Differences between Saline and Mannitol Diuresis in Hydropenic Man*

Goldberg, Martin; McCurdy, Donna K.; Ramirez, Manuel A.

doi:10.1172/jci105133

Cited by 66 publications

(39 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since the capacity to reabsorb sodium in this segment is thought to be unsaturable, measurement of CblZo and the reabsorption of solute-free water (TC,;,o) have been used as indices of sodium reabsorption in the proximal segment of the nephron (7,18). An increase in proximal reabsorption would result in a decrease in the amount of sodium delivered to the ascending limb and, consequently, would be reflected by a decrease in these parameters of renal function which are dependent upon sodium absorption at that site.…”

Section: Discussionmentioning

confidence: 99%

A Study of the Renal Handling of Water in Lipoid Nephrosis

et al. 1976

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

A Study of the Renal Handling of Water in Lipoid Nephrosis

et al. 1976

View full text Add to dashboard Cite

“…Measurement of TCH2o during hypertonic (3%) saline diuresis in six hydropenic hypertensive patients was performed as previously described from this laboratory (9). Experiments were performed in the morning with patients in the recumbent position.…”

Section: Methodsmentioning

confidence: 99%

“…Studies during ingestion of a low sodium diet (less than 20 mEq/day) were performed in addition on patient P. L. and in two other hypertensive patients (F. G. and L. C.). The data on changes in TCHo and sodium excretion from these patients were compared with data obtained from six normal hydropenic subjects given hypertonic saline, studied similarly in this laboratory and reported previously (9). Maximum urine osmolality was determined after a standard protocol of fluid deprivation and Pitressin administration (11).…”

Section: Methodsmentioning

confidence: 99%

Mechanism of exaggerated natriuresis in hypertensive man: impaired sodium transport in the loop of henle

Buckalew¹,

Puschett²,

Kintzel³

et al. 1969

J. Clin. Invest.

Self Cite

View full text Add to dashboard Cite

A B S T R A C T To evaluate the effects of saline loading on distal sodium reabsorption in hypertensive man, studies were performed during both water deprivation and water diuresis in eight hypertensive subjects, and the results were compared to data obtained from similar studies in normal subjects. All hypertensive patients exhibited an enhanced excretion of filtered sodium (Ca/CIn) at any level of distal delivery of sodium compared to normal controls. Free water reabsorption (TCH2o) during hypertonic saline loading was quantitatively abnormal in the hypertensives at high levels of osmolar clearance (Co.m), and also the curve of TCHIo vs. Co.m leveled off above a Co.m of 18 ml/min per 1.73 m' in the hypertensive group in contrast to the normal controls in whom TCH,0o showed no evidence of achieving an upper limit. Sodium depletion exaggerated the abnormality in T'Ho in hypertensives, and resulted in a positive free water clearance (CH2o) during hydropenia.During hypotonic saline loading in water diuresis, changes in free water clearance per 100 ml of glomerular filtrate (CIo0/CI.) were less at any given increment in urine flow per 100 ml of glomerular filtrate (V/CG.) in the hypertensives compared to normal controls (P < 0.001). This abnormality in CH2o/CI. in the hypertensives in conjunction with the defect in T'H2o observed during hydropenia indicates that sodium reabsorption in the loop of Henle was abnormal at any given rate of distal delivery of sodium in hypertension. Furthermore, these abnormalities in TCH2o and CH20 coincided temporally with the development of the exaggerated natriuresis. Although the distal defect in sodium transport, in large part, accounted for the augmented natriuresis in hyperThis work was presented in part at the 1st Annual Meeting of the

show abstract

“…The association of these changes with the changes of solute-free water clearance which we describe suggest that they are responsible for the natriuretic effect of this atrial peptide in man. Similar changes are seen with the natriuresis caused by infusion of saline (Goldberg et al 1965;Thomsen, 1984). To this extent, it remains possible that endogenous human x-atrial natriuretic peptide may act as a natriuretic hormone released in response to expansion of the extracellular fluid volume in man.…”

Section: Renal Action Of Atrial Peptide In Manmentioning

confidence: 71%

“…This is known to happen at the exaggerated rates of tubular flow which occur during profound osmotic diuresis in the dog because a hypotonic urine is excreted despite maximum levels of antidiuretic hormone (Orloff, Wagner & Davidson, 1958). However, in dehydrated man, urine does not become hypotonic, even during extreme osmotic diuresis with rates of urine flow approaching 20 % of the rate of glomerular filtration (Goldberg, McCurdy & Ramirez, 1965). The dose of human oc-atrial natriuretic peptide used here was selected to give much lower rates of urinary flow during dehydration.…”

Section: Renal Action Of Atrial Peptide In Manmentioning

confidence: 99%

Renal mechanisms of human alpha‐atrial natriuretic peptide in man.

Brown

Corr

1987

The Journal of Physiology

View full text Add to dashboard Cite

SUMMARY1. Eight normal volunteers were studied on two separate days after being dehydrated overnight. Each volunteer received a background intravenous infusion of arginine vasopressin (5 5 x 1t-0 i.u. kg-' min-') on both days and also received an intravenous infusion of human a-atrial natriuretic peptide (15 pmol kg-' min-') plus carrier on one day and carrier alone on the other. The ensuing changes in blood pressure, in the excretion of urinary solutes, and in the excretion of solute-free water were recorded.2. The infusion of atrial peptide had a small hypotensive effect, and increased the rate of excretion of sodium but not of potassium. There were no significant changes of urinary osmolality or of creatinine clearance.3. The infusion of atrial peptide increased the rate of solute-free water reabsorption and did so in direct proportion to its effect of increasing sodium excretion.4. A further six normal, dehydrated volunteers were studied on each of two days after taking 500 mg of lithium carbonate on the previous evening. On one day, they received an intravenous infusion of human a-atrial natriuretic peptide (15 pmol kg-' min-') plus carrier and on the other day they received carrier alone. The excretion of urinary electrolytes and the creatinine clearance were recorded. 5. The infusion of atrial peptide produced significant increases in the rates of excretion of both sodium and lithium, but there were no such changes of creatinine clearance.6. Another six normal volunteers were studied on each of two days. On each day they drank 2 1 of water over 30 min and then water to replace their urinary losses. They also received loading doses and maintenance infusions of inulin and sodium para-aminohippurate. Once a full water diuresis had become established, each subject received an infusion of human a-atrial natriuretic peptide (15 pmol kg-' min-') plus carrier on one day and carrier alone on the other, exactly as before. The excretion of sodium and solute-free water, and the clearances of inulin and para-aminohippurate were recorded.7. The infusion of atrial peptide increased the rates of excretion of both sodium and solute-free water. It also increased the clearance of inulin, but not that of para-aminohippurate.8. These results suggest that, in our volunteers, infusion of human a-atrial natriuretic peptide increases sodium excretion mainly by increasing the delivery of J. BROWN AND L. CORR sodium along the renal tubule from sites upstream of the loop of Henle. This occurs partly as the result of an increase in the rate of glomerular filtration, but the peptide also increases the fractional excretion of filtered lithium and this suggests that human a-atrial natriuretic peptide can also reduce the fractional reabsorption of filtered sodium from the proximal tubule in man.

show abstract

Differences between Saline and Mannitol Diuresis in Hydropenic Man*

Cited by 66 publications

References 22 publications

A Study of the Renal Handling of Water in Lipoid Nephrosis

A Study of the Renal Handling of Water in Lipoid Nephrosis

Mechanism of exaggerated natriuresis in hypertensive man: impaired sodium transport in the loop of henle

Renal mechanisms of human alpha‐atrial natriuretic peptide in man.

Contact Info

Product

Resources

About