Aldosterone Excretion and Potassium Retention in Subjects living at High Altitude

Ayres, P. J.; Hurter, Rona; Williams, E. S.; Rundo, J.

doi:10.1038/191078b0

Cited by 30 publications

(5 citation statements)

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“…Our observation that renal excretion of arginine vasopressin changes little is thus consistent; quite a large isosmotic reduction of plasma volume is needed to increase plasma concentration of arginine vasopressin (Davies, Slater, Forsling & Payne, 1976). However, as indicated above, the observation which remains inconsistent with current concepts is the remarkable and pronounced fall of renal aldosterone excretion (Ayres et al 1961;Slater, Tuffley et al 1969) and the rate of aldosterone secretion (Slater, Tuffley et al 1969). Delamare & Jones (1979) have shown under uncontrolled conditions that altitude appears to lower plasma aldosterone concentration, so confirming the earlier studies of Maher et al ( 1975) and Sutton et al ( 1977); the present study, carried out under strict dietary control, further confirms that basal plasma levels of aldosterone fall sharply at altitude and rise sharply on return to sea level.…”

Section: Discussionmentioning

confidence: 90%

“…Since the activity of the renin-aldosterone system is now considered to be a major variable in the finer control of sodium homeostasis, it is pertinent to consider it in some detail. An early uncontrolled study (Ayres, Hurter, Williams & Rundo, 1961) indicated a sharp reduction in the rate of the renal excretion of the 18-glucuronide metabolite of aldosterone. A later study (Slater, Tuffley, Williams, Beresford, Sönksen, Edwards, Ekins & McLaughlin, 1969;, under controlled conditions of diet and exercise, showed a sharp reduction in the rate of aldosterone secretion, despite potassium retention and an actual increase in the rate of cortisol secretion.…”

Section: Introductionmentioning

confidence: 97%

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Renin and Aldosterone at High Altitude in Man

Keynes¹,

Smith²,

Slater³

et al. 1982

Journal of Endocrinology

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Measurements have been made of hormonal changes relevant to salt and water balance during prolonged exposure to hypoxia to improve our understanding of the syndrome of acute mountain sickness. We have attempted to delineate the detailed inter-relationships between the renin-aldosterone and the vasopressin systems by a metabolically controlled study, involving an orthostatic stress (45 degrees head-up tilt) and an injection of a standard dose of ACTH to test adrenal responsiveness. Three Caucasian medical students underwent a 7-day equilibration at 150 m (Lima, Peru), followed by a 6-day sojourn at 4350 m (Cerro de Pasco, Peru) and a final 7 days at 150 m. Measurements were made of sodium and potassium balance, body weight and the 24-h renal excretion of vasopressin, cortisol and aldosterone 18-glucuronide. These variables showed little change, except for that of aldosterone 18-glucuronide, which fell sharply at altitude and rebounded even more sharply on return to sea level. At altitude, basal plasma levels of renin activity and aldosterone fell, and the response to orthostasis was attenuated, but the fall of plasma renin activity, as compared to plasma aldosterone, was delayed; on return to sea level this dissociation was exacerbated with the return of normal renin responsiveness lagging behind that of aldosterone. We suggest that unknown factors which dissociate the orthodox renin-aldosterone relationship, other than the activity of the angiotensin I-converting enzyme, are operative on exposure to hypoxia.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 97%

Renin and Aldosterone at High Altitude in Man

Keynes¹,

Smith²,

Slater³

et al. 1982

Journal of Endocrinology

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“…The results are illu strated in figure 12. As already reported (Ayres et al 1961) the body content of potassium was assayed by whole-body radiation assay of the isotope ^K in three subjects before and after the expedition and an increase in total body potassium content thereby demonstrated. In the discussion which follows haemodynamic factors will be considered.…”

Section: Col Du Midimentioning

confidence: 56%

Electrolyte regulation during the adaptation of humans to life at high altitude

Williams

1966

Proc. R. Soc. Lond. B.

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Studies related to the body’s regulation of its sodium and potassium content have been made on a number of occasions during periods spent at high altitude. It is shown that on ascent from usual levels of residence the ratio of sodium to potassium in the saliva tends to rise above normal and later to fall with continued residence at altitude. The implications of this finding have been confirmed by subsidiary studies. The urinary aldosterone excreted while resident at altitude has been assayed and it has been shown to fall to very low levels. In contrast to what occurs with 17-hydroxycorticosteroids there appears to be a delay in the fall of urinary aldosterone although this has still to be confirmed by further studies which are in course of preparation. With continued residence at high altitude the urinary aldosterone level recovers but complete recovery takes several weeks. Published data are reviewed and it is concluded that these results are due to the changes in intravascular volume which occur on ascent to an environment of reduced p 0 2 . It is probable that the significant volume changes are intrathoracic.

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“…Increased Na excretion and net K retdntion appeared essential to acclimatization at high attitudes for "stronger" climbers had a significant higher (+ 30%) Na excretion than "weaker" climbers (Table 3). Williams (1966) had observed similar changes in electrolyte levels of mountain climbers associated with decreased aldosterone excretion (Ayres, Hurter and Williams, 1961) and attributes these changes to increases in extracellular volume at high altitude. Increases in extraeellular volume in the brain could increase intracranial pressure and relate to the retinal hemorrhages observed in this (Schumacher and Petajan, 1972) and ether studies (Singh et al, 1969).…”

Section: E L E C T R O L Y T E Smentioning

confidence: 75%