The Mechanism of Aldosterone Response to Furosemide Test in Patients with Shy-Drager Syndrome

Abstract

We examined the renin-angiotensin-aldosterone system in seven patients with Shy-Drager syndrome by studying their response to the stimulation of 1 mg/kg furosemide injection followed by sitting for 1 hour. Six of the seven patients showed a low response of plasma renin activity to the stimulation. However, in five of the low responders, the plasma aldosterone levels after stimulation were observed to be similar to those of the control subjects; in addition, an increment in the plasma cortisol level appeared although no such increment was observed in normal subjects. Next, we studied the aldosterone response to angiotensin II. The five patients who showed a low plasma renin activity response and a normal aldosterone response to furosemide administration also showed low plasma aldosterone response to angiotensin II. Furthermore, in the patients who demonstrated a low plasma renin activity response and a normal aldosterone response to furosemide administration, the pretreatment with 2 mg dexamethasone for 2 days caused a marked inhibition of aldosterone response to the stimulation. These findings suggested that in most patients with Shy-Drager syndrome, the plasma aldosterone response to the stimulation of furosemide injection followed by sitting for 1 hour might be controlled by ACTH but not by plasma renin activity.

Differences between acute and long‐term metabolic and endocrine effects of oral beta‐adrenoceptor agonist therapy with pirbuterol for cardiac failure.

“…Khoner et al (1971) found no changes in serum FFA concentrations in hypertensive patients treated over a period of 1 year with frusemide. Similarly there is no evidence that frusemide affects plasma cortisol concentrations in either normal or hypertensive subjects (Fraser et al, 1965;Tosti-Croce et al, 1981;Sasaki et al, 1983).…”