Postural Effects on Renal Tubular Activity 1

Surtshin, A.; White, H. L.

doi:10.1172/jci103272

Cited by 18 publications

(7 citation statements)

References 20 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The renal response to tilting described in these experiments agrees well with previous reports (Pearce & Newman, 1954;Streeten & Speller, 1966;Surshin & White, 1956) which describe an antidiuresis, antinatriuresis and antikaliuresis in sustained increase in the tubular reabsorption of sodium.…”

Section: Discussionsupporting

confidence: 91%

“…In normal humans, transfer from the recumbent to the upright position is associated with a twofold rise in plasma renin activity (Oparil et al, 1970), an antidiuresis, antinatriuresis and antikaliuresis (Pearce & Newman, 1954;Streeten & Speller, 1966;Surshin & White, 1956 with informed consent. The experimental protocol was approved by the ethics committee of Addenbrooke's Hospital, Cambridge.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of enalapril on the renal response to tilting in humans.

Lewis

Ferguson

1989

Brit J Clinical Pharma

View full text Add to dashboard Cite

1. Seventeen normal subjects were tilted on a tilt table and changes in blood pressure, heart rate and renal function were monitored in the absence of drug treatment; the same measurements were repeated during treatment with enalapril in eight of these subjects. 2. In the absence of drug, tilting of the whole body to the 45 degree head up position caused an antidiuresis, antinatriuresis and antikaliuresis; the antinatriuresis resulted from a transient fall in glomerular filtration and from a sustained increase in the tubular reabsorption of sodium, as reflected by a prolonged fall in fractional sodium excretion. 3. Enalapril caused a reduction in blood pressure in the upright position; there was no effect on heart rate. The antinatriuresis of tilt was significantly blunted by enalapril. This resulted from blunting of the transient fall in creatinine clearance and of the increase in tubular sodium reabsorption. Urinary potassium excretion during tilting was not altered by enalapril. 4. These findings are consistent with a direct intrarenal action of angiotensin II, mediating some of the alterations in renal function apparent on assumption of the upright position.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The effect of enalapril on the renal response to tilting in humans.

Lewis

Ferguson

1989

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…Hydrocortisone, however, caused a much greater improvement in all the characteristics of the water diuresis. If these drugs and Compound F-like steroids act primarily at the renal level, it should be possible to fit their actions into the generally accepted schema for the renal tubular reabsorption of solutes and water (17,19,20,29,(31)(32)(33).…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Impaired Water Excretion in Adrenal and Pituitary Insufficiency. I. The Role of Altered Glomerular Filtration Rate and Solute Excretion12

Maxwell¹,

Rockney²

1958

J. Clin. Invest.

View full text Add to dashboard Cite

The inability to excrete an oral or parenteral load of water in a normal manner is a characteristic of the adrenalectomized or hypophysectomized animal and of the patient with adrenal or pituitary insufficiency ( 1-9). This defect persists in the presence of a normal salt balance, extracellular volume, and an adequate supply of salt-retaining hormone, desoxycorticosterone acetate (DCA) or aldosterone (4,7,8,10,11), but it can usually be corrected by the administration of hydrocortisone-like steroids (3,4,7,9).The basic mechanisms responsible for impaired water tolerance in these diseases have not been adequately clarified, nor have the processes by which hydrocortisone causes a normal water diuresis to occur.Gaunt, Birnie and Eversole (8) and others (7, 12) have suggested that a homeostatic "balance" exists between the antidiuretic hormone (ADH) of the neurohypophysis and the 11, 17 hydroxylated steroids of the adrenal cortex. They suggest that in the absence of these steroids, a relative or absolute excess of ADH exists, preventing a normal water diuresis. To prove this hypothesis, a sustained level of secretion of ADH should be demonstrated after the adrenal or anterior pituitary deficient animal has been water loaded, a procedure which ordinarily inhibits ADH secretion. To date, no such sustained activity has been observed using a generally acceptable and specific assay technique (6,13,14). Furthermore, the patient with adrenal or pituitary insufficiency normally inactivates and is not hypersensitive to exogenous antidiuretic hormone (Pitressin®) (6). Recent studies have stressed the importance of nonhormonal factors in determining the characteristics of water diuresis in normal subjects. The rate of glomerular filtration and solute excretion, and the distribution of the reabsorbed solutes between the proximal and distal tubules can profoundly alter the diuretic response to water in the absence of circulating ADH (15-21). Reduced glomerular filtration and renal blood flow are usually present in subjects with pituitary and adrenal insufficiency. In the latter, and occasionally in the former group, tubular reabsorption of sodium is impaired. Welt (22) postulated that the impaired water diuresis of these states is related primarily to alterations in the nonhormonal factors rather than to any disturbance in the secretion, metabolism, or action of ADH. If this theory is correct, it should be possible, while these subjects are under the influence of a sustained water load, to improve considerably their response to water loading by techniques which increase glomerular filtration rate and alter the distribution of solute (sodium) reabsorption between the proximal and distal tubule.This approach formed the basis of the present study. Aminophyllin was used to increase glomerular filtration acutely and alter the tubular reabsorption of solute. Its effect was compared in the same subject with the subsequent administration of hydrocortisone. The results indicate that the marked improvement in the execretion of water which...

show abstract

“…Surtshin & White (1956) have emphasized alterations in proximal, rather than distal, reabsorption of sodium in renal postural responses. This conclusion depended on several assumptions, including that of complete suppression of antidiuretic hormone (ADH) secretion under conditions of maximal water diuresis in both the standing and recumbent positions.…”

Section: Discussionmentioning

confidence: 99%

Some effects of change of posture on water and electrolyte excretion by the human kidney*

Thomas¹

1957

The Journal of Physiology

View full text Add to dashboard Cite

Change of posture is known to be followed by alterations in the renal excretion of water and various urinary constituents. The earlier literature was summarized by Rosenbaum, Ferguson, Davis & Rossmeisl (1952 (Sj6strand, 1953) include changes in renal haemodynamics (Smith, 1951) and when glomerular filtration rate (G.F.R.) alters it is difficult to evaluate the relative importance of glomerular and tubular factors, particularly in the short periods of observation used by most workers.The main object of the present work was to attempt to demonstrate the importance of alterations in tubular activity in the renal adjustments to change of posture. It seemed likely that while acute alterations in renal water and electrolyte excretion could be attributable to changes in renal haemodynamics, the occurrence of more prolonged changes, particularly in urinary hydrion outputs, might indicate the participation of renal tubular factors. In the experiments reported here, the urinary outputs of water, sodium, chloride, potassium, inorganic phosphate, bicarbonate and ammonium, and urinary pH, have been followed for several hours before and after change of * The material included in this paper formed part of a thesis submitted for the degree of M.D., University of Wales in June 1956.

show abstract

Postural Effects on Renal Tubular Activity 1

Cited by 18 publications

References 20 publications

The effect of enalapril on the renal response to tilting in humans.

The effect of enalapril on the renal response to tilting in humans.

Mechanisms of Impaired Water Excretion in Adrenal and Pituitary Insufficiency. I. The Role of Altered Glomerular Filtration Rate and Solute Excretion12

Some effects of change of posture on water and electrolyte excretion by the human kidney*

Contact Info

Product

Resources

About