The urine output of normal subjects varies greatly from hour to hour. Two of the important factors affecting the urine volume are the degree of activity of the posterior pituitary gland and the amount of solids to be excreted in the urine. In general, whenever the normal kidney is excreting a concentrated urine of low volume, secretion of the antidiuretic hormone (ADH) of the posterior pituitary gland is occurring. This secretion may be due to emotional, drug, or other nervous stimulation, or to an increased osmotic pressure in the extracellular fluid. The excretion of a large amount of very dilute urine by the normal kidney occurs when ADH production is inhibited either by nervous or osmotic stimuli. When concentrated electrolyte solutions are administered intravenously, a large quantity of concentrated urine is produced. This large urine volume appears to be the result of the osmotic effects of the solids in the urine, and the volume is not decreased by secretion of ADH.While there is general agreement as to the effects of ADH on water excretion, there has been little information on its effects on sodium, chloride and potassium excretion in man. The purposes of this study were (1 ) to determine the effect of endogenously produced ADH on the excretion of water, sodium and chloride, (2) to determine whether minute doses of commercial Pitressin given intravenously had the same effects on water and electrolyte excretion as endogenously produced ADH, (3) to determine whether the rate of excretion of sodium modified the antidiuretic effectiveness of Pitressin, and (4) to determine whether Pitressin given intravenously in minute doses altered glomerular filtration rate or renal plasma flow. Victoria Hospital, Montreal, Canada.
MATERIALS AND METHODSAll of the following studies have been carried out on human subjects without endocrine, renal, cardiac, or other disease which has a known effect on water and electrolyte metabolism. All had been on normal salt and water intakes in the past. All subjects were studied in the post-absorptive state as regards food. The differing water and electrolyte conditions which were introduced as a part of the study will be mentioned specifically in the results.In all studies the same lot of Pitressin (commercial ADH prepared by Parke, Davis and Company) has been used. Fresh solutions of Pitressin in .9% NaCl were prepared for each experiment. The doses varied somewhat as specifically mentioned but where it is not mentioned, the dose was arbitrarily fixed at 1.0 milliunit per kilo of body weight.Urine collections were made from an indwelling urethral catheter which was placed at the bladder neck with considerable care. Throughout the full period of each study, which was carried out in a quiet, isolated environment, the patient was recumbent but not sleeping. As much assurance as possible was given to avoid any emotional upset during the simple procedures that were carried out.In all cases except the clearance studies, urine was collected at arbitrary time intervals of 10 minutes. Individ...