Electrolyte Excretion After Single Doses of Acth, Cortisone, Desoxycorticosterone Glucoside, and Motionless Standing 123

Abstract

There are marked hourly variations in the urinary output of sodium, chloride, and potassium in normal subjects. Some of these are clearly related to intake and others are produced by major physiologic adaptations, as changing from the supine to the erect position. However, considerable variations occur from day to day and hour to hour in the fasting supine subject. The purpose of this paper is to report the variations in excretion of Na, Cl, and K in normal subjects at rest and during motionless standing and compare them with the changes produced by cortisone and desoxycorticosterone glucoside (DCG), and after adrenal stimulation by corticotropin (ACTH). METHODSSodium and potassium in urine were measured by the flame photometer (1). Urinary chloride was measured by the silver iodate method (2).Normal healthy college students were used. For three days before the experiments, the subjects were on a low-sodium diet (less than 0.5 Gm. NaCI) and were given 3 Gm. of NaCl orally every three hours. This was a daily intake of 24.5 Gm. NaCl or 422 mEq. We hoped that this high intake of NaCl would inhibit the mechanism normally causing retention of NaCl and thus allow ACTH, cortisone and DCG to have maximum action on salt excretion.Except for water, ad lib., and 3 Gm. of NaCi every three hours, subjects were fasted for 12 hours before the experiment. In most instances, they slept in the laboratory on the night before the experiment. designed to measure the effect of ACTH, cortisone, DCG and tilting on the excretion of Na, Cl, and K. The excretion rates during the first and second hours were compared with the excretion rates for the first and second hours of the control group to be certain that comparable factors were acting during all sets of experiments. Two hours after the experiment started, ACTH, DCG and cortisone were given. In determining whether significant changes had occurred after the use of drugs, comparable hours were compared with those from the control series. RESULTSFasted subjects in bed without medication. Twelve experiments were run on five subjects. The hourly excretion (not recorded here) of Na, K, and Cl from 6:00 a.m. to 12:00 noon varied up and down from day to day and hour to hour in both the same and different subjects. There was no detectable correlation between the initial hourly excretion rate and the ratios Na/Cl, K/Cl, and K/Na. Over the six hours of the experiment, in spite of wide hourly variations, the quantities of Na, K, and Cl excreted progressively increased.The Na/Cl ratio showed little change. The K/Na and K/Cl ratios rose slightly in the first four hours as K excretion increased and then fell back toward the initial values as Na and Cl excretion continued to rise (data not recorded).Intravenous ACTH. Seven experiments were run on four subjects. ACTH (Wilson) was given intravenously in three minutes in doses of 20 units at 8:00 a.m. In the first two hours before ACTH, Na excretion was somewhat less than in the fasted group (p < .05). The excretion of K, Cl, and Na/Cl, K/Cl, and K/Na r...

Some effects of change of posture on water and electrolyte excretion by the human kidney*

“…The acute reductions in urine flow and in outputs of sodium and chloride observed after standing, and the reverse changes after lying down, confirm the abundant observations in the literature (Lewis, Buie, Sevier & Harrison, 1950;McCance, 1951;Viar, Oliver, Eisenberg, Willis, Lombardo & Harrison, 1951;Chalmers & Squires, 1953;Goodyer & Seldin, 1953;Netravisesh, 1953;Holland & Stead, 1954;Pearce & Newman, 1954) (Kattus et al 1949;Pearce & Simmons, 1954).…”

Postural Effects on Renal Tubular Activity 1

“…In a previous communication (4) the literature has been summarized to indicate that a) most workers find a fall in filtration rate on changing from the horizontal to a head-up tilt or to standing, b) all workers find falls in water and sodium excretion on changing from the horizontal to a head-up tilt or to standing. Additional relevant reports have since been published (5,(18)(19)(20).…”

Reversal of Rhythmic Water and Sodium Excretion Patterns during Ganglionic or Adrenergic Block

“…Submitted for publication December 29, 1961. In standing, sitting, tilted and ambulatory subjects a variable retention of water and sodium (chloride) occurs (Erlanger and Hooker 1904;White et al 1926; Kattus et al 1949;Epstein et al 1951;Ford et al 1953;Holland and Stead 1954;Newman 1954). As a rule the reduction in the output of water and sodium chloride is accompanied by a fall in glomerular filtration rate, especially during tilting and quiet standing, when excessive demands are being made on the circulation.…”