Alterations of Fluid and Electrolyte Distribution and Renal Function in Diarrhea of Infancy 1

Katcher, Avrum L.; Levitt, Marvin F.; Sweet, Avron Y.; Hodes, Horace L.; Spanier, Charlotte; Haber, Herbert

doi:10.1172/jci102812

Cited by 14 publications

(5 citation statements)

References 27 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, these differences between the acromegalic and healthy subjects are similar to those observed between infants and adults (19,25,26).…”

Section: Discussionsupporting

confidence: 78%

Body Water and Sodium in Patients With Acromegaly 1

Ikkos¹,

Luft²,

Sjögren³

1954

J. Clin. Invest.

View full text Add to dashboard Cite

The acromegalic state often is accompanied by an enlargement of the soft tissues of the body. The purpose of the present work was to determine whether these tissue changes are accompanied by changes in the content and distribution of water and electrolytes in the body. In this connection the administration of growth hormone was shown to induce an increase in the total body water of normal (1-4) and hypophysectomized (5) rats, and of normal dogs and cats (3). Similarly, growth hormone caused a retention of sodium and potassium in normal (6) and diabetic (7) rats, and a retention of sodium, potassium, and chloride in adrenalectomized rats (8). The thiocyanate space in normal and hypophysectomized rats (9) and the plasma volume in dogs (10) increased after injection of growth hormone.The present paper gives the results of measurements of the total body water, the extracellular water and the exchangeable sodium in 18 acromegalic patients. MATERIAL AND METHODSTotal body water was calculated from the volume of distribution of antipyrine (11). Total exchangeable sodium was calculated from the apparent volume of distribution of the radioactive sodium isotope Na' (12). The extracellular water was calculated from the volumes of distribution of inulin (13) Radioactive sodium, Nan, was injected intravenously, immediately after the determination of the extracellular water was completed. Urine was collected for the following 18 hours, and blood samples were taken at the end of the urine collection period.Antipyrine in plasma was analyzed according to Brodie, Axelrod, Soberman, and Levy (15). In our hands the time necessary for the completion of the reaction between antipyrine and sodium nitrite was different from day to day. Repeated readings, therefore, were taken every five to ten minutes after the addition of sodium nitrite. The maximal extinctions obtained were plotted on a semilogarithmic paper, and the extinction at zero time was obtained by extrapolation. The volume of distribution of antipyrine was calculated by dividing the given amount of antipyrine by its zero time plasma concentration.The inulin in plasma was analyzed by Roe's resorcinol method, as modified by Schreiner (16). The inulin space was obtained by dividing the total amount of inulin excreted after discontinuation of the infusion by the inulin concentration in plasma at equilibrium. The thiosulfate in plasma was analyzed by the indirect iodometricmacromethod of Newman, Gilman, and Philips (17). The thiosulfate concentration at zero time was obtained by extrapolation, and the volume of distribution calculated from this value and the amount of thiosulfate given.The concentration of'sodium in plasma was measured by a Beckman flame photometer.The conversion of the antipyrine, inulin, and thiosulfate spaces to total body water and extracellular water, respectively, was made by multiplying the values obtained by 0.93. The concentration of sodium in plasma water was calculated from the corresponding value in plasma, using the same figure, 0.93. The plasma wate...

show abstract

“…However, these differences between the acromegalic and healthy subjects are similar to those observed between infants and adults (19,25,26).…”

Section: Discussionsupporting

confidence: 78%

Body Water and Sodium in Patients With Acromegaly 1

Ikkos¹,

Luft²,

Sjögren³

1954

J. Clin. Invest.

View full text Add to dashboard Cite

show abstract

“…Previous evidence has indicated that under the influence of diverse stimuli, variable quantities of sodium, chloride, and water may be rapidly transferred into the fluid phase of the extracellular compartment (1)(2)(3). The precise source of these electrolytes has not been established.…”

mentioning

confidence: 99%

The Response of Bone, Connective Tissue, and Muscle to Acute Acidosis 12

Levitt¹,

Turner²,

Sweet³

et al. 1956

J. Clin. Invest.

Self Cite

View full text Add to dashboard Cite

“…Transient alterations of renal function have been well described in infantile diarrhea. There is a considerable diminution of total body water, due chiefly to extracellular fluid loss, with a low glomerular filtration rate (14). Previous studies have concluded that the most important causal factor for the metabolic acidosis is a failure of acid excretion by the kidneys (15,16).…”

Section: Resultsmentioning

confidence: 99%

Type of Acidosis and Clinical Outcome in Infantile Gastroenteritis

Weizman,

Houri,

Gradus

1992

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

SummaryTo explore different types of metabolic acidosis in acute gastroenteritis of infancy, and to correlate it with nutritional status and clinical outcome, we examined prospectively 27 consecutive infants admitted with moderate to severe dehydration and arterial blood pH 7.20. Serum anion gap, creatinine, divalent cations (Ca, Mg), and the anionic contribution of total protein, lactate, and phosphate as well as ketones and urine pH, were determined on admission and compared with age‐matched controls. Twenty infants (Group A) presented with normal anion gap (13.1 ± 2.7) associated with hyperchloremia (115.8 ± 4.2 mmol/L, p < 0.01) and diminished bicarbonate (9.7 ± 2.4 mmol/L, p < 0.01), compared with controls. The other seven infants (group B) demonstrated an increased anion gap (26.7 ± 3.2, p < 0.01), associated with significant elevations of lactate (3.4 ± 0.7 mmol/L, p < 0.001), total protein (93.4 ± 12.3 g/L, p < 0.01), as well as phosphate (2.3 ± 0.2 mmol/L, p < 0.01) and creatinine (164.9 ± 45.1 μmol/L, p < 0.001), compared with controls. No significant deviations of blood divalent cations or ketones were noted in both groups. Urine pH was ± 5.5 in all subjects. Analysis of nutritional status and clinical outcome in both groups revealed significant differences. Infants in group B, compared with group A, were significantly more severely malnourished (7 of 7 versus 4 of 20, p < 0.001), were more likely to have prolonged diarrhea ( > 14 days) (5 of 7 versus 3 of 20, p < 0.001), and required longer durations of both intravenous therapy (6.7 ± 2.3 versus 2.2 ± 0.7 days, p < 0.001) and hospitalization (19.4 ± 4.6 versus 5.4 ± 1.6 days, p < 0.001). We conclude that some infants with acute diarrhea may develop severe dehydration and anion‐gap acidosis associated with lactic acidemia and renal dysfunction. These high‐risk infants more often demonstrate severe malnutrition, persistent course of diarrhea, and prolonged hospital stay. Early identification of such infants, and aggressive therapy, will probably improve outcome.

show abstract

Alterations of Fluid and Electrolyte Distribution and Renal Function in Diarrhea of Infancy 1

Cited by 14 publications

References 27 publications

Body Water and Sodium in Patients With Acromegaly 1

Body Water and Sodium in Patients With Acromegaly 1

The Response of Bone, Connective Tissue, and Muscle to Acute Acidosis 12

Type of Acidosis and Clinical Outcome in Infantile Gastroenteritis

Contact Info

Product

Resources

About