Rat enterocyte Na+ transport in vitro. Action of parathyroid hormone and calcitonin.

Parathyroid hormone (PTH) and calcitonin exert well known effects on the renal tubule which are thought to involve specific hormone receptors and adenyl cyclase. In the intestine, it is not clear whether the action of PTH and calcitonin is only indirect or also direct, and their mechanisms of action are much less well established. In the present study, possible direct effects of PTH and calcitonin on Na+ transport in isolated intestinal epithelial cells of rats were investigated. In the presence of bovine PTH (1.2 I.U/ml) in the incubation medium, the Na+ efflux rate constant (oKNa) of isolated enterocytes was significantly reduced when compared to that in control experiments with the hormone vehicle only. The mean depression of oKNa induced by bovine PTH was 26% as compared to the control (100%) and to that induced by ouabain (4.0 mM) which was 44%. No depressant effect of bovine PTH on oKNa was observed when the isolated enterocytes were incubated with ouabain (4.0 mM). Thus, bovine PTH appeared to inhibit the ouabain-sensitive Na+ pump. When incubating the isolated epithelial cells in an EGTA-containing CA2+-free medium, bovine PTH lost its capacity to inhibit oKNa. Thus, the presence of extracellular Ca2+ appeared necessary for the inhibitory effect of bovine PTH. In contrast to its effect on oKNa, bovine PTH induced no change in net Na+ uptake by isolated enterocytes. Moreover, no significant effect on enterocyte Na+ transport could be demonstrated for salmon or porcine calcitonin at two different concentrations in the incubation medium, Neither bovine PTH nor salmon calcitonin induced significant changes in enterocyte cyclic AMP or cycle GMP concentrations. It was concluded that bovine PTH, but not calcitonin, exerted a directed inhibitory effect on the ouabain-sensitive oKNa of isolated rat enterocytes. The effect of bovine PTH occurred without measurable activation of the cyclic nucleotide system but needed the presence of Ca2+ in the incubation medium to be operative.

Liquid scintillation counting for measurement of tritiated uptake in lymphocyte transformation in vitro: a new direct-suspension procedure.

Liquid scintillation counting of trichloracetic acid extracts of [3H] TdR-labelled lymphocytes has been studied by a direct suspension method without previous solubilization. In this new method, mixing of the labelled powder in water suspension with Scintillator Emulsifying Mixture (SEM) results in a firm gel whose mechanical properties provide an heterogeneous sample ready for counting. Counting efficiency and stability of such samples are related to the amount of labelled cells. Comparative studies with standard hyamine procedure have shown that this simple and rapid method gives reliable results.

Noninvasive experimental determination of the individual kidney filtration fraction by means of a dual-tracer technique.

A noninvasive method for measurement of the individual kidney filtration fraction (FF) is presented, based on an analysis of the early rise of the kidneys' time-activity curves obtained after simultaneous injection of tubular [131I] ortho-iodohippurate and glomerular (Tc-99m DTPA) tracers. The analysis is based on the assumption that an insignificant amount of tracer leaves the kidney during the first few moments following injection. Therefore the kidney activity during this period is directly proportional to the integral of the blood (heart) activity. The dual-tracer technique allows the direct calculation of the ratio of glomerular to tubular clearances, i.e., the FF. In vivo studies were performed on 12 dogs, including normals as well as others with acute ureteral ligation or Benemid-induced tubular blockade. The calculated FF correlated well with the FF obtained from single-shot clearances performed simultaneously. We conclude that the FF can be calculated directly for each kidney, noninvasively, from the early part of the tubular and glomerular time-activity curves by noninvasive external detection.

Recent advances in factors that alter lipid metabolism in chronic renal failure.

The following conclusions and speculations can be tentatively drawn from the changes in lipoprotein composition and metabolism: (1) The presence of apo B-48 in serum VLDL and the high serum apo A-IV concentrations indicate a greater than normal contribution of alimentary remnant particles to the hypertriglyceridemia of uremic patients, (2) The presence of apo E and C in triglyceride-enriched serum LDL, together with the triglyceride enrichment of all lipoproteins, probably stems from a deficiency of lipoprotein lipase (LPL) and hepatic lipase (HL) activity, (3) The decreased ratio of serum apo C-II/C-III in VLDL is at least in part responsible for the depressed activity of LPL, (4) The accumulation of lipoprotein particles with distorted apoprotein and lipid patterns (particularly beta-VLDL with enrichment in cholesterol) could be associated with an increased atherogenesis because a recent study has demonstrated a strong association between raised serum IDL and VLDL concentrations and the degree of coronary atherosclerosis, (5) The increased apo E content of VLDL and HDL in uremic patients could particularly point to a disturbed cholesterol metabolism because such lipoproteins could interact with LDL at apo B, E receptors, (6) The decrease in serum HDL-cholesterol has been shown to be strongly associated with atheromatous vascular disease, and this could also hold for uremic patients; however, it is probable that low serum HDL-cholesterol together with a diminished capacity to form cholesterol-rich, apo E containing HDL represents a decrease in the antiatherogenic defense of the organism rather than an increased atherogenic potential [21].

Cholecalciferol metabolites binding in porcine parathyroid glands.

We studied the cytoplasmic and nuclear binding of 25-hydroxychole-calciferol and 1alpha,25-dihydroxycholecalciferol inside porcine parathyroid glands. Both sterols bind to cytoplasmic components, but a specific nuclear uptake was demonstrated only for 1alpha,25-dihydroxycholecalciferol. These findings support the hypothesis that mammalian parathyroid glands are a target organ for some cholecalciferol metabolites.

Effect of parathyroid hormone and volume expansion on jejunal calcium, sodium, and water transport in the rat.

The effects of PTH on jejunal calcium, sodium, and water transport were studied in the rat in situ. In TPTx rats, as well as in normal rats, bovine PTH induced a decrease in net calcium, sodium, and water absorption. Additionally, lumen-to-plasma calcium flux was found decreased in both groups. Stimulation of endogenous PTH secretion by calcium-poor hyperoncotic albumin resulted in a similar decrease in net calcium, sodium, and water absorption. It is suggested that PTH has a direct inhibitory effect on jejunal calcium, sodium, and water absorption.

Effect of parathyroid hormone on rat enterocyte Na transport in vitro.

In the presence of b.PTH (1.2 I.U./ml) in the incubation medium, the Na efflux rate constant (degree KNa) of isolated rat enterocytes was significantly reduced when compared to control experiments. The mean depression of degree KNa induced by b.PTH was 26% as compared to control (100%). No depressant effect of b.PTH on degree KNa was observed when the isolated enterocytes were incubated with ouabain (4.0mM). Thus, b.PTH appeared to inhibit the ouabain-sensitive Na pump. When incubating the isolated epithelial cells in an EGTA-containing Ca free medium, b.PTH lost its capacity to inhibit degree KNa. Thus, the presence of extracellular Ca appeared necessary for the inhibitory effect of b.PTH. In contrast to its effect on degree KNa, b.PTH induced no change of net Na uptake by isolated enterocytes. Moreover, b.PTH did not induce significant changes in enterocyte cAMP or cGMP concentrations. It was concluded that b.PTH exerted a direct inhibitory effect on the ouabain-sensitive Na efflux rate constant of isolated rat enterocytes. The effect of b.PTH occurred without a measureable activation of the cyclic nucleotide system but needed the presence of Ca in the incubation medium to be operative.

[Retinal complications in diabetics with renal failure]. / Complications rétiniennes du diabétique en insuffisance rénale.

The following conclusion, are based on this series of 27 patients, all diabetics with end-stage renal failure: All, except one, with both diabetes and nephropathy exhibited retinopathy. Retinopathy, its severity and the prevalence of complications are primarily related to the evolution of diabetes, whatever the type and severity of the nephropathy, and independent of the presence or severity of hypertension. Good glycemia control did not induce efficient prevention of retinopathy. In insulin-dependent diabetic patients, the type of insulin used had no influence on the evolution or severity of the retinopathy. The duration of diabetes and the beginning in childhood are the major factors for complications risks.

[The future of hemodialysis in the adult]. / Les perspectives de l'hémodialyse de l'adulte.

By the year 2000, the perspectives for hemodialysis performed in adults will be oriented towards facilitation of the practice of hemodialysis as a better control of clinical symptoms observed in end stage renal failure treated by hemodialysis. Blood access is the main problem which remains to be solved. The authors describe the advantages and disadvantages of the methods presently used and give the "state of the art" of "blood access" prosthesis. Almost all symptoms encountered in renal failure patients treated by hemodialysis can be efficiently treated. Hypotensive drugs usually reduce hypertension which resists adequate treatment by hemodialysis. Most of the symptoms of osteodystrophy can be avoided by adequate diet associated with the prescription of vitamin D analogs. Nevertheless, the prolongation of hemodialysis treatment duration over 7 years has led to the apparition of destructive arthropathies which are very painful and handicapping. They are related to amyloid deposit of beta 2-microglobulins. Progress in hemodialysis technics and a better control of uremic symptoms allow application of this treatment at all ages of life. The authors examine specific problems concerning school-aged teenagers and aged persons. They show that results already achieved allow a daily treatment of these patients. This is a first step for the generalisation of this procedure to all patients and its advantages are described. Improvement of hemodialysis technics for the year 2000, as can be expected, mainly depends upon progress in knowledge of biocompatibility parameters between materials used in the artificial kidney and patients tissues, mainly blood vessels.