A B S T R A C T In these experiments we investigated whether NAD could serve as an intracellular modulator of the brush border membrane (BBM) transport of inorganic phosphate (Pi). NAD, both oxidized (NAD+) and reduced (NADH) form, inhibited the Na+-dependent uptake of 32Pi in the concentration range of 10-300 zM NAD when added in vitro to BBM vesicles isolated from rat kidney cortex, but did not inhibit BBM uptake of D-[3H]glucose or BBM uptake of 22Na+. Neither nicotinamide (NiAm) nor adenosine alone influenced BBM uptake of 32Pi. NAD had a similar relative effect (percent inhibition) in BBM from rats stabilized on low Pi diet (0.07% Pi), high Pi diet (1.2% Pi), or normal Pi diet (0.7% Pi).Subsequently, we examined the renal effects of changing the tissue NAD level in vivo. Rats stabilized on low Pi diet were injected intraperitoneally with NiAm (0.25-1.0 g/kg body wt); urinary excretions of Pi (UpV), of fluid, and of other solutes were measured before and after NiAm injection, then renal cortical tissue nucleotide content was determined, and a BBM fraction was isolated for transport measurements. In BBM from NiAm-treated rats, the Na+-dependent uptake of 32Pi was decreased, but BBM uptake of D-[3H]glucose and BBM uptake of22Na+ were not changed. NiAm 29 December 1980. mum change, 290%), a lesser increase in NADH (maximum change, +45%), but no change in the content of ATP or cyclic AMP in the renal cortex. Na+-dependent BBM uptake of 32Pi was inversely correlated with NAD+ content in renal cortex (r = -0.77+0.1; P < 0.001) arid with UpiV (r = -0.67+0.13; P < 0.01). NAD+ in renal cortex was positively correlated with UpjV (r = 0.88±0.05; P < 0.001). Injection of NiAm elicited a marked increase in Up1V, but no change in excretions of creatinine or K+, or in urine flow; excretion of Na+ and Ca declined. NiAm injection caused similar renal responses, in normal and in thyroparathyroidectomized rats, as well as in rats on normal Pi diet and low Pi diet.We conclude that NAD can serve as an intracellular modulator (inhibitor) of Na+-dependent transport of Pi across the renal luminal BBM and across the proximal tubular wall by its direct interaction with BBM. We propose that at least some hormonal and/or metabolic stimuli elicit phosphaturia by increasing NAD+ in cytoplasm of proximal tubular cells.
INTRODUCTIONA Na+-dependent Pi uptake by the luminal brush border membrane (BBM) and its regulation by various hormonal and metabolic stimuli (1-3) are initial and perhaps quantitatively determining cellular steps in proximal tubular reabsorption of phosphate (Pi). Parathyroid hormone (PTH) or vitamin D (1, 3) has been reported to decrease BBM uptake ofPi, whereas growth hormone reportedly has an opposite effect (4). In phosphaturia associated with starvation (5) or a high Pi diet (2), the capacity of the BBM to transport Pi is diminished; feeding with a diet selectively deficient in Pi, however, leads to a marked increase in BBM uptake of Pi (1)(2)(3)5), which is apparently independent of the J. Clin. (5, 16). HPD ...