Haemodynamic Studies in Man Before and After Hypophysectomy

Abstract

Determinations of cardiac output and oxygen consumption simultaneously with measurements of glomerular filtration rate and renal plasma flow were performed before and after hypophysectomy in two cases of acromegaly, two cases of metastatic mammary carcinoma, one case of diabetes mellitus and in one case of chromophobe adenoma. After hypophysectomy evidence of adrenocortical insufficiency was present in all but one subject and these patients were on substitution therapy with cortisone (17,21-dihydroxy-pregn-4-ene 3,11,20-trione) at the time of the postoperative studies. In two patients at least, postoperative hypothyroidism could not be demonstrated. In all cases, however, hypophysectomy was followed by a marked and roughly parallel reduction in cardiac output and oxygen consumption. A substantial decrease in glomerular filtration rate, renal plasma flow and renal blood flow following hypophysectomy was also found while no or only slight changes in mean brachial arterial blood pressure were observed. The changes in renal function did not always parallel the reduction in cardiac output.

Long-term Effects of Transsphenoidal Hypophysectomy on Growth Hormone, Renal Function and Eyeground in Patients With Diabetic Retinopathy

“…Examination of phosphate clearances before and after growth hormone administration revealed a marked increase in tubular reabsorption of phosphates. Similar experiments in different types of patients, however, have been carried out by Bojs et al, 54 Corvilain and Abramov 55 and Ehrlich and Randle. 56 The ratio Cp/C T hio decreased while the GFR increased, indicating that HGH has not only a passive hemodynamic effect on renal clearances but also a specific effect on active transport mechanisms.…”

“…Bojs and coworkers 54 have observed a reduction in cardiac output after hypophysectomy. This is taken as circumstantial evidence that elimination of GH leads to a reduction of the blood volume per minute.…”

Plasma Catecholamines in Long-Term Diabetics with and without Neuropathy and in Hypophysectomized Subjects

“…Vasoconstriction is known to take place following hypophysectomy. Falkheden (12) found an average increase in total vascular resistance of 30% in a group of hypophysectomized patients. Renal blood flow is reduced (14,15), and we have recently found a considerable decrease in hand blood flow.2 It seems likely that venous return and cardiac output in the hypophysectomized diabetics are reduced to such a degree that an unchanged blood pressure can be maintained only by a considerable increase in the activity of the sympathetic nervous system.…”

“…Cardiac output is decreased (12) probably secondary to a decreased venous return. Arterial blood pressure in the supine position remains unchanged (1,3,12). Blood volume is reduced (13).…”

The Effect of Hypophysectomy, Adrenalectomy and Acth Administration on Compensatory Renal Hypertrophy in Rats

“…Crude extract of the glandular part of the pituitary, when administered to hypophysectomized, unilaterally nephrectomized, rats and dogs raises the size of the remaining kidney to a value above normal. The influence of the anterior pituitary on kidney function [White, 1955;Goodkind et al, 1957;Bojs et al, 1962] and size, seems to be unequivocally established [Winternitz and Water, 1940; McQueen-Williams and Thompson, 1940]. It is not clear, however, how such influence is brought about.…”