A Study of the Roles of Adrenocortical Steroids and Glomerular Filtration Rate in the Mechanism of the Diurnal Rhythm of Water and Electrolyte Excretion

Martel, P; Sharp, Geoffrey W. G.; Slorach, S. A.; Vipond, H. J.

doi:10.1677/joe.0.0240159

Cited by 27 publications

(9 citation statements)

References 4 publications

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“…In normal subjects, the morning rise in cortisol production coincides with the increase in electrolyte excretion but this does not mean that they are interdependent. Martel et al (1962) have shown that when normal subjects change their sleeping habits reversal of electrolyte excretion precedes by several days any change in cortisol production. Doe, Vennes & Flink (1960) found that cortisol given in doses of 5 mg every 3 hr throughout the day re-established a normal circadian rhythm of electrolyte excretion in patients with Addison's disease despite a constant excretion of cortisol metabolites.…”

Section: Discussionmentioning

confidence: 99%

Nocturia in Patients on Long-Term Steroid Therapy

1970

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1. About half of our asthmatic patients on long-term treatment with prednisone developed nocturia.2. This is due to reversal of the normal circadian rhythm of water and electrolyte excretion and is partially corrected within 48 hr of stopping treatment.3. The disturbance in water and electrolyte excretion appeared to be due to a decrease in proximal tubular reabsorption of sodium at night. This was not directly related to a change in the secretion of cortisol, aldosterone or antidiuretic hormone.Nocturia is known to occur in Cushing's syndrome and in Addison's disease (Doe, Vennes & Flink, 1960) and is a recognized feature of Conn's syndrome (Lennon, Ruetz &Engstrom, 1961) but has not been described in patients on long-term treatment with steroids. Few complain spontaneously of nocturia yet enquiry has revealed that it is a common symptom. Of eightyseven patients receiving maintenance doses of 5 or 10 mg of prednisone for asthma, forty-one (47%) stated that they passed more urine by night than by day. These patients had been accustomed to routine collection of 24 hr urine specimens for tests of pituitary and adrenal function. The symptom is not confined to patients with asthma; patients with rheumatoid arthritis given steroids also develop nocturia but the incidence has not been established in this disease.The onset is variable. Some patients notice nocturia on starting steroids while in others it appears after a period of treatment. To elucidate the mechanism of this phenomenon, detailed studies were carried out on a few patients receiving prednisone. PATIENTS A N D METHODSFive patients with well-controlled asthma and without hypertension or evidence of renal disease were admitted to hospital for study. They were not confined to bed but were given a

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Section: Discussionmentioning

confidence: 99%

Nocturia in Patients on Long-Term Steroid Therapy

1970

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“…In the second series of experiments (Martel et al 1962) urine was sampled every second day after phase reversal, and again every second day after return to normal time, and these data are also presented in Fig. 12. It appears that adaptation, and readaptation, of both potassium and sodium rhythms took about 6 days, but any individual differences are again obscured by the presentation of the mean of the four subjects involved.…”

Section: Urinary Rhythmsmentioning

confidence: 99%

“…Above, data of Sharp (1960), mean of six subjects; mean of four control days, third day after phase reversal, and mean of sixth, ninth and twelfth days after phase reversal. Below, data of Martel et al (1962), mean of four subjects; mean of four control days, then values every second day after phase reversal, and again after return to normal phase.…”

Section: Urinary Rhythmsmentioning

confidence: 99%

The effect of real and simulated time‐zone shifts upon the circadian rhythms of body temperature, plasma 11‐hydroxycorticosteroids, and renal excretion in human subjects

Elliott¹,

Mills²,

Minors³

et al. 1972

The Journal of Physiology

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SUMMARY1. Observations were made upon five subjects who flew through 4j-6 time zones, four of them returning later to their starting point, and upon twenty-three subjects experiencing simulated 6 or 8 hr time zones shifts in either direction in an isolation unit.2. Measurements were made of plasma concentration of li-hydroxycorticosteroids, of body temperature, and of urinary excretion of sodium, potassium and chloride. Their rhythm was defined, where possible, by fitting a sine curve of period 24 hr to each separate 24-hr stretch of data and computing the acrophase, or maximum predicted by the sine curve.3. The adaptation of the plasma steroid rhythm was assessed by the presence of a sharp fall in concentration after the sample collected around 08.00 hr. The time course of adaptation varied widely between individuals; it was usually largely complete by the fourth day after westward, and rather later after eastward, flights. After time shift the pattern often corresponded neither to an adapted nor to an unadapted one, and in a subject followed for many months after a real flight a normal amplitude only appeared 2-3 months after flight.4. Temperature rhythm adapted by a movement of the acrophase, without change in amplitude, although on some days no rhythm could be observed. This movement was always substantial even on the first day, and was usually nearly complete by the fifth.5. High nocturnal excretion of electrolyte was often seen in the early days after time shift, more notably after simulated westward flights. Adaptation of urinary electrolyte rhythms usually proceeded as with temperature, but the movement of the acrophase was slower, more variable ANN L. ELLIOTT AND OTHERS between individuals, more erratic, and sometimes reversed after partial adaptation. On a few days there were two maxima corresponding to those expected on real and on experimental time.6. Sodium excretion was much less regular than that of potassium, but adapted more rapidly to time shift, so that the two often became completely dissociated. Chloride behaved much as sodium.7. The time course of adaptation of the plasma steroid and urinary potassium rhythms were sufficiently similar to suggest a causal connexion. The time course of adaptation of the temperature rhythm did not coincide with that of any other component considered here.

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“…The mechanisms underlying the diurnal variations in the composi tion of urine are not yet known (2,7,17,20,22,23,30,31,35,38). However, the results of most previously reported studies and of this investigation reveal the similarity of the diurnal urinary excretory pat terns in subjects from various geographical locations living under different environmental conditions (2,8,16,17,35,38).…”

Section: Discussionmentioning

confidence: 54%

“…They are characterized by a simultaneous rise in the output of urine, sodium, chloride, potassium and bicarbonate in the morning hours, with a peak around noon, the excretion of each being lowest at night (2,7,20,33,35). The process of urinary acidifi cation is also known to display cyclic changes.…”

Section: Variation Nyctémcral De La Composition Du Sang Et De L'urinementioning

confidence: 99%

Diurnal Variations in the Composition of Blood and Urine of Man Living in Hot Climate

Toor¹,

Massry²,

Katz³

et al. 1965

Nephron

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The diurnal variations in the composition of blood and urine during 24 h recumbency and the influence of 8 h of heavy physical work on the urinary excretory patterns were examined in nine young healthy subjects, permanent inhabitants of the hot region of Eilat near the Red Sea. The effects of change in posture, heat stress, light activity, aldosterone and dehydration on the midday sodium and water excretory patterns were studied on the same subjects. The diurnal rhythms exhibited during complete rest were similar to those described in temperate climate, except for an earlier excretory peak of potassium. Heavy physical work brought about the displacement of the midday peak water and sodium excretion to the evening and changed the hydrogen ion and phosphate excretory patterns. Potassium excretion was high during the working hours and decreased gradually thereafter to a minimum during the night. It was also found that in hot climate the peak midday natriuresis and the accompanying trough in hydrogen ion excretion, considered to be a constant feature of the diurnal urinary excretory patterns, are liable to changes even under the short-term influence of factors affecting sodium homeostasis. The possible role of body sodium homeostasis as a mechanism underlying the diurnal urinary excretory patterns is suggested.

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A Study of the Roles of Adrenocortical Steroids and Glomerular Filtration Rate in the Mechanism of the Diurnal Rhythm of Water and Electrolyte Excretion

Cited by 27 publications

References 4 publications

Nocturia in Patients on Long-Term Steroid Therapy

Nocturia in Patients on Long-Term Steroid Therapy

The effect of real and simulated time‐zone shifts upon the circadian rhythms of body temperature, plasma 11‐hydroxycorticosteroids, and renal excretion in human subjects

Diurnal Variations in the Composition of Blood and Urine of Man Living in Hot Climate

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