Studies of the Antidiuresis of Quiet Standing: The Importance of Changes in Plasma Volume and Glomerular Filtration Rate 1

Epstein, Franklin H.; Goodyer, Allan V. N.; Lawrason, F. Douglas; Relman, Arnold S.

doi:10.1172/jci102417

Cited by 71 publications

(23 citation statements)

References 30 publications

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“…They also suggest that the greater tubular reabsorption of sodium and water and the larger decreases in glomerular filtration rate and renal plasma flow in patients exercising in the upright position is for the most part related to the posture itself. This view is supported by other studies (3,4,(12)(13)(14) which have shown that the upright posture alone in normal subjects causes an increased renal tubular reabsorption of sodium and water and a decrease in renal plasma flow associated with slight or no fall in glomerular filtration rate.…”

Section: Discussionsupporting

confidence: 75%

The Effects of Exercise on Cardiovascular and Renal Function in Cardiac Patients With and Without Heart Failure 1

Judson¹,

Hollander²,

Hatcher³

et al. 1955

J. Clin. Invest.

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Exercise in the upright position results in the retention of salt and water in normal subjects (1-5) and in patients with congestive failure (6). The mechanisms which set off these antidiuretic and antisaluretic responses are not definitely known. The following factors have been considered: 1) Sensory stimuli from the legs; 2) upright position; 3) hemoconcentration; 4) reduction and/or redistribution of the effective circulating blood volume; 5) metabolic products or alteration of acid-base balance; and 6) a relatively inadequate cardiac output resulting in a tendency to hypotension or collapse. Studies in this laboratory on normal subjects in the supine position showed that strenuous exercise (alternate straight leg-raising) does not regularly produce such antidiuretic and antisaluretic responses (7). In the present investigation the study was extended to include patients with valvular and non-

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Section: Discussionsupporting

confidence: 75%

The Effects of Exercise on Cardiovascular and Renal Function in Cardiac Patients With and Without Heart Failure 1

Judson¹,

Hollander²,

Hatcher³

et al. 1955

J. Clin. Invest.

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“…Some of these reports have been concerned with the excretion of electrolytes which accompany a change in blood volume or in its distribution (24)(25)(26)(27)(28)(29). It is pertinent to this discussion and the concept presented to point out the situations in which an increase in blood volume in the cardiovascular system in the thorax is associated with a water diuresis.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Continuous Negative Pressure Breathing on Water and Electrolyte Excretion by the Human Kidney

Sieker¹,

Gauer²,

Henry³

1954

J. Clin. Invest.

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The effects of decreased intrathoracic pressure on arterial blood pressure (1), venous pressure (2, 3), cardiac output (4), and pulmonary pressure and volume (5) have been investigated in the past. The present study was prompted by the association of marked diuresis with continuous negative pressure breathing in anesthetized animals (6) and the observation that in unanesthetized man continuous positive pressure breathing leads to an oliguria (7). The purpose of this investigation was to demonstrate that human subjects like anesthetized animals have an increased urine flow in response to continuous negative pressure breathing. Observations were made on the renal excretion of water, sodium and potassium, urinary pH, and endogenous creatinine clearance in the hope that the mechanism of the diuresis might be elucidated. METHODSSixteen experiments and six control studies were done with eight normal males who ranged in age from 18 years to 43 years. The subjects received their usual breakfast without added salt on the morning of the experiment. The study was carried out with the subject in the recumbent position in a constant temperature environment In order to obtain an adequate urine volume and a steady state, each subject was maintained on 50 cc. and in some cases 100 cc. of 0.14 per cent saline by mouth (8) and expiration was applied through a standard U. S. Air Force pressure breathing oxygen mask attached by a short tubing to a 40 liter cylinder. This cylinder was ventilated by a suction pump with fresh air at the rate of 100 to 160 liters per minute and rebreathing was prevented by means of a two-way valve in the face mask. The desired negative pressure, which in these experiments was a mean pressure of 15 to 18 centimeters of water, was obtained by varying the air inlet to the container. Control studies duplicated the procedure exactly except that the negative pressure breathing was omitted. Repeat studies were done in all but two subjects.The urine volume for each 15-minute interval was noted and the pH of each sample was determined by means of a glass-calomel electrode pH meter which had an accuracy of 0.1 pH units. Sodium and potassium determinations were made on each urine specimen with an internal standard Perkin Elmer flame photometer. The endogenous creatinine content of the blood and urine was measured by the method of Bonsnes and Taussky (9). The creatinine clearance was used for convenience in these studies with an awareness of both its accuracy and its limitations. The pulse and respiratory rates were followed and periodic observations of the blood pressure were made with a standard sphygmomanometer. RESULTS

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“…The effects of quiet standing alone, without solute loading, were studied in three experiments during dehydration and hydration. (2,9), on the effects of mannitol loads in supine subjects, and of saline infusions in both supine and standing subjects, have also been used in the construction of Table III and Figures 1 and 2.…”

Section: Methodsmentioning

confidence: 99%

“…Urea and ammonia in the urine were determined by the methods of Conway (18), and chloride by a modification of the method of Volhard and Harvey (19). Acute changes in plasma volume were calculated from changes in the hemoglobin and hematocrit as described previously (9). The pH of serum was determined, with anaerobic precautions, with a glass electrode (Beckman).…”

Section: Methodsmentioning

confidence: 99%

“…Since quiet standing constitutes an extremely potent stimulus for sodium and water retention (7)(8)(9), the present experiments were undertaken with the following objectives in mind: (1) to determine whether normal subjects, under the intense stimulus to retain sodium imposed by quiet standing, nevertheless develop the usual diuresis of sodium with solute loads; (2) to decide, by means of clearance techniques, whether the effects observed are mediated by changes in glomerular filtration or tubular transport; and (3) to identify, where possible, the changes in the internal environment which may have been conditioning the renal response.…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Quiet Standing on Solute Diuresis 1

Goodyer¹,

Seldin²

1953

J. Clin. Invest.

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Studies of the Antidiuresis of Quiet Standing: The Importance of Changes in Plasma Volume and Glomerular Filtration Rate 1

Cited by 71 publications

References 30 publications

The Effects of Exercise on Cardiovascular and Renal Function in Cardiac Patients With and Without Heart Failure 1

The Effects of Exercise on Cardiovascular and Renal Function in Cardiac Patients With and Without Heart Failure 1

The Effect of Continuous Negative Pressure Breathing on Water and Electrolyte Excretion by the Human Kidney

The Effects of Quiet Standing on Solute Diuresis 1

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