Roles of bladder distension, urinary pH and urinary sodium ion concentration in cell proliferation of urinary bladder epithelium in rats ingesting sodium salts.

The relative importance of bladder distension, urinary pH and sodium ion concentration for cell proliferation in the bladder epithelium of rats fed various sodium salts was investigated. When a diet containing 5% NaHCO3 was fed to male rats, the bladder epithelium showed an increase in replicating cells, together with distension, increased urine pH and high urine sodium ion concentration. Cell proliferation also occurred when bladders were subjected to distension in vivo by mechanical (female) or physiological (male) means. Inclusion of CaCO3 in the diet produced high urinary pH without alteration in the other factors and did not induce cell proliferation. Increased proliferation occurred when CaCO3 was combined with these mechanical or physiological treatments. Thus, high urinary pH was of secondary importance to bladder distension as a causative factor, but acted to enhance cell proliferation when distension occurred. Similar findings were obtained with regard to sodium ion concentration. In conclusion, this study demonstrated that bladder distension is one of the prerequisites for promoter-induced cell proliferation in the bladder epithelium, with high urinary pH and sodium ion concentration.