Spironolactone and Amiloride in the Treatment of Low Renin Hyperaldosteronism and Related Syndromes

1973 ◽  
Vol 45 (s1) ◽  
pp. 213s-218s ◽  
Author(s):  
D. Kremer ◽  
D. G. Beevers ◽  
J. J. Brown ◽  
D. L. Davies ◽  
J. B. Ferriss ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Extracellular Fluid ◽  
Plasma Renin ◽  
Prolonged Treatment ◽  
Exchangeable Sodium ◽  
Total Body Potassium ◽  
Plasma Electrolyte ◽  
Potassium Plasma ◽  
Total Body ◽  
Electrolyte Abnormalities

1. Prolonged treatment with spironolactone in low-renin hyperaldosteronism invariably corrects plasma electrolyte abnormalities and usually lowers blood pressure. 2. Total exchangeable sodium, total body water, extracellular fluid and plasma volumes are reduced; total exchangeable and total body potassium, plasma renin and angiotensin II concentrations are increased. 3. Spironolactone is similarly effective in patients with apparently isolated deoxycorticosterone (DOC) excess; also in suspected mineralocorticoid excess not associated with elevation of aldosterone or DOC. 4. Studies of amiloride reveal similar effectiveness to spironolactone in low-renin hyperaldosteronism and in suspected mineralocorticoid excess.

Increase of Total Body Potassium and Decrease of Exchangeable Sodium after Long-Term Treatment with a β-Receptor-Blocking Agent (Prindolol) in Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 551s-554s
Author(s):  
H. M. Brecht ◽  
E. Werner ◽  
W. Schoeppe
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Term Treatment ◽  
Renin Activity ◽  
Exchangeable Sodium ◽  
Total Body Potassium ◽  
Long Term Treatment ◽  
Total Body

1. The effect of long-term treatment with prindolol on blood pressure, total body potassium (Kt), exchangeable sodium (Nae) and plasma renin activity was investigated in twelve patients with essential hypertension. 2. Systolic and diastolic pressures were significantly reduced from 164/112 to 127/90 mmHg under basal conditions. 3. Before treatment Na. in patients with essential hypertension was significantly higher than in normotensive individuals. After an average of 16 weeks on prindolol Nae in patients with essential hypertension was significantly decreased, despite an average increase in body weight of 2 kg in the patients. 4. In contrast to the decrease in Nae, Kt was found to be significantly increased after long-term treatment with prindolol. Kt values of patients before and after prindolol, however, did not differ significantly from the corresponding sex- and age-dependent normal values. 5. Plasma renin activity was slightly diminished under basal and orthostatic conditions; the stimulatory effect of orthostasis was not abolished but reduced by prindolol. 6. It is suggested that the changes in sodium balance contribute to the anti-hypertensive effect of prindolol in patients with essential hypertension.

The Relationship between Body Fluid Compartment Volumes, Renin Activity and Blood Pressure in Chronic Renal Failure

1973 ◽  
Vol 45 (1) ◽  
pp. 77-88 ◽  
Author(s):  
J. R. E. Dathan ◽  
D. B. Johnson ◽  
F. J. Goodwin
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Body Fluid ◽  
Plasma Renin ◽  
Renin Activity ◽  
Exchangeable Sodium ◽  
Arterial Blood ◽  
Fluid Compartment ◽  
Total Body ◽  
The Relationship

1. The relationship between various body fluid compartment volumes, plasma renin activity and mean arterial blood pressure was studied in twenty-six patients with chronic renal failure. 2. Mean arterial blood pressure was positively correlated with total exchangeable sodium, blood volume and plasma renin activity: there was no significant correlation with either total body water or extracellular fluid volume. 3. Multiple regression analysis revealed that plasma renin activity combined with total exchangeable sodium, blood volume, red cell mass or total body water provided a better means of predicting blood pressure than any of the variables taken alone. 4. In a second study performed after a period of regular dialysis treatment no correlation was found between mean arterial pressure and either body fluid compartment volumes or plasma renin activity.

Regulation of body fluid compartments during short-term spaceflight

1996 ◽  
Vol 81 (1) ◽  
pp. 105-116 ◽  
Author(s):  
C. S. Leach ◽  
C. P. Alfrey ◽  
W. N. Suki ◽  
J. I. Leonard ◽  
P. C. Rambaut ◽  
...  
Keyword(s):  
Body Fluid ◽  
Extracellular Fluid ◽  
Plasma Renin ◽  
Capillary Membranes ◽  
Urinary Cortisol Excretion ◽  
Hormone Responses ◽  
Body Fluid Compartments ◽  
Cortisol Excretion ◽  
Fluid Compartments ◽  
Total Body

The fluid and electrolyte regulation experiment with seven subjects was designed to describe body fluid, renal, and fluid regulatory hormone responses during the Spacelab Life Sciences-1 (9 days) and -2 (14 days) missions. Total body water did not change significantly. Plasma volume (PV; P < 0.05) and extracellular fluid volume (ECFV; P < 0.10) decreased 21 h after launch, remaining below preflight levels until after landing. Fluid intake decreased during weightlessness, and glomerular filtration rate (GFR) increased in the first 2 days and on day 8 (P < 0.05). Urinary antidiuretic hormone (ADH) excretion increased (P < 0.05) and fluid excretion decreased early in flight (P < 0.10). Plasma renin activity (PRA; P < 0.10) and aldosterone (P < 0.05) decreased in the first few hours after launch; PRA increased 1 wk later (P < 0.05). During flight, plasma atrial natriuretic peptide concentrations were consistently lower than preflight means, and urinary cortisol excretion was usually greater than preflight levels. Acceleration at launch and landing probably caused increases in ADH and cortisol excretion, and a shift of fluid from the extracellular to the intracellular compartment would account for reductions in ECFV. Increased permeability of capillary membranes may be the most important mechanism causing spaceflight-induced PV reduction, which is probably maintained by increased GFR and other mechanisms. If the Gauer-Henry reflex operates during spaceflight, it must be completed within the first 21 h of flight and be succeeded by establishment of a reduced PV set point.

Letters to the Editor

PEDIATRICS ◽  
1968 ◽  
Vol 41 (6) ◽  
pp. 1147-1148
Author(s):  
John C. Sinclair
Keyword(s):  
Oxygen Consumption ◽  
Cell Mass ◽  
Extracellular Fluid ◽  
Chemical Constituent ◽  
Metabolic Function ◽  
Total Body Potassium ◽  
Letters To The Editor ◽  
Relative Growth ◽  
Total Body

Professor Burmeister, in dealing with problems of relative growth, uses equations of the form Y = a Xh, as proposed by Huxley. Values for the exponent b, in equations of this form, indicate the rate of accretion of the part (organ, chemical constituent, body compartment, metabolic function) in relation to the whole. Values for b of less than one indicate a relatively lesser rate of accretion of the part See Images in the PDF File e.g., our exponent for extracellular fluid, b = 0.80 (Table II of Burmeister's reference 5); values of greater than one indicate a relatively greater rate of accretion of the part–e.g., Burmeister's exponents for total body potassium, 1.09, and for cell mass, 1.11, and ours for resting oxygen consumption, 1.22, and for fat, 2.18 (Table II of Burmeister's reference 5).

Renal sodium handling in normal humans subjected to low, normal, and extremely high sodium supplies

1985 ◽  
Vol 249 (6) ◽  
pp. F941-F947 ◽  
Author(s):  
J. C. Roos ◽  
H. A. Koomans ◽  
E. J. Dorhout Mees ◽  
I. M. Delawi
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Sodium Intake ◽  
Extracellular Fluid ◽  
Plasma Renin ◽  
Renin Activity ◽  
Sodium Reabsorption ◽  
Lithium Clearance ◽  
Renal Sodium Handling ◽  
Sodium Handling

We studied renal sodium handling, extracellular fluid volume (ECFV), plasma renin activity, aldosterone and norepinephrine, and blood pressure in eight healthy volunteers after equilibration on intakes of 20, 200, and 1,128 +/- 141 meq sodium, respectively. Renal sodium handling was assessed by means of clearance studies during maximal water diuresis and lithium clearance. Urinary sodium excretions were 22 +/- 4, 202 +/- 19, and 1,052 +/- 86 meq/day. From the lower to the upper sodium intake level, 24-h creatinine clearance rose from 111 +/- 7 to 136 +/- 11 ml/min and inulin clearance from 103 +/- 9 to 129 +/- 9 ml/min, whereas proximal and distal fractional sodium reabsorption (FSRprox and FSRdist, respectively) fell from 86.8 +/- 1.3 to 79.0 +/- 2.7% and from 96.5 +/- 0.5 to 76.0 +/- 1.9%, respectively. During the normal sodium intake (200 meq), intermediate values were recorded. The changes in fractional lithium clearance were less consistent but correlated with FSRprox (r = 0.78, P less than 0.001) and not with FSRdist. Major changes in plasma renin activity, aldosterone, and, to a lesser extent, norepinephrine accompanied these changes in kidney function, displaying inverse and exponential correlations with daily sodium excretion and ECFV. No consistent rise in blood pressure was detected. These observations indicate that in healthy humans renal adaptation to vast variations in sodium intake includes resetting of glomerular filtration rate, FSRprox, and, in particular, FSRdist. Alterations in neurohumoral factors may play a dominant role in this adaptation.

Sodium and Renin in the Hypertension of Early Renal Disease

1978 ◽  
Vol 55 (s4) ◽  
pp. 301s-303s ◽  
Author(s):  
S. F. Wong ◽  
M. I. Mitchell ◽  
V. Robson ◽  
R. Wilkinson
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Exchangeable Sodium ◽  
Hypertensive Patients ◽  
Body Build ◽  
Activity Response ◽  
Normal Controls

1. Plasma renin activity, response to saralasin and exchangeable sodium have been measured in 43 patients with early renal disease. 2. Blood pressure was directly proportional to plasma renin activity. However, mean plasma renin activity was lower in patients with renal disease than in normal controls. 3. Blood pressure fell in response to saralasin infusion in proportion to the pre-infusion plasma renin activity. 4. Exchangeable sodium in hypertensive patients with renal disease did not exceed that in normotensive patients in contrast to earlier reports. Discrepancies may arise from the difficulty in interpreting measured exchangeable sodium in relation to body build.

The Use of Frusemide and Propranolol in the Treatment of the Hypertension of Chronic Renal Disease

1974 ◽  
Vol 19 (1_suppl) ◽  
pp. 25-32 ◽  
Author(s):  
R. Wilkinson ◽  
Mary Pickering ◽  
Valerie Robson ◽  
R. W. Elliott ◽  
D. N. S. Kerr
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Renal Disease ◽  
Serum Creatinine ◽  
Marked Reduction ◽  
Chronic Renal Disease ◽  
Plasma Renin ◽  
Sodium Retention ◽  
Exchangeable Sodium ◽  
Standing Blood Pressure

Nine patients with renal disease, hypertension and impairment of renal function of varying degree have been studied before and during treatment with frusemide. In three patients observations were repeated following the addition of propranolol. In most cases frusemide resulted in a reduction of both lying and standing blood pressure but for the group the fall was not significant (P>0.05). In all patients a reduction in exchangeable sodium was achieved and the fall was significant for the group (P<0.05); this was accompanied by a significant increase in serum creatinine (P < 0.05). Plasma renin activity was increased in all patients during treatment with frusemide and the change for the group was significant (P<0.05). The addition of propranolol resulted in a marked reduction in renin in the three patients treated but in two blood pressure actually rose; in these two sodium retention had occurred following the introduction of propranolol.

Total body potassium and water, and exchangeable sodium, in muscular dystrophy

1985 ◽  
Vol 68 (4) ◽  
pp. 379-385 ◽  
Author(s):  
C. J. Edmonds ◽  
T. Smith ◽  
R. D. Griffiths ◽  
J. Mackenzie ◽  
R. H. T. Edwards
Keyword(s):  
Muscular Dystrophy ◽  
Total Body Water ◽  
Similar Rate ◽  
Body Water ◽  
Exchangeable Sodium ◽  
Total Body Potassium ◽  
Normal Body Weight ◽  
Normal Males ◽  
Predicted Values ◽  
Total Body

1. Total body potassium (40K method) and total body water and exchangeable sodium (both by isotope dilution) were determined in 26 boys, aged 5-17 years, with muscular dystrophy. Total body potassium values were compared with measurements in a large series of normal boys on the basis of height. 2. Total body potassium was reduced even in the youngest patients and was only slightly higher in the older boys, despite their considerably greater height. Exchangeable sodium increased with increasing height in a way similar to that of normal boys. Total body water was also reduced but increased with growth, although to a lesser extent than expected for normal boys. The total body water measurements indicated that many of the affected boys were very obese, despite an apparently normal body weight. 3. An intravenous bolus of 22Na distributed at a similar rate in boys with muscular dystrophy to that in normal males. 4. In relation to the predicted values, total body potassium and 24 h urinary creatinine excretion of the affected boys both declined at a rate of 4% per year.

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