Salt and Water Losses in Diuretin Diuresis and Their Relation to Serum Non-Protein Nitrogen and Electrolyte Concentrations

Abstract

The losses of sodium, potassium, chloride, nitrogen, and water following the administration of diuretin to rabbits over 5 to 9 day periods together with the changes in serum concentrations of sodium, chloride, N. P. N., and total protein occurring simultaneously with these losses are described. The circumstances responsible for the presence of azotemia in the animals were investigated in particular and the dependence of nitrogen retention upon dehydration and the modification of this dependence by variation in urine volume were demonstrated. It was clearly shown that no direct relationship exists between the azotemia and the coincident hypochloremia. It was found that nitrogen retention can be removed by the administration of water without salt, and the extent to which serum electrolyte and protein concentrations can be lowered by this procedure was also observed. The withdrawal from the body of large amounts of potassium as well as of sodium and chloride following the administration of diuretin, and also the inefficacy of sodium chloride solution in preventing the potassium loss was demonstrated.

Studies on the Suprarenal Cortex

“…The consequences of withdrawal of suprarenal cortical extract in the suprarenalectomized dog may be compared to those produced by certain diuretic agents. They differ from the effects of diuretin diuresis, as reported by Kerpel-Fronius and Butler (14), in which a marked excretion of potassium, as well as of sodium, chlorides and nitrogen takes place. Loss of potassium is also reported to follow the use of acid-producing diuretics in human subjects (I6).…”

“…The rise in the concentration of blood nonprotein nitrogen, which is chiefly, but not exclusively, in the urea fraction, during the course of suprarenal insufficiency following withdrawal of extract from these dogs, both in these experiments and in those previously reported (13) is more closely related to the rise in plasma potassium than it is to the fall in plasma sodium or chlorides. Kerpel-Fronius and Butler (14) have assembled data of their own and from the literature indicating the lack of necessary association between electrolyte concentration and azotemia, and similar data may be found in suprarenal insufficiency in the dog with alterations in salt and water intake (13). It is to these variations, we believe, in salt and water intake and excretion, that the increased sodium and chloride levels in the plasma may be attributed which have been described during suprarenal insufficiency in the marmot and opossum (15).…”

Acid-Base Balance, Renal Function, and Gastric Secretion During Hypochloremia in the Dog 1

“…Both in clinical and experimental salt deficiency the loss of chloride is abrupt and is rapidly followed by a marked loss of body water. The nitrogen retention, therefore, may be explained simply on the basis of excessive protein breakdown associated with anhydremia (21,22,23). The azotemia in hypochloremia has been attributed also to impaired renal function secondary to dehydration (24,25).…”

The Salt and Water Metabolism of Adrenal Insufficiency and Partial Starvation in Rats 1

“…It is also true that during undernutrition sodium is lost, but to a lesser extent. Similarly, in many unrelated conditions which have dehydration as a factor in common, i.e., starvation (15), diabetic acidosis, diuresis (16,17), and nephritis (18), sodium is lost from the body in large amounts, and the sodium and chlorine changes of the blood serum, where they have been investigated, are similar to the sodium and chlorine changes of the blood in adrenal insufficiency. From these facts alone it would appear that the sodium loss in adrenal insufficiency is not necessarily a specific function of the adrenal gland but is an accompaniment of dehydration.…”

“…The kidney in this case excretes a more concentrated sodium solution so as to permit the water retention. In a study by Kerpel-Fronius and Butler (17) where diuretin was administered to rabbits, they found that along with a marked diuresis, sodium and potassium were lost in large quantities. The blood sodium in these animals was found to be lowered to a degree comparable with that of adrenal insufficiency.…”