Effect of Posture on the Metabolic Clearance Rate, Plasma Concentration and Blood Production Rate of Aldosterone in Man<sup>1</sup>

Balikian, H. M.; Brodie, Angela; Dale, Sidney L.; Melby, James C.; Tait, John; Faire, A. C.; Flood, Charles A.; Willoughby, S.; Wilson, Thomas E.

doi:10.1210/jcem-28-11-1630

Cited by 99 publications

(28 citation statements)

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“…Other investigators have not alway\s foundi( a close association between renin activity and aldosterone secretion (7,(14)(15)(16)(17). Since experimental design and methodologic differences could explain some of these rel)orts, the present study was designed to carefully control other factors wrhich could alter the level of renin activity or aldosterone and thereby artifactuallv produce dlissociation between them.…”

Section: Resultsmentioning

confidence: 96%

Studies of the Control of Plasma Aldosterone Concentration in Normal Man

Williams¹,

Tuck²,

Rose³

et al. 1972

J. Clin. Invest.

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A B S T R A C T The peripheral plasmna levels of aldosterone, renin activity, potassium, sodium, corticosterone, and cortisol were measured in six normal subjects four times daily-10 a.m., 2 p.m., 5 p.m., 11 p.m.-on 3 consecutive days. A constant daytime activity program was maintained throughout the study. After 5 days on a 10 mEq sodium/100 mEq potassium isocaloric intake, the mean upright 10 a.m. plasma renin activity was 1773±186 ng/100 xnl per 3 hr and the mean plasma aldosterone, 81±+14 ng/100 ml. These two parameters fell continuously throughout the day parallel to the fall in plasma cortisol and corticosterone. In response to 2 liters of normal saline infused from 10 a.m. to 2 p.m. on 2 consecutive days, plasma aldosterone levels fell significantly to 13±5 ng/100 ml at 2 p.m. after the 1st day's infusion and to 6±1 ng/100 ml at 2 p.m. after the 2nd. Plasma renin activity demonstrated a parallel fall to 368±63 ng/ 100 ml per 3 hr and 189±27 ng/100 ml per 3 hr at 2 p.m. on the 1st and 2nd days, respectively. There was no significant alteration in plasma levels of cortisol, corticosterone, potassium, or sodium on the 2 days of sodium loading in comparison with the control day. In an additional study, five normal supine subjects received 500 ml saline/hr for 6 hr. As in the 2 day study, plasma aldosterone and renin activity had parallel decrements at 1, 2, 4, and 6 hr after the start of the saline infusion. From these studies, it is concluded that plasma renin activity is the dominant factor controlling plasma aldosterone when sodium-depleted normal subjects are acutely repleted.Dr. Williams is an Investigator of the Howard Hughes Medical Institute.

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Section: Resultsmentioning

confidence: 96%

Studies of the Control of Plasma Aldosterone Concentration in Normal Man

Williams¹,

Tuck²,

Rose³

et al. 1972

J. Clin. Invest.

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“…The maximal reduction in plasma aldosterone concentration (66%) and plasma potassium concentration (29%) occurred at 120 min after the infusion of glucose and insulin was begun. If one assumes that the volume of distribution and metabolic clearance rate (MCR) of aldosterone remained constant, this reduction in plasma aldosterone concentration is indicative of a 66% reduction in the aldosterone production and/or secretion rate (15). The effect of glucose and insulin administration on either the volume of distribution or the MCR of aldosterone is unknown.…”

Section: Resultsmentioning

confidence: 99%

Modulation of Plasma Aldosterone Concentration by Plasma Potassium in Anephric Man in the Absence of a Change in Potassium Balance

Cooke¹,

Horvath²,

Moore³

et al. 1973

J. Clin. Invest.

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A B S T R A C T In studies on seven anephric patients, glucose and insulin administration before hemodialysis produced a significant reduction in plasma potassium concentration (mean reduction = 1.3, 1.7, and 1.4 meq/ liter at 60, 120, and 180 min, respectively) which was accompanied by a significant and sustained reduction in plasma aldosterone concentration. There was a significant correlation between plasma aldosterone and plasma potassium concentration (r = +0.74, P < 0.001) and between changes in the concentration of plasma aldosterone occurring in individual patients and the corresponding changes in plasma potassium concentration (r = +0.52, P < 0.01). There was no significant change in plasma sodium concentration, and plasma corticoid concentration, which was monitored as an index of ACTH elaboration, was reduced at 60 min but increased subsequently as symptoms attributable to hypoglycemia were observed.These studies demonstrate that plasma aldosterone concentration can be modulated acutely by transitory changes in plasma potassium concentration without a change in potassium balance. The effect of glucose and insulin administration on intracellular potassium in the adrenal cortex is uncertain, and although increased net movement of potassium into cells is the presumptive mechanism of the reduction in plasma potassium concen-

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“…Some controversy remains over whether the reninangiotensin system is required to support the increased aldosterone secretion that occurs in response to upright posture since, in contrast with most reports, 5 ' "•" Mitra et al 18 reported posturally induced increases in aldosterone in anephric patients. Our results indicate that plasma aldosterone can increase normally during tilt even when the renin-angiotensin system is made unresponsive by acute betablockade; under these circumstances, orthostatic stress appears to evoke an increase in ACTH, reflected by increased cortisol levels, which appears able to replace angiotensin in stimulating aldosterone secretion.…”

Section: Discussionmentioning

confidence: 99%

The substitutive role of ACTH in supporting aldosterone response to head-up tilt during acute renin suppression in patients with essential hypertension.

Morganti¹,

Sealey²,

Lopez-Ovejero³

et al. 1979

Hypertension

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SUMMARYThe relatire contribution of the renin-angiotensin system, adenocorticotrophic hormone (ACTH) and plasma electrolytes in the response of plasma aldosterone to 30 minutes of 65° bead-up tilt was assessed in 10 essential hypertensire patients. Studies were carried out before and during acute blockade of renin release by propranolol, ACTH suppression by dexamethasone and combined renin and ACTH blockade.In control studies orthostasis induced significant increases only in plasma renin activity and aldosterone. In contrast, when the renin response to tilt was acutely suppressed by propranolol administration, the aldosterone response was nonetheless maintained but now appeared to be under ACTH control, since concurrent increases In cortisol were observed. During ACTH suppression aldosterone increased during tilt and so did renin. However, during combined ACTH and renin blockade aldosterone failed to increase during tilt.These studies suggest that the aldosterone secretory response to head-up tilt is normally mediated by the renin-angiotensin system but, when the renin response is suppressed, an ACTH response is elidted which assumes a backup role. However, when these two systems are blocked other factors appear unable to respond during tilt to support a normal aldosterone response.

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Effect of Posture on the Metabolic Clearance Rate, Plasma Concentration and Blood Production Rate of Aldosterone in Man¹

Cited by 99 publications

References 0 publications

Studies of the Control of Plasma Aldosterone Concentration in Normal Man

Studies of the Control of Plasma Aldosterone Concentration in Normal Man

Modulation of Plasma Aldosterone Concentration by Plasma Potassium in Anephric Man in the Absence of a Change in Potassium Balance

The substitutive role of ACTH in supporting aldosterone response to head-up tilt during acute renin suppression in patients with essential hypertension.

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Effect of Posture on the Metabolic Clearance Rate, Plasma Concentration and Blood Production Rate of Aldosterone in Man1

Cited by 99 publications

References 0 publications

Studies of the Control of Plasma Aldosterone Concentration in Normal Man

Studies of the Control of Plasma Aldosterone Concentration in Normal Man

Modulation of Plasma Aldosterone Concentration by Plasma Potassium in Anephric Man in the Absence of a Change in Potassium Balance

The substitutive role of ACTH in supporting aldosterone response to head-up tilt during acute renin suppression in patients with essential hypertension.

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Effect of Posture on the Metabolic Clearance Rate, Plasma Concentration and Blood Production Rate of Aldosterone in Man¹