PubMed · 4341075
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H Müller, E H Graul. 1972. [Functional nephrography].. https://pubmed.ncbi.nlm.nih.gov/4341075/
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Basolateral membrane vesicles made from rabbit kidney proximal tubules were frozen and irradiated with a high energy electron beam and the effects of irradiation on Na,K-ATPase activity, p-aminohippurate (PAH) transport, the membrane diffusion barrier and vesicle volume were measured. The vesicle volume and diffusion barrier were not significantly changed by radiation exposure. Na,K-ATPase activity was inactivated as a simple exponential function of radiation dose. Target size analysis of the data yielded a molecular size of 267 +/- 17 kDa, consistent with its existence as a (alpha beta)2 dimer. The carrier-mediated PAH uptake by basolateral membrane vesicles was also inactivated as a function of radiation dose. A target molecular size of 74 +/- 16 kDa was calculated for the PAH transport system. This study is the first measurement of the functional size of the organic acid transport system based directly on flux measurements.
Orthoiodohippuric (OIH) acid labeled with 131I is a widely used renal radiopharmaceutical agent and has been the standard radiopharmaceutical agent for the measurement of effective renal plasma flow (EPRF). Limitations to the routine clinical use of 131I OIH are related to the suboptimal imaging properties of the 131I radionuclide and its relatively high radiation dose. 123I has been substituted for 131I; however, its high cost and short shelf-life have limited its widespread use. Recent work has centered on the development of a new 99mTc renal tubular function agent, which would use the optimal radionuclidic properties and availability of 99mTc and combine the clinical information provided by OIH. The search for a suitable 99mTc renal tubular function agent has focused on the diamide dithiolate (N2S2), the paraaminohippuric iminodiacetic acid (PAHIDA), and the triamide mercaptide (N3S) donor ligand systems. To date, the most promising 99mTc tubular function agent is the N3S complex: 99mTc mercaptoacetyltriglycine (99mTc MAG3). Studies in animal models in diuresis, dehydration, acid or base imbalance, ischemia, and renal artery stenosis demonstrate that 99mTc MAG3 behaves similarly to 131I OIH. A simple kit formulation is available that yields the 99mTc MAG3 complex in high radiochemical purity. Studies in normal subjects and patients indicate that 99mTc MAG3 is an excellent 99mTc renal tubular agent, but its plasma clearance is only 50% to 60% that of OIH. In an effort to develop an improved 99mTc renal tubular function agent, changes have been made in the core N3S donor ligand system, but to date no agent has been synthesized that is clinically superior to 99mTc MAG3.
Excretion of organic acids and bases was studied in twelve fetal sheep aged 120-140 days. There was no significant plasma protein binding of the organic anion, p-aminohippurate (PAH), nor of the organic cation, [14C]tetraethylammonium (TEA). There was a significant amount of acetyl-PAH (20 +/- 3%) in fetal urine but none could be detected in fetal plasma. The fractional excretion of unconjugated PAH was less than one, i.e. there was net reabsorption of 31.7 +/- 3.9% of the filtered load of unconjugated PAH. Since there was no acetyl-PAH in fetal plasma it is concluded that all acetyl-PAH in fetal urine occurred as a result of metabolism of PAH and secretion of the metabolite into the tubular lumen. The rate of excretion of acetyl-PAH in fetal urine varied from 0 to 14.0 micrograms min-1. Thus unconjugated PAH is filtered and there is net reabsorption; in addition, PAH is metabolized and enters the urine via tubular mechanisms. The fractional excretion of PAH was unaffected by I.V. administration of penicillin either acutely or chronically. The clearance of [14C]TEA was significantly greater than the glomerular filtration rate (GFR). The mean fractional excretion of [14C]TEA was 5.4 +/- 0.17. Thus 80.7 +/- 0.63% of the excreted TEA was secreted. The clearance of TEA was related to body weight (P less than 0.001) but the fractional excretion of TEA declined with gestation age, probably because GFR increased at a greater rate than the rate at which the secretory pathways increase their activity. It is concluded that those pathways that excrete organic anions like PAH into the urine mature much later (probably after birth) than those pathways responsible for the tubular secretion of organic bases.