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PubMed1995

Thiamin status, diuretic medications, and the management of congestive heart failure.

OBJECTIVE: To assess the prevalence of thiamin deficiency in patients with congestive heart failure who are treated with diuretics that inhibit sodium and chloride reabsorption in the thick ascending limb of the loop of Henle (loop diuretic therapy). DESIGN: A cross-sectional investigation of thiamin status of consecutive patients with congestive heart failure being treated with loop diuretic therapy. SETTING: Cardiology clinic of a midwestern tertiary-care medical center. SUBJECTS: Thirty-eight patients were recruited (mean age +/- standard deviation = 55 +/- 14 years). Validation of methodology was conducted with nine age-matched control subjects. MAIN OUTCOME MEASURES: Thiamin status was assessed biochemically by in vitro erythrocyte transketolase activity assay. Assessment of dietary intake of thiamin was accomplished with a semiquantitative food frequency questionnaire. STATISTICAL ANALYSES PERFORMED: Fisher's exact test and logistic regression were used to evaluate relationships between thiamin status and variables of interest. RESULTS: Biochemical evidence of thiamin deficiency was found in 8 of 38 (21%) patients. Evidence of risk for dietary thiamin inadequacy was found in 10 of 38 patients (25%). Seven of the 8 patients with biochemical evidence of thiamin deficiency met study criteria for dietary adequacy, although quantified data suggested that only 4 of the patients achieved two thirds of the Recommended Dietary Allowance. Biochemical evidence of thiamin deficiency tended to be more common among patients with poor left ventricular ejection fractions (P = .07). CONCLUSIONS: Thiamin deficiency may occur in a substantial proportion of patients with congestive heart failure, and dietary inadequacy may contribute to increased risk.

Adult↗
PubMed1993

Prostaglandin synthesis inhibition stimulates lithium reabsorption in Henle's loop in rats.

The effect of prostaglandin (PG) synthesis inhibition on tubular lithium (Li) handling in the rat was studied by micropuncture at the late proximal (LPT) and early distal (EDT) tubules. Animals received no treatment (N = 7), meclofenamate (MECLO; 5 mg/kg i.p. and 5 mg/kg i.v.; N = 7) or indomethacin (INDO, 1 mg/kg i.v.; N = 6). Whole kidney fractional Li excretion fell from 26.2 +/- 1.5% in control rats to 12.8 +/- 1.3% and 14.6 +/- 1.3% in MECLO and INDO treated rats. Fractional delivery of Li to the LPT was not affected by PG synthesis inhibition. All of the rise in tubular Li reabsorption took place between the LPT and EDT; at the EDT fractional Li delivery fell from 32.3 +/- 2.0% in the control group to 19.1 +/- 1.6% and 20.0 +/- 1.4% in the rats given MECLO or INDO. Water reabsorption between the LPT and EDT also increased. The tubular fluid/plasma Li concentration ratio ([T/P]Li) at the LPT was approximately 1.15 in all groups of rats. At the EDT, this ratio was approximately 1.06 in control rats, but only approximately 0.82 (P < 0.01) in rats subjected to PG synthesis inhibition. The finding that the [T/P]Li fell from values exceeding unity at the LPT to values below unity at the EDT during PG synthesis inhibition indicates that reabsorption of Li between these sites was stimulated to a greater extent than that of water. This dissociation strongly suggests that at least part of the increased Li reabsorption between the LPT and EDT took place in the water-impermeable thick ascending limb.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗
PubMed1995

Effects of glucocorticoid and mineralocorticoid on potassium transport in the rat medullary thick ascending limb of Henle's loop.

Potassium transport in the thick ascending limb is conducted by heterogeneous cells to opposite directions. Effects of glucocorticoids and mineralocorticoids on potassium transport of the rat medullary thick ascending limb (MTAL) were examined by in vitro microperfusion technique by measuring net potassium flux (JK), and apparent potassium conductances in the apical and basolateral membranes of two cell populations. Segments of MTAL were obtained from four groups of rats: sham operated control rats, adrenalectomized rats (ADX), adrenalectomized rats treated with dexamethasone (DEX), and adrenalectomized rats treated with aldosterone (ALDO). Fractional urinary potassium excretion was reduced by ADX and partially recovered by either DEX or ALDO. JK of the isolated perfused MTAL was markedly decreased by ADX from 5.13 to 1.94 pmol/min/mm. It was partially recovered by DEX (3.36 pmol/min/mm), but not by ALDO (2.07 pmol/min/mm). Random impalement of MTAL cells with a microelectrode in the control group revealed two cell populations; 76% was high basolateral conductance cell (HBC) and 24% was low basolateral conductance cell (LBC). In the ADX group, the basolateral potassium conductance of the HBC cell was markedly reduced, whereas the apical membrane potassium conductance of the HBC cell was increased. These changes were recovered in the DEX group, but not in the ALDO group. Potassium conductances of the apical and basolateral membranes in the LBC were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

Three-dimensional functional reconstruction of inner medullary thin limbs of Henle's loop.

Digital three-dimensional (3-D) functional reconstructions of inner medullary nephrons were performed. Antibodies against aquaporins (AQP)-1 and -2 and the chloride channel ClC-K1 identified descending thin limbs (DTLs), collecting ducts (CDs), and ascending thin limbs (ATLs), respectively, through indirect immunofluorescence. Tubules were labeled in transverse sections and assembled into 3-D arrays, permitting individual tubule or combined surface representations to depths of 3.3 mm to be viewed in an interactive digital model. Surface representations of 75 tubules positioned near the central region of the inner medulla were reconstructed. In most DTL segments that form loops below 1 mm from the inner medullary base, AQP1 expression begins at the base, becomes intermittent for variable lengths, and continues nearly midway to the loop. The terminal DTL segment exhibiting undetectable AQP1 represents nearly 60% of the distance from the medullary base to the tip of the loop. AQP1 expression was entirely undetectable in shorter long-looped DTLs. ClC-K1 is expressed continuously along the terminal portion of all DTLs reconstructed here, beginning with a prebend region approximately 164 microm before the bend in all tubules and continuing through the entire ascent of the ATLs to the base of the inner medulla. CDs express AQP2 continuously and extensive branching patterns are illustrated. 3-D functional reconstruction of inner medullary nephrons is capable of showing axial distribution of membrane proteins in tubules of the inner medulla and can contribute to further development and refinement of models that attempt to elucidate the concentrating mechanism.

Animals↗
PubMed2002

Analysis of NaCl transport in thin ascending limb of Henle's loop in CLC-K1 null mice.

To characterize the nature of NaCl transport in the thin ascending limb (tAL), we examined the transport properties of Na(+) and Cl(-) using in vitro microperfusion of the tAL in CLC-K1 null mice. In the presence of a transmural NaCl concentration gradient (100 mM higher in the lumen), the transepithelial diffusion voltage (V(d)) was 15.5 +/- 1.0 and -7.6 +/- 1.4 mV in CLC-K1(+/+) and CLC-K1(-/-) mice, respectively. Neither Cl(-) transport inhibitor 5-nitro-2-(3-phenylpropylamino)-benzoate (NPPB) nor acidification of the bathing fluid changed the V(d) values in CLC-K1(-/-) mice. The addition of 300 microg/ml protamine, a selective blocker of paracellular conductance, to the bath increased the V(d) values by 5.6 +/- 0.7 and 12.6 +/- 1.5 mV (P < 0.001) in CLC-K1(+/+) and CLC-K1(-/-) mice, respectively. Although efflux coefficients of (36)Cl were significantly decreased in CLC-K1(-/-) mice (188.3 +/- 25.6 in 4 tubules vs. 17.2 +/- 7.0 x 10(-5) cm/s in 6 tubules), those of (22)Na were not different between CLC-K1(+/+) and CLC-K1(-/-) mice. These results clearly indicate that the major component of Cl(-) transport sensitive to NPPB or pH is mediated by CLC-K1 in the tAL.

Angiogenesis Inhibitors↗
PubMed1977

Origin of electrical PD's in hamster thin ascending limbs of Henle's loop.

Microelectrodes with 2-micronm-tip diameters arranged to record differentially between this ascending limbs (ALH) and ascending vasa recta (AVR), gave values of 1.95 +/- 0.17 mV, ALH positive, in hydropenia with mineral oil bathing the kidney. Average values remained in the range of 1-2 mV when the ALH and AVR values were obtained sequentially, when the kidney was bathed in Ringer solution, when 5-8 Momega Ling-Gerard microelectrodes were used in the ALH, or when the hamsters were in saline diuresis. These results contradict reports of earlier studies with high impedance Ling-Gerard electrodes that the PD was -9 mV, ALH negative. Perfusion of ALH in saline diuresis with solutions of various compositions provided estimates of ionic transport numbers: tNa+ = 0.33 +/- 0.01, tK+ = 0.00 +/- 0.02, tC1- = 0.67 +/- 0.02. When the perfusion solution was designed to have the same Na+, K+, and C1- concentrations as AVR plasma, the PD was 1.36 +/- .20 mV; when ouabain or furosemide were included (10(-5) M), the PD declined 1.35 +/- 0.21 mV and 1.41 +/- 0.28 mV, respectively. The results suggest that active C1- transport is mainly responsible for the PD, but that diffusion potentials can contribute.

Animals↗
PubMed1980

How descending limb of Henle's loop permeability affects hypertonic urine formation.

An isomorphic, dynamic model of the antidiuretic medulla and distal tubule was used to determine how vasa recta (VR) plasma flow and the nature of descending limb (DLH) equilibration influences inner medullary urine concentrating ability in the steady state. Four DLH modes were examined: water recycling with limited solute permeability, ideal water recycling, mixed water-solute recycling, and strict solute recycling. Each DLH mode was evaluated with and without thin ascending limb (tALH) NaCl active transport. Results indicate that VR plasma flow strongly affects medullary solute accumulation, that NaCl reabsorption from passive tALH is insufficient to establish a positive corticomedullary NaCl gradient, that even limited DLH solute entry compromises the medulla's ability to establish an axial osmotic gradient without active transport, and that with tALH active NaCl transport, positive inner medullary NaCl and osmotic gradients could be established with all four DLH modes. We conclude that tALH NaCl active transport or some other form of osmotic work must be invoked to account quantitatively for inner medullary concentrating effects in rodents.

Animals↗
PubMed1991

Effect of protamine on ion conductance of ascending thin limb of Henle's loop from hamsters.

To evaluate the contribution of paracellular shunt pathway in ascending thin limb (ATL) of hamsters, we examined the effect of protamine, a selective blocker of paracellular conductance, on salt-diffusion voltage (dVT) and transmural resistance (RT) during in vitro microperfusion. Lumen-negative dVT generated on reduction of lumen NaCl concentration was increased further from -7.3 +/- 0.5 to -10.3 +/- 0.7 mV when 300 micrograms/ml protamine was added to the lumen, and calculated Na+/Cl- permeability ratio was decreased from 0.46 +/- 0.03 to 0.31 +/- 0.03. Although the effect of protamine persisted after removal of the agent from the lumen, addition of 30 U/ml heparin returned the dVT toward the control level. The effect of protamine was dose dependent from 30 to 300 micrograms/ml. Protamine also exerted its effect from the bath, and the effect was inhibited by heparin either from the lumen or from the bath. The inhibitory effect was almost the same when the orientation of imposed NaCl gradient was reversed. Inhibition of transcellular Cl- transport with 0.1 mM 5-nitro-2-(3-phenylpropylamino)-benzoate (NPPB) in the bath caused lumen-positive dVT. This voltage was decreased significantly by protamine. Protamine markedly decreased the apparent transference number for Na+ but slightly increased the value for Cl-. Transmural cable analysis showed that 300 micrograms/ml protamine added to the lumen increased RT from 0.59 +/- 0.10 to 1.20 +/- 0.20 omega.cm2, with the effect being reversed by 30 U/ml heparin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1999

Vasopressin increases Na-K-2Cl cotransporter expression in thick ascending limb of Henle's loop.

To investigate whether the enhancement of thick ascending limb (TAL) NaCl transport in response to long-term increases in circulating vasopressin concentration is associated with increased expression levels of the apical Na-K-2Cl cotransporter in the rat TAL, we have carried out immunoblotting and immunofluorescence studies using affinity-purified, peptide-directed antibodies. Semiquantitative immunoblotting studies demonstrated a marked increase (193% of controls) in Na-K-2Cl cotransporter band density in response to restriction of water intake to 15 ml/day for 7 days. In contrast, the expression levels of two other apical proteins of the TAL (the type 3 Na/H exchanger and Tamm-Horsfall protein) were unchanged in the outer medulla. A 7-day subcutaneous infusion of the V2 receptor-selective vasopressin analog, 1-desamino-[8-D-arginine]vasopressin (DDAVP), to Brattleboro rats also markedly increased Na-K-2Cl cotransporter expression in the outer medulla (183% of controls). Immunofluorescence localization in outer medullary tissue sections confirmed the increase in Na-K-2Cl cotransporter expression in response to DDAVP. We conclude that vasopressin strongly upregulates the expression of the Na-K-2Cl cotransporter of the TAL and that it is likely to play an important role in the long-term regulation of the countercurrent multiplication system.

Animals↗