Intra- and Interindividual Variability in Sodium Intake in Normal Subjects and in Patients With Renal Insufficiency

1. The effect on plasma renin activity (PRA) of dopamine and noradrenaline infusions was studied in three patients with Shy—Drager syndrome, three patients with Parkinson's disease and normal autonomic reflexes, and three healthy volunteers. The patients with the Shy—Drager syndrome had functional evidence of a peripheral lesion of the sympathetic nervous system and subnormal PRA on a controlled sodium intake. 2. In all subjects catecholamines were infused step-wise for 4 min until a 30% rise in systolic blood pressure occurred. 3. In each subject, PRA fell after noradrenaline but rose after dopamine. The mean fractional increase in PRA after dopamine was no less in the Shy—Drager patients than in the control groups. 4. The results suggest, first, that stimulation of dopamine receptors can release renin, and secondly, that inadequate renin stores cannot explain the low PRA found in our patients with autonomic failure.

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ANP kinetics in normal men: in vivo measurement by a tracer method and correlation with sodium intake

AJP Renal Physiology ◽

10.1152/ajprenal.1993.264.3.f480 ◽

1993 ◽

Vol 264 (3) ◽

pp. F480-F489 ◽

Cited By ~ 1

Author(s):

G. Iervasi ◽

A. Clerico ◽

S. Berti ◽

A. Pilo ◽

F. Vitek ◽

...

Keyword(s):

High Performance ◽

Sodium Intake ◽

Mean Transit Time ◽

Normal Subjects ◽

The Body ◽

Metabolic Clearance ◽

Healthy Human ◽

Large Space ◽

Wide Range

125I-labeled atrial natriuretic peptide (ANP) was bolus injected into seven healthy human male subjects on an unrestricted diet (sodium intake ranging from 80 to 300 mmol/day). A high-performance liquid chromatographic procedure was used to purify the labeled hormone and the principal labeled metabolites in venous plasma samples collected up to 50 min after injection. The main ANP kinetic parameters were derived from the disappearance curves of the 125I-ANP, which were satisfactorily fitted by a biexponential function in all subjects. Newly produced ANP initially distributes in a large space (plasma-equivalent volume is 12.1 +/- 3.6 l/m2 body surface); the hormone rapidly leaves this sampling space through both degradation and distribution in peripheral spaces, as indicated by the single-pass mean transit time through the sampling space (3.9 +/- 1.2 min). The mean residence time in the body (22.7 +/- 23.1 min) and the plasma-equivalent total distribution volume (30.9 +/- 12.0 l/m2) indicate that ANP is also widely distributed outside the initial space. Metabolic clearance rate (MCR) values were distributed across a wide range (from 740 to 2,581 ml.min-1 x m-2) and were shown to correlate strongly with the daily urinary excretion of sodium. These results indicate that: 1) newly produced ANP is rapidly distributed and degraded, 2) the body pool of the hormone can be considered as a combination of two exchanging spaces, 3) circulating ANP is < or = 1/15 of the body pool, and 4) MCR of ANP is closely related to sodium intake, at least in normal subjects on a free sodium intake diet.

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Hormonal responses to gradual changes in dietary sodium intake in humans

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1989.256.6.r1171 ◽

1989 ◽

Vol 256 (6) ◽

pp. R1171-R1175 ◽

Cited By ~ 4

Author(s):

G. A. Sagnella ◽

N. D. Markandu ◽

M. G. Buckley ◽

M. A. Miller ◽

D. R. Singer ◽

...

Keyword(s):

Atrial Natriuretic Peptide ◽

Sodium Intake ◽

Plasma Renin ◽

Normal Subjects ◽

Progressive Increase ◽

Plasma Aldosterone ◽

Dietary Sodium ◽

Sodium Balance ◽

Initial Increase ◽

Hormonal Responses

The effects of gradual (50 mmol/day) increases in dietary sodium intake from 10 to 350 mmol/day on plasma atrial natriuretic peptide (ANP), aldosterone, and plasma renin activity (PRA) were studied in six normal subjects. With the increases in sodium intake there was a progressive increase in urinary sodium from 12.2 +/- 4.4 to 314.8 +/- 31.4 mmol/24 h; plasma ANP increased gradually from 9.9 +/- 1.1 to 23.3 +/- 2.2 pg/ml, with the increases being closely associated with the changes in cumulative sodium balance. Plasma aldosterone decreased significantly from 2,519.7 +/- 147.4 pmol/l on the 10 mmol/day to 1,393.3 +/- 125.4 pmol/l when the sodium intake was increased to 50 mmol/day and decreased further to 251.6 +/- 78.7 pmol/l by the end of the study. The changes in PRA paralleled those in plasma aldosterone with the exception of no significant change in plasma PRA within 24 h of the initial increase in sodium intake. This marked sensitivity in the responses of both the ANP and the renin-aldosterone system to small increases in sodium intake clearly points to their importance in the renal adaptations to alterations in dietary sodium intake.

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Low sodium intake enhances sensitivity of 11-deoxycortisol and deoxycorticosterone to ACTH in ACTH-suppressed normal subjects

The Journal of Steroid Biochemistry and Molecular Biology ◽

10.1016/0960-0760(92)90453-p ◽

1992 ◽

Vol 42 (6) ◽

pp. 617-623 ◽

Cited By ~ 1

Author(s):

Claudio E. Kater ◽

Edward G. Biglieri ◽

Ilan Irony

Keyword(s):

Sodium Intake ◽

Normal Subjects ◽

Low Sodium

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Glucose reabsorption in experimental renal insufficiency: Effects of proportional reduction of sodium intake

Kidney International ◽

10.1038/ki.1979.169 ◽

1979 ◽

Vol 16 (5) ◽

pp. 590-599 ◽

Cited By ~ 2

Author(s):

R. William Schmidt ◽

Gabriel M. Danovitch

Keyword(s):

Renal Insufficiency ◽

Sodium Intake ◽

Glucose Reabsorption ◽

Proportional Reduction

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Serum Concentration and Urinary Excretion of Doxycline in Normal Subjects and Patients with Renal Insufficiency

Chemotherapy ◽

10.1159/000221802 ◽

1974 ◽

Vol 20 (3) ◽

pp. 129-140 ◽

Cited By ~ 5

Author(s):

N.K. Ao ◽

O.P. Taneja ◽

V.N. Bhatia ◽

D.S. Aggarwal

Keyword(s):

Serum Concentration ◽

Renal Insufficiency ◽

Urinary Excretion ◽

Normal Subjects

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Hepatic Metabolism of Aminopyrine in Patients with Chronic Renal Failure

Clinical Science ◽

10.1042/cs0540133 ◽

1978 ◽

Vol 54 (2) ◽

pp. 133-140 ◽

Cited By ~ 5

Author(s):

S. Scherrer ◽

B. Haldimann ◽

A. Küpfer ◽

F. Reubi ◽

J. Bircher

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Renal Insufficiency ◽

Serum Creatinine ◽

Hepatic Metabolism ◽

Normal Subjects ◽

Hepatic Disease ◽

Dialysis Treatment ◽

History Of ◽

Aminopyrine Demethylation

1. To evaluate potential alterations in hepatic metabolism of drugs occurring in patients with renal insufficiency the fate of aminopyrine was studied in 17 patients with chronic renal failure and in 27 normal subjects. 2. Although patients with chronic renal failure exhibited large variations, their aminopyrine plasma disappearance times (mean 0·62 ± sd 0·24 h−1) were significantly higher than those found in normal subjects (0·30 ± 0·07 h−1, P < 0·002). 3. 14CO2 derived from [dimethylamine-14C]aminopyrine disappeared from breath more rapidly in patients with chronic renal failure and a history of analgesic abuse (0·40 ± 0·04 h−1) than in control subjects (0·22 ± 0·03 h−1, P < 0·01) and in other patients with chronic renal failure (0·24 ± 0·04 h−1). 4. Dialysis treatment and serum creatinine concentrations were not correlated with the rates of aminopyrine metabolism. Two additional patients, however, with combined renal and hepatic disease, exhibited markedly slowed rates of aminopyrine demethylation. 5. Although chronic renal failure by itself might not alter microsomal drug metabolism it is concluded that, in patients with a history of abuse of phenacetin-containing analgesics, marked acceleration in aminopyrine N-demethylation may be observed.

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Enhanced rectal potassium secretion in chronic renal insufficiency: Evidence for large intestinal potassium adaptation in man

Clinical Science ◽

10.1042/cs0710393 ◽

1986 ◽

Vol 71 (4) ◽

pp. 393-401 ◽

Cited By ~ 55

Author(s):

G. I. Sandle ◽

E. Gaiger ◽

S. Tapster ◽

T. H. J. Goodshep

Keyword(s):

Renal Insufficiency ◽

Large Intestine ◽

Chronic Renal Insufficiency ◽

Rectal Mucosa ◽

Normal Subjects ◽

Potential Difference ◽

Secretory Process ◽

Potassium Adaptation ◽

K Secretion ◽

K Concentration

1. The role of the large intestine in K+ excretion in chronic renal insufficiency was studied with a rectal dialysis technique in 14 normal subjects and eight normokalaemic, normotensive patients with chronic renal insufficiency. 2. At initial intraluminal K+ concentrations of 10, 20, 30 and 45 mmol/l, net K+ secretion in patients with renal insufficiency was significantly greater than in normal subjects by approximately 1.8 μmol h−1 cm−2. The increase in net K+ secretion was more marked in those patients with creatinine clearances of less than 10 ml/rnin. In contrast, there were no significant differences in net Na+ and water transport, transmucosal potential difference and plasma aldosterone concentrations between the two groups. 3. With an initial intraluminal K+ concentration of 30 mmol/l, the addition of amiloride (final concentration 1 mmol/l) to the rectal lumen decreased net Na+ absorption and transmucosal potential difference in normal subjects by 69% (P < 0.005) and 31% (P < 0.005) respectively, and in patients with renal insufficiency by 75% (P < 0.05) and 36% (P < 0.05) respectively, but there was no change in net K+ secretion in either group. 4. These results indicate that the K+ secretory capacity of the rectal mucosa increases in chronic renal insufficiency, and the large intestine may therefore contribute to the maintenance of K+ homoeostasis as renal K+ excretion declines. Increased rectal K+ secretion in renal insufficiency occurs independently of changes in plasma K+ and aldosterone concentrations, net Na+ absorption and transmucosal potential difference, and may reflect stimulation of an active K+ secretory process.

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Dietary chloride modifies renin release in normal humans

AJP Renal Physiology ◽

10.1152/ajprenal.1981.241.4.f361 ◽

1981 ◽

Vol 241 (4) ◽

pp. F361-F363 ◽

Cited By ~ 1

Author(s):

R. J. Koletsky ◽

R. G. Dluhy ◽

R. G. Cheron ◽

G. H. Williams

Keyword(s):

Sodium Intake ◽

Plasma Renin ◽

Normal Subjects ◽

Renin Release ◽

Upright Posture ◽

Ang Ii ◽

Low Salt ◽

Normal Humans ◽

The Mean ◽

Induced Changes

The effect of high and low chloride diets on the responses of plasma renin activity (PRA), angiotensin II (ANG II), and aldosterone (Aldo) to upright posture was studied in the same normal subjects in balance on constant sodium intake. Diet 1 consisted of 10 meq Na/day (low Na) and either 50 or 150 meq Cl/day. Diet 2 consisted of 200 meq Na/day (high Na) and either 20 or 200 meq Cl/day. The mean recumbent PRA level on the high Na-high Cl diet tended to be lower than on the high Na-low Cl diet but was not significantly different. However, the absolute peak upright PRA levels, 8.8 +/- 1.0 vs. 4.4 +/- 0.8 ng . ml-1 . h-1, and the incremental difference (delta PRA) between recumbent and peak upright PRA levels, 5.5 +/- 0.8 vs. 2.2 +/- 0.5 ng . ml-1 . h-1, were significantly less on the high Na-high Cl diet compared with the high Na-low Cl diet. Similar significant changes were seen in ANG II and Aldo levels. However, there were no significant changes in PRA, ANG II, and Aldo responses to upright posture on the low Na diet when the dietary Cl was varied. It is concluded that dietary Cl is another factor modifying renin release. However, Cl is probably less important than Na because Cl-induced changes in PRA were not seen in the low salt state.

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