Suppression of Para-aminohippurate Transport in the Isolated Perfused Kidney by an Inhibitor of Protein Binding in Uremia

摘要: Serum from patients with advanced renal failure contains substances that inhibit binding of small ligands to albumin. The extractable inhibitors albumin (IX), which were previously shown in rat kidney slices para-aminohippurate (PAH) transport, added the vitro perfused an attempt investigate effects on organic acid transport intact organ. Following addition extract perfusate there was immediate and profound decrease whole PAH secretion. Mean clearance fell average 60% ± 7% after human uremic pleural exudate 62% 6% similarly prepared normal urine. There no change inulin clearance, vascular resistance, urine flow, or fractional reabsorption sodium. effect be as marked when bovine serum (4.0 g/dL) perfusate, clearances falling 66% 7%. Controls showed during 90 minutes perfusion. An increase ultraviolet (UV) absorbance by within inhibitor suggested tubular secretion a major portion extract. Partial recovery observed 20 40 most kidneys near complete occurred some kidneys. inhibitory duplicated hippurate at 24 mg/dL (1.2 mmol/L) perfusate. These findings show mammalian can specifically reversibly suppressed partially purified protein uremia. Similar suggest several protein-bound acids accumulating body fluids may account for both phenomena.