The Influence of Cortisone Upon the Diurnal Rhythm of Renal Excretory Function

Rosenbaum, Jack D.; Ferguson, Bruce C.; Davis, Robert K.; Rossmeisl, Elsie C.

doi:10.1172/jci102635

Cited by 59 publications

(11 citation statements)

References 36 publications

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“…Conversely, recumbent subjects given water loads at night characteristically manifest a steady decline in sodium excretion, without change in the rate of water diuresis (25 (41). Similar parallelism in the excretion of salt and water has been observed in studies concerning their diurnal variation (25,26,42,43).…”

Section: Discussionsupporting

confidence: 53%

Variation in the Diuretic Response to Ingested Water Related to the Renal Excretion of Solutes 1

Rosenbaum¹,

Nelson²,

Strauss³

et al. 1953

J. Clin. Invest.

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The administration of a large amount of water to the normal subject results in the copious excretion of a dilute urine. An extensive body of evidence indicates that this response is primarily dependent upon a decrease in the effective osmotic pressure of the plasma and extracellular fluid, with resultant inhibition of the secretion of antidiuretic hormone (ADH) by the neurohypophysis and decreased facultative reabsorption of water by the renal tubules (2-5).Although alterations of this normal response to water loading have been studied in a variety of abnormal conditions, factors which influence the magnitude of water diuresis in normal man have received scant attention, even though Haldane and Priestley in 1916 noted that the initial high rates of urine flow which followed the ingestion of water subsequently underwent a gradual moderate decline despite a continued large fluid intake (6). Depletion of body sodium in man and experimental animals has been shown to diminish the excretion of administered water, but under the conditions of these studies general impairment of renal excretory function was evident (7-9) or was not excluded (10, 11).The present communication describes observations which indicate that in man the maintenance of a large water load evokes a diuresis the magnitude of which is. greatly influenced by factors which evoke concomitant changes in the renal excretion of solutes, particularly sodium. These influences include the dietary intake of sodium, postural effects, and the administration of various solute loads. METHODSThe subjects were three normal men and seven adult male patients, of whom four had neurodermEititis, one psoriasis, one bronchial asthma, and one rheumatoid ar-1A preliminary report (1) thritis. All were free of renal or cardiovascular disease. Dietary intake was controlled only with regard to its sodium content. The regimens employed were: 1) "saltfree" diet providing approximately 15 mEq. of sodium daily; 2) "salt-poor" diet providing 35-70 mEq. of sodium daily; 3) "regular" diet of unrestricted salt content containing approximately 170-250 mEq. of sodium; 4) "high-salt" diet consisting of the "regular" diet with 170 mEq. of added sodium chloride. The same regimen was employed for a minimum of three days before each experiment, except that the "high-salt" diet was given for only one day prior to an experiment in subjects who had previously been taking the regular diet. Repeated studies were performed on the same subjects at intervals which ranged from one week to 10 months. Hence weight changes unrelated to dietary salt intake occurred.The subjects came to the laboratory one to two hours after breakfast, voided, and were weighed on a scale sensitive to + 10 gm. Arterialized venous blood (12) was then obtained and a water load established by the ingestion of tap water at room temperature. In most experiments, 1500 ml. were drunk during a period of 10 to 40 minutes. The subject was again weighed and the water load was maintained throughout the experiment by oral administration ...

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Section: Discussionsupporting

confidence: 53%

Variation in the Diuretic Response to Ingested Water Related to the Renal Excretion of Solutes 1

Rosenbaum¹,

Nelson²,

Strauss³

et al. 1953

J. Clin. Invest.

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“…Urine and serum were analyzed for sodium, potassium, chloride and creatinine by methods previously described (5). Serum creatinine was determined after adsorption on Lloyd's reagent (6).…”

Section: Chemical Methods and Calculationsmentioning

confidence: 99%

The Effects of Cortisone and Hydrocortisone on Water Diuresis and Renal Function in Man

Raisz¹,

McNeely²,

L³

et al. 1957

J. Clin. Invest.

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The deficient diuretic response to water which is characteristic of patients with adrenal insufficiency can be rapidly corrected by the administration of cortisone (1-3). The mechanism of the defective diuresis and the precise nature of the response to hormonal replacement have not been established. A number of observations, chiefly in experimental animals, have suggested that administration of various adrenocortical preparations in large "pharmacologic" doses also influences water diuresis in the normal organism (4). However, no systematic study of the latter effect has been made in man. The present report describes the effects of large doses of cortisone and hydrocortisone on water diuresis, renal solute excretion, glomerular filtration rate, and effective renal plasma flow in man. Striking augmentation of the maximal rates of urine flow observed during maintained water loading was a regular occurrence. The steroids studied appear to have a specific influence upon water reabsorption by the renal tubules, an action which can be separated from their effect on renal hemodynamics. MATERIALS AND METHODSThe subjects were adult male patients free from cardiovascular, renal and endocrine disease. Three sets of studies concerning water diuresis were carried out.Group I-A-Intermittent studies during prolonged intramuscular administration of cortisone. In these experiments creatinine clearance was measured, but not inulin or para-aminohippurate clearances. Urinary total solute concentration was calculated from determined cations and urea; freezing point determinations were not made.1 Present address: Veterans Administration Hospital, Syracuse, New York.Group I-B--Serial studies at intervals of one to three days during prolonged oral cortisone and hydrocortisone administration. Clearances of inulin and para-aminohippurate, as well as of creatinine, were determined. Urinary osmolality was measured cryoscopically.Group II-The acute response to intravenous infusion of hydrocortisone during water diuresis. Renal clearances and urinary total solute concentrations were measured as in I-B.Details of experimental procedure will be given together with the results in each group. Chemical methods and calculationsUrine and serum were analyzed for sodium, potassium, chloride and creatinine by methods previously described (5). Serum creatinine was determined after adsorption on Lloyd's reagent (6). Total solute concentration in urine and serum was measured by freezing point depression using a Fiske osmometer (Advanced Instruments, Inc., Needham, Mass.

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“…The earlier literature was summarized by Rosenbaum, Ferguson, Davis & Rossmeisl (1952 (Sj6strand, 1953) include changes in renal haemodynamics (Smith, 1951) and when glomerular filtration rate (G.F.R.) alters it is difficult to evaluate the relative importance of glomerular and tubular factors, particularly in the short periods of observation used by most workers.…”

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

Thomas¹

1957

The Journal of Physiology

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Change of posture is known to be followed by alterations in the renal excretion of water and various urinary constituents. The earlier literature was summarized by Rosenbaum, Ferguson, Davis & Rossmeisl (1952 (Sj6strand, 1953) include changes in renal haemodynamics (Smith, 1951) and when glomerular filtration rate (G.F.R.) alters it is difficult to evaluate the relative importance of glomerular and tubular factors, particularly in the short periods of observation used by most workers.The main object of the present work was to attempt to demonstrate the importance of alterations in tubular activity in the renal adjustments to change of posture. It seemed likely that while acute alterations in renal water and electrolyte excretion could be attributable to changes in renal haemodynamics, the occurrence of more prolonged changes, particularly in urinary hydrion outputs, might indicate the participation of renal tubular factors. In the experiments reported here, the urinary outputs of water, sodium, chloride, potassium, inorganic phosphate, bicarbonate and ammonium, and urinary pH, have been followed for several hours before and after change of * The material included in this paper formed part of a thesis submitted for the degree of M.D., University of Wales in June 1956.

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The Influence of Cortisone Upon the Diurnal Rhythm of Renal Excretory Function

Cited by 59 publications

References 36 publications

Variation in the Diuretic Response to Ingested Water Related to the Renal Excretion of Solutes 1

Variation in the Diuretic Response to Ingested Water Related to the Renal Excretion of Solutes 1

The Effects of Cortisone and Hydrocortisone on Water Diuresis and Renal Function in Man

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

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