Studies on the Action of Diuretics I. The Effect of Euphyllin and Salyrgan Upon Glomerular Filtration and Tubular Reabsorption 1

Abstract

Since the appearance in 1887 of von Schroeder's first publication (1) concerning the action of xanthine diuretics there has been much debate regarding the mechanism by which these substances produce diuresis. Similarly there has been considerable controversy as to the manner in which salyrgan and other organic mercury compounds increase the output of urine. REVIEW OF LITERATUREIn the earlier work on xanthine diuresis investigators were chiefly interested in distinguishing between direct action on the renal cells and effects produced through changes in renal circulation. Von Schroeder (1) (2) concluded from his experiments that the effect of caffeine and related substances upon urine output was independent of circulatory changes. Loewi, Fletcher and Henderson (3) held the opposite point of view. They confirmed the observation, first made by Phillips and Bradford (4), that caffeine usually increases the volume of the kidney and considered this as evidence that diuresis was caused by dilatation of the renal blood vessels. Although this observation concerning kidney volume during caffeine diuresis is generally accepted, its significance has been questioned by Gottlieb and Magnus (5) because diuresis sometimes occurs without increase in kidney volume, by Brings and Molitor (6) who concluded that the increase in volume was of too short duration to be significant, and by Cushny (7) who pointed out that increase in kidney volume does not necessarily indicate vasodilatation.

The Measurement of Glomerular Filtration. Creatinine, Sucrose and Urea Clearances in Subjects Without Renal Disease 1

“…This phenomenon may well be due to quite different causes. Some tendency for the creatinine clearance to fall off with time has been observed in dogs by Davenport, Fulton, Van Auken and Parsons (4), and by Schmitz (20). In view of the repeated demonstrations by Shannon and others of the identity of creatinine and inulin clearances in this animal, it is only reasonable to assume that these changes represent actual changes in glomerular filtration rate, and are not comparable to the phenomenon observed by us in man.…”

Electrolyte Equilibrium During Mercurial Diuresis 12

“…The diuretic action of these drugs may be accounted for by a direct renal action (16,17). Diuresis after single doses of mercurial compounds is not associated with an increase in the renal blood flow or in glomerular filtration rate but is apparently the result of a decreased tubular reabsorption of certain electrolytes (18)(19)(20). It is not clear whether the depression of reabsorption occurs in the proximal or in the distal tubule.…”

The Effect of Theophylline Ethylene Diamine on Renal Function in Control Subjects and in Patients With Congestive Heart Failure 1

“…In lower animals, some xanthines increase filtration rate, while others do not. For instance, Schmitz (18) reported that euphyllin consistently increased glomerular filtration rate in dogs while others (19)(20)(21) found renal hemodynamics unaltered significantly after the injection of theophylline in rabbits and dogs.…”