Sodium Handling and Interaction in Numerous Organs
Sodium Handling and Interaction in Numerous Organs
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许多器官中的钠处理和相互作用
DOI：
10.1093/ajh/hpaa049
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发表时间：
2020
影响因子：
3.2
通讯作者：
Kitada Kento
中科院分区：
文献类型：
--
作者：
Minegishi Shintaro;Luft Friedrich C;Titze Jens;Kitada Kento
盐（NaCl）是生命的先决条件。然而，据说过量摄入盐会增加疾病风险，包括高血压、动脉硬化、心力衰竭、肾脏疾病、中风和癌症。因此，在当前钠平衡概念的基础上，对钠处理机制进行了大量的研究。这些研究必然依赖于相对短期的实验，并专注于人类的极端盐摄入量。超长期盐平衡受到的关注要少得多。我们在摄入6,9和12g /天的情况下进行了长期盐平衡研究，发现尽管肾脏仍然是长期排泄门户，但组织和血浆钠浓度不一定相同，尿盐排泄也不一定反映全身盐含量。我们发现，为了排泄盐，身体会努力保存水分，从而导致盐排泄的尿钠-输尿管原则。值得注意的是，肾脏钠处理的特点是渗透物排泄与反平行水重吸收，这是一种通过多器官相互作用实现的状态。在这篇综述中，我们讨论了新的钠和水平衡的概念，参考我们的超长期研究。了解人体钠代谢的一个重要关键是关注水分保存，这是防止脱水的生物学原理，因为过量的饮食盐排泄到尿液中会导致肾脏因钠尿而失水。我们认为我们的研究方向不仅与盐平衡有关，而且与心血管调节机制有关。
Salt (NaCl) is a prerequisite for life. Excessive intake of salt, however, is said to increase disease risk, including hypertension, arteriosclerosis, heart failure, renal disease, stroke, and cancer. Therefore, considerable research has been expended on the mechanism of sodium handling based on the current concepts of sodium balance. The studies have necessarily relied on relatively short-term experiments and focused on extremes of salt intake in humans. Ultra-long-term salt balance has received far less attention. We performed long-term salt balance studies at intakes of 6, 9, and 12 g/day and found that although the kidney remains the long-term excretory gate, tissue and plasma sodium concentrations are not necessarily the same and that urinary salt excretion does not necessarily reflect total-body salt content. We found that to excrete salt, the body makes a great effort to conserve water, resulting in a natriuretic-ureotelic principle of salt excretion. Of note, renal sodium handling is characterized by osmolyte excretion with anti-parallel water reabsorption, a state-of-affairs that is achieved through the interaction of multiple organs. In this review, we discuss novel sodium and water balance concepts in reference to our ultra-long-term study. An important key to understanding body sodium metabolism is to focus on water conservation, a biological principle to protect from dehydration, since excess dietary salt excretion into the urine predisposes to renal water loss because of natriuresis. We believe that our research direction is relevant not only to salt balance but also to cardiovascular regulatory mechanisms.