Recovery of distal nephron enzyme activity after release of unilateral ureteral obstruction.

Purpose: Unilateral ureteral obstruction (UUO) for 24 hours results in a severe compromise of distal tubular function. The acidification defect is believed to be localized in the collecting duct. To characterize distal tubular function recovery one month after junction release, clearance studies in whole animals and enzyme studies in microdissected segments were performed in an experimental model of unilateral ureteral obstruction.

Materials And Methods: Following release of ureteral obstruction of 24 hours duration, a significant decrease of whole kidney glomerular filtration rate was observed in the postobstructed kidney (POK) with a marked increase in urinary pH, fractional excretion of bicarbonate (FEHCO3-) and decrease in urinary osmolality. By orthograde stop flow experiment, bicarbonate excretion rate (Fr:Ff HCO3-/Fr:Ff Inutest) increased in the first and second urine fractions of 120 microl. corresponding to the collecting segment in the POK, one day after release. Decrease in U-P pCO2 (p<0.01) suggested an impaired H+ secretion on distal nephron in POK. Recovery of inulin clearance and values of urinary pH, FEHCO3- and urinary osmolality near contralateral and control kidneys were observed thirty days following ureteral release. The decline in enzyme activity in the distal nephron due to structural damage from high intratubular pressure was evaluated. Bafilomycin sensitive H+ -ATPase activity measurement in the medullary collecting duct segments of the POK showed an important decrease (68%), with lightly reduced activity (20%) in the cortical collecting duct, 24 hours after obstruction release. Localized in the connecting tubule cells and secreted into the tubular fluid in the late distal nephron, renal kallikrein has been involved in bicarbonate transport at cortical collecting duct segments. The renal kallikrein-like activity was reduced in POK (p<0.01).

Results: Recovery of enzyme activity was shown thirty days after unilateral ureteral obstruction. Our results show severe functional damage of the collecting duct after 24 hours of unilateral ureteral obstruction. H+ -ATPase activity was markedly decreased on medullary collecting duct segments.

Conclusions: A correlation between the functional impairment of distal H+ secretion and decreased distal nephron enzyme activity has been shown. Recovery of both the functional and the enzyme activity at the distal nephron was demonstrated thirty days after obstruction release.