The Effects of Concentrated Salt-Poor Albumin on the Metabolism and Excretion of Water and Electrolytes in Nephrosis and Toxemia of Pregnancy 12

Orloff, Jack; Welt, Louis G.; Stowe, Lyman

doi:10.1172/jci102314

Cited by 42 publications

(18 citation statements)

References 21 publications

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“…Increases in both glomerular filtration rate and renal plasma flow have been noted in animals (23). In the present study, a 12 per cent solution was used, and the average fall in hematocrit was 30 per cent indicating that a larger increase in plasma volume was achieved, due perhaps to the hyperoncotic -solution used and the existing hypoproteinemic state (21). This larger increase in plasma volume may account for the increases in renal plasma flow observed in the present study.…”

Section: Discussionmentioning

confidence: 45%

“…Glomerularfiltration rate, however, rose in only two of four patients in whom observations were made. The general effects appear to resemble those produced by infusion of hyperoncotic salt-poor human serum albumin (20,21), except that in the patients stud-ied by Orloff, Welt, and Stowe the solute concentration (sodium) in the extracellular fluid increased during infusion.…”

Section: Discussionmentioning

confidence: 84%

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Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

James¹,

Gordillo²,

Metcoff³

1954

J. Clin. Invest.

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Dextran is a bacterial polysaccharide which is being increasingly used as a plasma substitute (1-4). Dextran molecules frequently have a molecular weight of several million, and consist of long branched chains of glucose units. For clinical use these large molecules are broken down artificially to an average molecular weight of 70,000. In the body, the larger molecular aggregates are further broken down and excreted as smaller fractions having (approximate) molecular weights less than 20,000, or are slowly metabolized.Dextran has been reported to induce diuresis regularly in patients with the nephrotic syndrome (5, 6). In addition to determining the clinical value of dextran, the intravenous infusion of hyperoncotic (12 per cent) dextran in water was used as an approach to the study of the following questions: 1) Effect of increased plasma volume on glomerular filtration rate;2) The relation of plasma volume, serum albumin concentration, and glomerular filtration rate to the glomerular permeability to albumin;3) The effect of increased post-glomerular colloid osmotic pressure on tubular reabsorption of water and solutes;4) The nature of the dextran-induced diuresis. METHODNephrotic children who showed no clinical evidence of renal failure were selected (i.e., no concomitant acidosis, azotemia and anemia). The children were recumbent during the study period. Infusions were administered

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 84%

Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

James¹,

Gordillo²,

Metcoff³

1954

J. Clin. Invest.

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“…It should be noted, however, that this antidiuresis was associated with a decrease in the concentration of total milliosmols in the urine. These responses with respect to the rates of excretion of sodium and water associated with infusions of hyperoncotic solutions of albumin in normal subjects are in striking contrast to the responses in patients with the nephrotic syndrome and toxemias of pregnancy (10)(11)(12)(13).…”

Section: Resultsmentioning

confidence: 63%

The Effects of an Increase in Plasma Volume on the Metabolism and Excretion of Water and Electrolytes by Normal Subjects 12

Welt¹,

Orloff²

1951

J. Clin. Invest.

108

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“…Silber and Porter (1953) have shown that cortisone causes a decrease in carcass proteins in adrenalectomized protein deficient rats but an increase in liver and plasma protein. This increase in plasma proteins may be an important factor in the diuretic action of cortisone demonstrated in our experience, because in nephrosis and in hepatic cirrhosis, in which, as in protein deficiency, the plasma albumin concentration is low, intravenously administered albumin has a diuretic effect and increases glomerular filtration rate (Luetscher, Hall, and Kremer, 1949;Orloff, Welt, and Stowe, 1949;Chinard, Lauson, Eder, Greif, and Hiller, 1954;Patek, Mankin, Colcher, Lowell, and Earle, 1948).…”

Section: Actions Of Corticotrophin and Cortisone Onmentioning

confidence: 60%

The Effect of Diuretics on the Water Excretion of Protein Deficient Rats

Blackmore¹,

Schnieden²

1957

British Journal of Pharmacology and Chemotherapy

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Adult rats kept for eleven weeks on a diet deficient in protein lost weight and some developed scrotal oedema. The retention of bromsulphthalein was increased, but the thymol turbidity test was unaffected; the apparent plasma volume was increased.Water diuresis in the protein deficient animals was impaired. There was no apparent delay in the mean rate of water absorption from the whole gastro-intestinal tract although a delayed absorption of water from the intestine was found in some animals. The concentrations of total plasma proteins and plasma albumin were low as compared with normal animals, but the plasma sodium levels were within normal limits. The inulin clearance (glomerular filtration rate) of the animals on the protein-deficient diet was significantly lower than that of the controls.In normal rats, aminophylline and acetazolamide were diuretic. Caffeine and sodium benzoate did not increase the urine output and mersalyl was antidiuretic. In the protein deficient rats, cortisone acetate increased the water diuresis. Caffeine and sodium benzoate, aminophylline and acetazolamide did not significantly increase this response, mersalyl had an antidiuretic effect. Cortisone acetate increased the food and water intake of the protein deficient rats; it also increased the glomerular filtration rate.It is now well established that animals kept on low protein diets have an impaired water diuresis (Dicker, Heller, and Hewer, 1946;Heller and Dicker, 1947;Leslie and Ralli, 1947; Guggenheim and Hegsted, 1953;Schnieden and Blackmore, 1955a). Rats kept on a protein deficient diet also have an increased total body water and are oedematous (Haigh and Schnieden, 1956). We have investigated the effects of diuretics on such animals to see whether water diuresis could be restored. In addition to the conventional drugs (mercurial and xanthine diuretics), cortisone and corticotrophin were also tested because these hormones have a diuretic effect in nephrosis (Luetscher, Deming, Harvey, Lew, and Poo, 1950; Luetscher, Deming and Johnston, 1951 Bergeim, 1942) 4.5, cod liver oil 3.0, supplemented by 50 mg. vitamin B complex powder (Crookes Laboratories/100 g. diet. It contained 0.4% thiamine, 0.5% riboflavine, 0.18% pyridoxine, 4% nicotinamide, and 0.0014% pantothenic acid. 3 mg. tocopherol acetate/100 g. diet was also added. This diet provided approximately 300 cal./100 g. and 0.2 protein/100 cal.Measurement of Food Intake.-The daily intake of food was estimated by placing groups of 6 rats in suspended cages. Weighed amounts of food in excess of the daily requirement were provided. Some scattering of food could not be prevented, so the cages were suspended over a tray lined with filter paper and the scattered food separated from the faeces each morning and added to food not consumed.Measurement of Water Intake.-Rats were placed in individual metabolism cages fitted with graduated drinking tubes. The amount of water drunk by each animal in 24 hr. was noted.Plasma Prateins.-A biuret method was employed for estimation of total plasm...

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The Effects of Concentrated Salt-Poor Albumin on the Metabolism and Excretion of Water and Electrolytes in Nephrosis and Toxemia of Pregnancy 12

Cited by 42 publications

References 21 publications

Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

The Effects of an Increase in Plasma Volume on the Metabolism and Excretion of Water and Electrolytes by Normal Subjects 12

The Effect of Diuretics on the Water Excretion of Protein Deficient Rats

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