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Departments of Laboratory Medicine and Pathobiology, and Chemistry, University of Toronto, Toronto M5G 1L5; and Hemosol, Etobicoke, Ontario, Canada M9W 4Z4
Is O2 diffusivity within renal capillaries rate limiting for O2 delivery to hypoxic renal tubules? Equations based on diffusion theory and developed here predict that soluble hemoglobin (Hb) increases O2 diffusivity by a factor of 1 + [442 Hb%/(P50 + PO2)], where P50 is the partial pressure of O2 at which the Hb is half saturated. To examine the effect of P50 and Hb concentrations on renal function, we perfused isolated rat kidneys with Hb-P35 (P50 = 35 mmHg) and Hb-P11 (P50 = 11 mmHg). Venous PO2 was lower with Hb-P11 (10 ± 1 vs 16 ± 1 mmHg with arterial PO2 = 35 mmHg and 28 ± 2 vs. 40 ± 2 mmHg with arterial PO2 =140 mmHg; P < 0.001). Perfusate P50 did not influence vascular resistance, glomerular filtration rate, O2 consumption, Na reabsorption, protein excretion, or free water clearance. Percent glucose and phosphate excretion were lower with Hb-P11 than with Hb-P35 (P < 0.001). Urine glucose was 0.17 mmol/l with Hb-P11 and 0.77 mmol/l with Hb-P35 (P < 0.001). Hb-P35 (2%) doubled O2 delivery and lowered glucose and phosphate excretion to the level obtained with 1% Hb-P11. Thus Hb-P11 delivered O2 twice as effectively as Hb-P35 to high-affinity sodium glucose and phosphate cotransporters in the late proximal tubule (S3 segment). Hb-P11 may also have shunted O2 from the outer cortex to the outer medulla and facilitated O2 diffusion where PO2 was low. We conclude that diffusivity is a limiting factor in delivery of O2 to hypoxic tubules.
sodium reabsorption; renal energy consumption; glomerular filtration rate; blood substitute; hemoglobin; oxygen affinity; facilitated diffusion
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