male subjects performed a cycle ergometer test for 60 min at 60% of maximum workload. Blood and urine samples were collectedbefore, during, and up to 24 h after exercise. During exercise, plasma[ANP] and renal Uro excretion were oppositely affected:whereas [ANP] increased from 46.5 ± 5.1 to 124.1 ± 10.6 pg/ml, urinary Uro excretion decreased from 120.8 ± 16.0 to49.5 ± 9.8 fmol/min and remained at a lower level until 1 h afterexercise. Glomerular filtration rate showed lowest values duringexercise (from 164.9 ± 15.3 to 75.8 ± 10.1 ml/min), and urineflow and the fractional excretion rate ofNa⁺(FE_Na⁺) andCl()had their nadir during the first hour after exercise. Positiverelationships were observed between Uro excretion andFE_Na⁺(P < 0.05) and, whereas a tendency toward a negative correlation was obtained between[ANP] andFE_Na⁺. It seemspossible that Uro may be, among other factors, involved in theexercise-related regulation of renalNa⁺ retention. The specific rolesUro and ANP play during exercise, however, remain to be investigated.

     

Human growth hormone response to repeated bouts of aerobic exercise

Kanaley, J. A., J. Y. Weltman, J. D. Veldhuis, A. D. Rogol,M. L. Hartman, and A. Weltman. Human growth hormone response torepeated bouts of aerobic exercise. J. Appl.Physiol. 83(5): 1756-1761, 1997.We examinedwhether repeated bouts of exercise could override growth hormone (GH)auto-negative feedback. Seven moderately trained men were studied onthree occasions: a control day (C), a sequential exercise day (SEB; at1000, 1130, and 1300), and a delayed exercise day (DEB; at 1000, 1400, and 1800). The duration of each exercise bout was 30 min at 70%maximal O₂ consumption (O_{2 max}) on a cycleergometer. Standard meals were provided at 0600 and 2200. GH wasmeasured every 5-10 min for 24 h (0800-0800). Daytime(0800-2200) integrated GH concentrations were ~150-160% greater during SEB and DEB than during C: 1,282 ± 345, 3,192 ± 669, and 3,389 ± 991 min · µg · l¹for C, SEB, and DEB, respectively [SEB > C(P < 0.06), DEB > C(P < 0.03)]. There were nodifferences in GH release during sleep (2300-0700). Deconvolutionanalysis revealed that the increase in 14-h integrated GH concentrationon DEB was accounted for by an increase in the mass of GH secreted perpulse (per liter of distribution volume,l_v): 7.0 ± 2.9 and 15.9 ± 2.6 µg/l_v for C and DEB,respectively (P < 0.01). Comparisonof 1.5-h integrated GH concentrations on the SEB and DEB days (30 minexercise + 60 min recovery) revealed that, with each subsequentexercise bout, GH release apparently increased progressively, with aslightly greater increase on the DEB day [SEB vs. DEB: 497 ± 162 vs. 407 ± 166 (bout 1), 566 ± 152 vs. 854 ± 184 (bout2), and 633 ± 149 vs. 1,030 ± 352 min · µg · l¹(bout 3),P < 0.05]. We conclude thatthe GH response to acute aerobic exercise is augmented with repeatedbouts of exercise.

     

High urine flow rate increases prostaglandin E excretion in the conscious dog

Although previous studies from this and other laboratories have shown that urinary prostaglandin E excretion (U_PGEV) can vary independent of urine flow rate, recent studies during water diuresis in the conscious dog have suggested that high urine flow rate per se may increase U_PGEV. To examine the effect of urine flow rate on U_PGEV we administered either mannitol, chlorothiazide or Ringer's solution to mongrel dogs and measured U_PGEV. During anesthesia neither mannitol or chlorothiazide increased U_PGEV. There was, however, a consistent increase with all three agents in awake animals. This increase in U_PGEV was independent of alterations in glomerular filtration rate. There was a consistent increase in urinary sodium excretion and decrease in urinary osmolality with all three agents. The changes in PGE, however, were similar to those found during water diuresis when no increase in sodium excretion was found. It is not presently clear whether these findings reflect a true increase in renal PGE synthesis due to some change in flow or pressure within the renal medulla or rather represent unchanged PGE synthesis by renal tubular cells, the high tubule fluid flow rate causing increased entry into the tubular lumen in contrast to the renal interstitium.     

A study on human urine in a high-selenium area of China by 1H-NMR spectroscopy

In this study, high-resolution 600-MHz ¹H-NMR (nuclear magnetic resonance) spectroscopies were used to compare the urinary metabolic profiles of healthy humans and humans in a high-selenium area of China. NMR biomarkers for renal and liver lesions were observed by comparing the urine ¹H-NMR spectra. In urinary excretion, the concentrations in human urine samples of formate, lactate, acetate, hippurate, and alanine in overexposure to selenium were increased, whereas citrate, creatine, and TMAO excretion were decreased compared with that of the healthy human—some of them even disappeared. An interesting result was the appearance of formate in urine, which has previously been shown to lead to acidosis and chronic renal failure and interfere with the lumen and proximal tubular cells. The level of creatine was associated with the seminal activity. The changes of acetate and citrate may explain the disorder of the cellular energy metabolism caused by selenium, and the changes of other amino acids were a result of the reuptake of these compounds that had been blocked in the glomerulus and proximal tubule. The results elucidate the renal/liver lesion in humans in high-selenium area by ¹H-NMR spectroscopy and offer the molecular basic of selenium toxicity.     

Effects of renal denervation on cardiovascular and renal responses to ACE inhibition in conscious lambs

Smith, Francine G., Suzanne Chan, and Saskia N. De Wildt.Effects of renal denervation on cardiovascular and renal responsesto ACE inhibition in conscious lambs. J. Appl.Physiol. 83(2): 414-419, 1997.Cardiovascular andrenal effects of either the angiotensin-converting enzyme inhibitorcaptopril or vehicle were measured in chronically instrumented lambs inthe presence (intact; n = 6) andabsence of renal sympathetic nerves (denervated; n = 5) to determine whether there wasan interaction between the renin-angiotensin system and renalsympathetic nerves early in life. Captopril caused a similar decreasein mean arterial pressure (P < 0.001) in intact and denervated lambs, predominantly through a decreasein diastolic pressure. Heart rate was increased from 177 ± 34 to213 ± 22 (SD) beats/min during captopril compared with vehicleinfusion in intact lambs. In denervated lambs, basal heart rates wereelevated to 218 ± 33 beats/min; there was no further increase inheart rate during captopril compared with vehicle infusion. Captoprilinfusion caused a decrease in renal vascular resistance but only in theabsence of renal nerves. These findings provide evidence to suggestthat early in life there is an interaction between renal sympatheticnerves and the renin-angiotensin system in regulating renalhemodynamics and the baroreflex control of the heart.

     

Endurance training attenuates the decrease in skeletal muscle malonyl-CoA with exercise

Hutber, C. Adrian, B. B. Rasmussen, and W. W. Winder.Endurance training attenuates the decrease in skeletal muscle malonyl-CoA with exercise. J. Appl.Physiol. 83(6): 1917-1922, 1997.Musclemalonyl-CoA has been postulated to regulate fatty acid metabolism byinhibiting carnitine palmitoyltransferase 1. In nontrained rats,malonyl-CoA decreases in working muscle during exercise. Endurancetraining is known to increase a muscle's reliance on fatty acids as asubstrate. This study was designed to investigate whether the declinein malonyl-CoA with exercise would be greater in trained than innontrained muscle, thereby allowing increased fatty acid oxidation.After 6-10 wk of endurance training (2 h/day) or treadmillhabituation (5-10 min/day), rats were killed at rest or afterrunning up a 15% grade at 21 m/min for 5, 20, or 60 min. Trainingattenuated the exercise-induced drop in malonyl-CoA and prevented theexercise-induced increase in the constant for citrate activation ofacetyl-CoA carboxylase in the red quadriceps muscle of rats run for 20 and 60 min. Hence, contrary to expectations, the decrease inmalonyl-CoA was less in trained than in nontrained muscle during asingle bout of prolonged submaximal exercise.

     

Effect of NH4Cl acidosis on the function of renin-angiotensin-aldosterone system in newborn infants.

The present study was undertaken to assess the influence of acute metabolic acidosis on the activity of renin-angiotensin-aldosterone system and renal function in a group of seven one-week-old neonates with mean birth weight of 2164 g (range: 1300-3750 g) and mean gestational age of 34 weeks (range: 28-40 weeks) undergoing oral NH4Cl load. NH4Cl was given in a dose of 2.8 mEq/kg to evaluate renal acidification. Prior to and following NH4Cl administration blood acid-base parameters, plasma urinary electrolytes, creatinine and aldosterone concentration as well as plasma renin activity, glomerular filtration rate, urine flow rate and net acid secretion were measured. NH4Cl administration significantly depressed blood pH (P < 0.05), total CO2 content (P < 0.01) and base excess (P < 0.01) and resulted in a significant elevation of plasma potassium concentration (P < 0.05). Furthermore, NH4Cl ingestion significantly increased urine flow rate, sodium, chloride and net acid excretion. In response to NH4Cl acidosis no consistent change in plasma renin activity and plasma aldosterone concentration could be detected. There was, however, an about 50% increase in urinary aldosterone excretion from the control value of 4.1 +/- 1.2 micrograms/day to 6.8 +/- 2.3 micrograms/day (P < 0.05) after NH4Cl administration. These data suggest that the responsiveness of neonatal adrenals to stimulation by metabolic acidosis is blunted, acidosis therefore, may play a minor role in the neonatal hyperfunction of renin-angiotensin-aldosterone system.