Adrenal Cortex and Water Metabolism

Gaunt, Richard A.; Birnie, James H.; Eversole, W. J.

doi:10.1152/physrev.1949.29.4.281

Cited by 164 publications

(50 citation statements)

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“…One (3)(4)(5)(6)(7)(8) is that, although the release of antidiuretic hormone (ADH)' from the hypothalamus in adrenal insufficiency is normally suppressed during water loading, the water impermeability of the distal nephron is incomplete in the absence of glucocorticoid hormone. In contrast, other authors (9)(10)(11) have suggested that the release of ADH is not suppressed normally during water loading in the presence of adrenal insufficiency and increased circulating levels of ADH account for the inability to excrete water normally. Utilization of the bioassay of ADH in adrenal insufficiency has not distinguished between these possible mechanisms, since evidence has been presented that ADH levels are both increased (9) and undetectable (8) in adrenal insufficiency.…”

Section: Introductionmentioning

confidence: 82%

“…The importance of sodium balance in the capacity of the adrenalectomized dog to excrete water was not only indicated by the acute water-loading studies but also by (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).' In an effort to avoid any secondary effects related to negative sodium balance and depletion of extracellular fluid volume, the initial group of studies were performed while the animals were offered a high sodium intake as saline drinking water.…”

Section: Periodsmentioning

confidence: 99%

“…Such an effect on systemic hemodynamics could affect water excretion by diminishing renal hemodynamics and/or stimulating the release of ADH. Although the defect in water excretion in adrenal insufficiency previously has been shown to be improved by replacement of glucocorticoid hormone, supraphysiological doses of the hormone have been used in these previous studies (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). In this regard, Oleesky (27) did not observe improvement in diluting capacity in humans with adrenal insufficiency who were treated with physiological doses of glucocorticoid hormone and improvement required the administration of amounts of the hormone in excess of that normally produced by the adrenal gland.…”

Section: V0mentioning

confidence: 99%

“…There is considerable evidence that adrenal insufficiency is associated with an impaired ability to attain a normal water diuresis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). The mechanisms involved in this impairment of water excretion have not been clearly elucidated, however, two possible mechanisms have been proposed.…”

Section: Introductionmentioning

confidence: 99%

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Importance of sodium intake and mineralocorticoid hormone in the impaired water excretion in adrenal insufficiency

Ufferman¹,

Schrier²

1972

J. Clin. Invest.

100

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A B S T R A C T The response of trained, conscious dogs to an acute water load was studied before adrenalectomy and under five conditions of hormonal replacement and sodium intake after adrenalectomy. Before adrenalectomy, with the dogs drinking isotonic saline, the minimal urinary osmolality (Uosm) was 47±7 (SEM) mOsm and free-water clearance (CH2o) was 8.6±1 ml/min. These values were not different after adrenalectomy with or without deoxycorticosterone (DOCA) if the animals continued to drink saline and receive dexamethasone. Moreover, after adrenalectomy in the presence of saline drinking both dexamethasone and DOCA could be withdrawn for up to 4 days without impairment of diluting ability (Uosm, 544+7 mOsm and CH20, 7.3±1 ml/min).In contrast, when the dogs drank tap water (Na intake 30 mEq/day), water loading in the absence of dexamethasone and DOCA was associated with a significantly higher Uosm (127±28,mOsm) and lower CH20 (2.7+0.3 ml/min). Replacing DOCA alone in the presence of this limited Na intake returned diluting ability to normal (Uosm 31±7 mOsm, CH2o 7.7±0.5 ml/min). Glomerular filtration rate for each animal was the same under each condition except for a significant diminution which occurred when dexamethasone and DOCA were withdrawn while the animals were on a 30 mEq sodium intake. In contrast to previous conclusions, the present results indicate that in the absence of adrenal hormones normal renal diluting ability may occur, indicating both maximal suppression of vasopressin release and maximal distal tubular impermeability to water.

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Section: Introductionmentioning

confidence: 82%

Section: Periodsmentioning

confidence: 99%

Section: V0mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Importance of sodium intake and mineralocorticoid hormone in the impaired water excretion in adrenal insufficiency

Ufferman¹,

Schrier²

1972

J. Clin. Invest.

100

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“…Dilution of body fluids might diminish the concentrations of certain intra-and/or extracellular solutes, critical for maximal activity of the concentrating mechanism. The possibility that hydration might variably stimulate secretion of adrenal cortical hormones antagonistic to Pitressing, evidence for which has recently been reviewed (20), should also be considered. Similarly, substances with anti-diuretic activity other than ADH might be present in the hydropenic subject, supplementing the action of the pituitary hormone and disappearing with hydration.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Relative Effectiveness of Hydropenia and of Pitressin® in Producing a Concentrated Urine12

West¹,

Traeger²,

Kaplan³

1955

J. Clin. Invest.

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It is a common assumption that exogenous antidiuretic hormone (Pitressing) is equal to the endogenous anti-diuretic hormone (ADH) in its ability to stimulate the production of a concentrated urine. However, clinical studies of urine formation after the administration of Pitressin'S or Pituitrin@ leave some doubt as to the ability of the exogenous hormone to produce a maximally concentrated urine. Sodeman and Engelhardt (1) found that if urinary specific gravity was low at the time of Pituitrin0 administration, the value attained was not so high as could be produced in the same subject by water deprivation. Similar observations were made by Little, Wallace, Whatley, and Anderson (2). Taylor, Peirce, and Page (3) gave Pituitrin@ at frequent intervals for 12 hours and found the urine to be often more dilute and of larger volume than after a 12-hour period of water deprivation. In every case the amounts of anti-diuretic hormone administered were much greater than are assumed to be normally produced.In the present study the ability of exogenous anti-diuretic hormone, administered as Pitressin@, to concentrate the urine has been reinvestigated in humans and in the dog. Because it is now recognized that the concentration of urine depends not only on the degree of hydropenia, but also on the prevailing rate of solute excretion (4-6), it seemed pertinent to investigate urinary concen- tration after Pitressin® administration during mild solute diuresis as well as under normal conditions of urine formation. To insure absence of circulating endogenous anti-diuretic hormone at the time PitressinD was tested, the subjects were hydrated and having a water diuresis at the start of hormone infusion. In evaluating the results, the urinary concentrations after Pitressins, expressed in milliosmols, have been compared with the urine osmolarity of hydropenic subjects, taking into account the fall in osmolarity normally occurring during solute diuresis.It was found that once water diuresis was inhibited by the administration of PitressinS, urine osmolarity slowly increased to approach, but rarely equal, values observed during hydropenia. Differences in plasma osmolarity in the hydratedPitressin(D and hydropenic groups accounted to some extent for the discrepancy. When urine osmolarity was expressed as a function of plasma osmolarity, either as the osmotic U/P ratio or the urine-plasma osmotic pressure difference, values after a sufficient period of Pitressin@ infusion were often comparable to those of hydropenic subjects providing solute diuresis was present. In the absence of solute diuresis, the results were not as consistent. Prolonged Pitressin® administration in several instances failed to elevate osmotic pressure differentials to values observed in hydropenic subjects. METHODSFor the study 32 experiments were performed, 17 on eight female mongrel dogs and 15 on five male subjects. At least two experiments were usually performed on each subject, one to determine urinary concentration during hydropenia and a second to test the eff...

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Adrenocortical Steroids, Their Derivatives, and Corticotropin

Hirsch¹

1956

AMA Arch Derm

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Adrenal Cortex and Water Metabolism

Cited by 164 publications

References 0 publications

Importance of sodium intake and mineralocorticoid hormone in the impaired water excretion in adrenal insufficiency

Importance of sodium intake and mineralocorticoid hormone in the impaired water excretion in adrenal insufficiency

A Comparison of the Relative Effectiveness of Hydropenia and of Pitressin® in Producing a Concentrated Urine12

Adrenocortical Steroids, Their Derivatives, and Corticotropin

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