THE EFFECT OF ALDOSTERONE ON SODIUM AND POTASSIUM DISTRIBUTION IN MAN

1966 ◽  
Vol 36 (2) ◽  
pp. 103-114 ◽  
Author(s):  
J. R. COX ◽  
MARGARET M. PLATTS ◽  
MARGARET E. HORN ◽  
ROSEMARY ADAMS ◽  
H. E. MILLER
Keyword(s):  
Body Weight ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Exchangeable Sodium ◽  
Cumulative Urinary Excretion ◽  
Plasma Electrolyte ◽  
Urinary Potassium ◽  
Before And After ◽  
Isotope Technique ◽  
The Mean

SUMMARY Total exchangeable sodium, potassium and bromide space were measured by a triple isotope technique, and antipyrine space, body weight, plasma electrolyte concentrations and urine electrolyte excretion were determined before and after intramuscular injection of 0·5 mg. aldosterone 6-hourly for 6–8 days in nine convalescent men. After the treatment with aldosterone there were mean increases in body weight of 2·5 kg., 2·5 1. in total body water, and of 3·0 1. in extracellular fluid volume; a slight decrease in intracellular fluid volume was not significant. The mean total exchangeable sodium increased by 463 m-equiv. and the mean cumulative urinary excretion of sodium decreased by 444 m-equiv. The sodium was retained in the extracellular fluid without significant change in exchangeable intracellular sodium. Mean total exchangeable potassium was reduced by 207 m-equiv. while mean cumulative urinary potassium excretion increased by 88 m-equiv. The potassium loss was entirely intracellular. The main source of error arose from isotope counting. The coefficient of variation of the sample count minus the background exceeded ±3% in 18 out of 150 samples: these results were discarded. Sixteen of the inaccurate counts were due to low concentrations of sodium or potassium in the specimens.

RENAL RESPONSE TO INFUSION OF ISOTONIC RINGER-LOCKE SOLUTION: EFFECT OF HYPOPHYSECTOMY

1977 ◽  
Vol 74 (2) ◽  
pp. 193-204
Author(s):  
J. T. BAKER ◽  
S. SOLOMON
Keyword(s):  
Body Weight ◽  
Proximal Tubule ◽  
Volume Expansion ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Water Reabsorption ◽  
Locke Solution ◽  
Hypophysectomized Rats ◽  
Distal Tubules

A comparison of the renal response to extracellular fluid volume expansion (5% body weight) was made between 25 normal and 25 chronically hypophysectomized rats. The extracellular fluid compartments averaged 25 ± 1% of body weight in both groups during control, fasted conditions. Extracellular fluid volume increased to 33 ± 1% in hypophysectomized and 34 ± 2% in normal rats during expansion, based on body weight. In addition, filtration fraction was similar in both normal and hypophysectomized rats during control (0·29 ± 0·03 and 0·26 ± 0·02 respectively) and infusion of Ringer–Locke solution (0·24 ± 0·05 and 0·27 ± 0·05 respectively). Thus our results cannot be explained by differences in the degree of expansion or failure to increase filtration in proportion to plasma flow. During infusion of isotonic Ringer–Locke solution, fractional water and sodium excretion both averaged 5·1% in normal rats and only 1·3% and 0·82% respectively in hypophysectomized rats. The ratio of single nephron to whole kidney filtration rate failed to increase as much in hypophysectomized compared with normal rats. Significant increases of fractional volume excretion occurred in both groups by the end of the accessible portion of the proximal tubule. However, fractional water reabsorption was depressed significantly more in normal (mean = 37%) than in hypophysectomized rats (mean = 19%). Fractional water reabsorption in distal tubules was similar in both groups during expansion. Arterial pressure was lower in hypophysectomized rats under control conditions, but showed similar changes during expansion compared with normal rats. Passage time decreased significantly in all groups after Ringer–Locke infusion, but remained prolonged in hypophysectomized rats in proximal and distal tubules. It is concluded that chronic hypophysectomy results in a less efficient renal excretion of volume and sodium chloride load. This inefficiency appears to be related in part to (1) failure of the proximal tubule to depress water reabsorption to a level equivalent to normal rats, and (2) failure to re-distribute flow to outer cortical glomeruli following extracellular fluid volume expansion in hypophysectomized rats.

scholarly journals Biochemical Markers of Renal Hypoperfusion, Hemoconcentration, and Proteinuria after Extreme Physical Exercise

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 154 ◽  
Author(s):  
Wojciech Wołyniec ◽  
Katarzyna Kasprowicz ◽  
Patrycja Rita-Tkachenko ◽  
Marcin Renke ◽  
Wojciech Ratkowski
Keyword(s):  
Physical Exercise ◽  
Statistical Significance ◽  
Blood Perfusion ◽  
Fractional Excretion ◽  
Creatinine Ratio ◽  
Plasma Urea ◽  
Urinary Potassium ◽  
Before And After ◽  
The Mean ◽  
Renal Hypoperfusion

Background and Objectives: Physical exercise increases the blood perfusion of muscles, but decreases the renal blood flow. There are several markers of renal hypoperfusion which are used in the differential diagnosis of acute kidney failure. Albuminuria is observed after almost any exercise. The aim of this study was to assess changes in renal hypoperfusion and albuminuria after a 100-km race. Materials and Methods: A total of 27 males who finished a 100-km run were studied. The mean age of the runners was 38.04 ± 5.64 years. The exclusion criteria were a history of kidney disease, glomerular filtration rate (GFR) <60 ml/min, and proteinuria. Blood and urine were collected before and after the race. The urinary albumin/creatinine ratio (ACR), fractional excretion of urea (FeUrea) and sodium (FeNa), plasma urea/creatinine ratio (sUrea/Cr), urine/plasma creatinine ratio (u/pCr), urinary sodium to potassium ratio (uNa/K), and urinary potassium to urinary potassium plus sodium ratio (uK/(K+Na)) were calculated. Results: After the race, significant changes in albuminuria and markers of renal hypoperfusion (FeNa, FeUrea, sUrea/Cr, u/sCr, urinary Na, uNa/K, uK/(K+Na)) were found. Fifteen runners (55.56%) had severe renal hypoperfusion (FeUrea <35, uNa/K <1, and uK/(Na+K) >0.5) after the race. The mean ACR increased from 6.28 ± 3.84 mg/g to 48.43 ± 51.64 mg/g (p < 0.001). The ACR was higher in the group with severe renal hypoperfusion (59.42 ± 59.86 vs. 34.68 ± 37.04 mg/g), but without statistical significance. Conclusions: More than 50% of the runners had severe renal hypoperfusion after extreme exercise. Changes in renal hemodynamics are probably an important, but not the only, factor of post-exercise proteinuria.

scholarly journals Efficacy and safety of tolvaptan in patients with malignant ascites: a phase 2, multicenter, open-label, dose-escalation study

2020 ◽  
Author(s):  
Toshihiro Kudo ◽  
Yoshiyuki Murai ◽  
Yoshitsugu Kojima ◽  
Kenji Uehara ◽  
Taroh Satoh
Keyword(s):  
Body Weight ◽  
Ascitic Fluid ◽  
Dose Escalation ◽  
Urine Volume ◽  
Fluid Volume ◽  
Phase 2 ◽  
Efficacy And Safety ◽  
Open Label ◽  
Dose Escalation Study ◽  
The Mean

Abstract Objective This phase 2 study examined the efficacy and safety of tolvaptan, an aquaretic drug, in the treatment of ascites associated with cancer. Methods In the dose-escalation phase, oral tolvaptan was initiated at a dose of 3.75 mg/day, and the dose was increased daily to 7.5, 15 and 30 mg/day. Dose escalation was terminated once the increase from baseline in the daily urine volume reached 500 ml, at which point the patient proceeded to the maintenance phase of 5–7 days. Improvement of ascites was determined primarily by reduction in body weight and ascitic fluid volume. Results The mean change from baseline in body weight was maintained below 0 kg throughout the study. The mean change (±standard deviation) from baseline in ascitic fluid volume at the end of treatment (EOT) was 237.45 ± 868.14 ml in 33 evaluable patients. Although an increase from baseline in ascitic fluid volume at the EOT was observed in 23 of 33 patients (maximum: 1589.3 ml, minimum: 3.83 ml), a reduction in ascitic fluid volume was observed in the remaining 10 patients (maximum: −2304.3 ml, minimum: −27.5 ml). The common treatment-emergent adverse events included vomiting (5 of 43 patients, 11.6%), abdominal distension, constipation, thirst, blood osmolarity increased and renal impairment (3 of 43 patients, 7.0% each). Conclusions Tolvaptan seemed to have no definitive effect on reducing ascites; however, it might be effective in at least some cancer patients. No new safety concerns were identified at doses of 3.75–30 mg/day.

Effect of Two Different Weight-Loss Rates on Body Composition and Strength and Power-Related Performance in Elite Athletes

2011 ◽  
Vol 21 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Ina Garthe ◽  
Truls Raastad ◽  
Per Egil Refsnes ◽  
Anu Koivisto ◽  
Jorunn Sundgot-Borgen
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Body Weight ◽  
Elite Athletes ◽  
Countermovement Jump ◽  
Repetition Maximum ◽  
Before And After ◽  
The Mean ◽  
And Performance ◽  
Better Than

When weight loss (WL) is necessary, athletes are advised to accomplish it gradually, at a rate of 0.5–1 kg/wk. However, it is possible that losing 0.5 kg/wk is better than 1 kg/wk in terms of preserving lean body mass (LBM) and performance. The aim of this study was to compare changes in body composition, strength, and power during a weekly body-weight (BW) loss of 0.7% slow reduction (SR) vs. 1.4% fast reduction (FR). We hypothesized that the faster WL regimen would result in more detrimental effects on both LBM and strength-related performance. Twenty-four athletes were randomized to SR (n = 13, 24 ± 3 yr, 71.9 ± 12.7 kg) or FR (n = 11, 22 ± 5 yr, 74.8 ± 11.7 kg). They followed energy-restricted diets promoting the predetermined weekly WL. All athletes included 4 resistance-training sessions/wk in their usual training regimen. The mean times spent in intervention for SR and FR were 8.5 ± 2.2 and 5.3 ± 0.9 wk, respectively (p < .001). BW, body composition (DEXA), 1-repetition-maximum (1RM) tests, 40-m sprint, and countermovement jump were measured before and after intervention. Energy intake was reduced by 19% ± 2% and 30% ± 4% in SR and FR, respectively (p = .003). BW and fat mass decreased in both SR and FR by 5.6% ± 0.8% and 5.5% ± 0.7% (0.7% ± 0.8% vs. 1.0% ± 0.4%/wk) and 31% ± 3% and 21 ± 4%, respectively. LBM increased in SR by 2.1% ± 0.4% (p < .001), whereas it was unchanged in FR (–0.2% ± 0.7%), with significant differences between groups (p < .01). In conclusion, data from this study suggest that athletes who want to gain LBM and increase 1RM strength during a WL period combined with strength training should aim for a weekly BW loss of 0.7%.

The use of bioimpedance spectroscopy to monitor response to treatment interventions with breast cancer-related lymphedema.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 138-138
Author(s):  
Chirag Shah ◽  
Frank Vicini ◽  
Peter D. Beitsch ◽  
Beth Anglin ◽  
Alison Lisa Laidley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Extracellular Fluid ◽  
Response To Therapy ◽  
Response To Treatment ◽  
Bioimpedance Spectroscopy ◽  
Post Surgery ◽  
Before And After ◽  
The Mean ◽  
Breast Cancer Related Lymphedema ◽  
Pre Treatment

138 Background: Currently, limited tools are available to assess response to therapy in patients with breast cancer related lymphedema (BCRL). The purpose of this study was to perform an exploratory analysis to determine if, in clinical settings, bioimpedance spectroscopy (BIS) can detect changes in extracellular fluid volume in response to treatment of BCRL. Methods: Three centers that had experience with BIS (L-Dex U400, ImpediMed Limited, Brisbane, Australia) provided retrospective data on 50 patients with breast cancer who were evaluated with BIS at baseline and following loco-regional procedures. Patients had a pre-surgical L-Dex measurement as well as at least 2 post-surgical measurements (before and after BCRL intervention). Decisions regarding intervention were made by physicians with no L-Dex score cut-off utilized. An analysis was performed comparing changes in L-Dex scores for those patients undergoing treatment for BCRL (n=13) versus those not undergoing intervention (n=37). A second analysis was also performed on all patients with elevated L-Dex scores compared to baseline prior to intervention (n=32). Results: The mean age was 54 years old. Fifty four percent of patients underwent SLN biopsy with a mean of 7.9 nodes removed. The mean change in L-Dex score from baseline (pre-treatment) to the first post-surgical L-Dex score measurement was 3.3 +/- 6.8. When comparing the cohort treated for BCRL to those not treated, L-Dex scores were significantly reduced (-4.3 v. 0.1, p=0.005) following intervention. For the subset of patients with elevated L-Dex scores post-surgery, the change in L-Dex score following BCRL intervention was significantly reduced (-5.8 v. 0.1, p=0.001) compared with those observed. Conclusions: These results confirm that BIS can detect increases in L-Dex scores following breast surgery and can also detect reductions in L-Dex scores following intervention for early onset lymphedema. These results demonstrate that BIS has significant clinical utility as it can be used to monitor patients with early BCRL who undergo intervention and to follow these patients (through serial measurements) to document their short and long-term response to these treatments.

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.

Role of renal arterial pressure in the regulation of extracellular volume in conscious dogs

1992 ◽  
Vol 82 (3) ◽  
pp. 247-254 ◽  
Author(s):  
Gabriele Kaczmarczyk ◽  
Klaus Schröder ◽  
Dirk Lampe ◽  
Rainer Mohnhaupt
Keyword(s):  
Body Weight ◽  
Arterial Pressure ◽  
Sodium Excretion ◽  
Urine Volume ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Conscious Dogs ◽  
Central Venous ◽  
Infusion Period

1. This study in conscious dogs examined the quantitative effects of a reduction in the renal arterial pressure on the renal homoeostatic responses to an acute extracellular fluid volume expansion. 2. Seven female beagle dogs were chronically instrumented with two aortic catheters, one central venous catheter and a suprarenal aortic cuff, and were kept under standardized conditions on a constant high dietary sodium intake (14.5 mmol of Na+ day−1 kg−1 body weight). 3. After a 60 min control period, 0.9% (w/v) NaCl was infused at a rate of 1 ml min−1 kg−1 body weight for 60 min (infusion period). Two different protocols were applied during the infusion period: renal arterial pressure was maintained at 102 ± 1 mmHg by means of a servo-feedback control circuit (RAP-sc, 14 experiments) or was left free (RAP-f, 14 experiments). 4. During the infusion period, in the RAP-sc protocol as well as in the RAP-f protocol, the mean arterial pressure increased by 10 mmHg, the heart rate increased by 20 beats/min, the central venous pressure increased by 4 cmH2O and the glomerular filtration rate (control 5.1 ± 0.3 ml min−1 kg−1 body weight, mean ± sem) increased by 1 ml min−1 kg−1. 5. Plasma renin activity [control 0.85 ± 0.15 (RAP-f) and 1.08 ± 0.23 (RAP-sc) pmol of angiotensin I h−1 ml−1] decreased similarly in both protocols. 6. Renal sodium excretion, fractional sodium excretion and urine volume increased more in the RAP-f experiments than in the RAP-sc experiments (P<0.05), renal sodium excretion from 8.2 to 70.1 (RAP-f) and from 7.7 to 47.4 (RAP-sc) μmol min−1 kg−1 body weight, fractional sodium excretion from 1.1 to 8.0 (RAP-f) and from 1.0 to 5.4 (RAP-sc)% and urine volume from 39 to 586 (RAP-f) and from 38 to 471 (RAP-sc) μl min−1 kg−1 body weight. 7. In the RAP-f experiments as well as in the RAP-sc experiments, urinary sodium excretion increased with expansion of the extracellular fluid volume, which increased by a maximum of 21% (fasting extracellular fluid volume: 206 ± 4 ml/kg body weight, six dogs, 28 days). 8. The increase in renal arterial pressure contributed significantly to the renal homoeostatic response, as 21% less urine and 31% less sodium were excreted when the extracellular fluid volume was expanded and the renal arterial pressure was kept constant below control pressure rather than being allowed to rise. The differences in sodium and water excretion were mainly due to the effect of renal arterial pressure on tubular reabsorption. However, the striking increase in sodium and urine excretion which occurred despite the reduction in renal arterial pressure emphasizes the importance of other homoeostatic factors involved in body fluid regulation.

SERIAL DETERMINATIONS OF EXTRACELLULAR FLUID VOLUME USING THE RADIOSULPHATE SPACE METHOD

1963 ◽  
Vol 41 (2) ◽  
pp. 497-510 ◽  
Author(s):  
Beverley Murphy ◽  
J. B. Dossetor ◽  
J. C. Beck
Keyword(s):  
Body Weight ◽  
Diurnal Variation ◽  
Extracellular Fluid ◽  
Time Of Day ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Blood Levels ◽  
Electrolyte Balance ◽  
Serum Samples ◽  
Space Method

The fate of injected and ingested radiosulphate was investigated. The appearance of radiosulphate in bile was shown to be very rapid. Ingested radiosulphate was rapidly and completely absorbed, peak blood levels occurring at 1 to 2 hours.The sulphate space method of measuring extracellular fluid volume was studied and a method adopted requiring two serum samples taken at 1/2 and 6 hours following injection. This procedure provided a convenient means of making independent observations of extracellular fluid volume as often as four times a day in individual subjects. When values for the sulphate space were compared in the same individuals under conditions similar with respect to diet, activity, and time of day, the coefficient of variation was calculated to be ± 5.7% or about ± 1% of body weight. Values among well-nourished subjects with no known abnormalities of water or electrolyte balance gave a mean of 17.5% body weight with a range of 13.5 to 22% body weight. Values among obese subjects averaged 12.8% body weight.Studies of the diurnal variation of the sulphate space made every 6 hours throughout the day suggested that in man, under conditions of uniform intake and normal activity, there is a diurnal variation of extracellular fluid volume, higher values occurring at night.

scholarly journals Single dose of testosterone in children with hypospadias: any effect on the diameter of the glans penis?

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Kevin Emeka Chukwubuike
Keyword(s):  
Body Weight ◽  
Single Dose ◽  
Glans Penis ◽  
Prospective Evaluation ◽  
Weight Group ◽  
Mean Diameter ◽  
Before And After ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background The purpose of this study was to assess the effect of a single dose of testosterone on the diameter of the glans penis. Methods This was a prospective evaluation of the effect of a single dose of testosterone on the diameter of the glans penis of children with hypospadias. The diameter of the glans penis was measured transversely at the level of the coronal sulcus using Vernier calipers. The patients were categorized into two groups: Group A and Group B. Group A received intramuscular testosterone at the dose of 2 mg per kilogram body weight. Group B did not receive any testosterone and served as control. The diameter of the glans penis was evaluated at the beginning of the study and at 4 weeks after the testosterone injection. Results Overall, 64 patients were evaluated. There were 32 patients in group A (50%) and 32 patients in group B (50%). The mean diameter in group A before and after testosterone injection was 17.6 mm ± 2.5 SD and 17.8 ± 2.3 SD, respectively. The mean diameter in group B at onset and after 4 weeks was 17.6 mm ± 2.4 SD and 17.7 ± 2.4 SD, respectively. p = 0.12 which is statistically insignificant. Conclusion Single dose of testosterone in children with hypospadias does not produce significant increase in the diameter of the glans penis.

Some metabolic effects of cold stress on undernourished non-pregnant ewes

1968 ◽  
Vol 19 (2) ◽  
pp. 273 ◽  
Author(s):  
BA Panaretto
Keyword(s):  
Body Weight ◽  
Cold Stress ◽  
Air Temperature ◽  
The Other ◽  
Metabolic Effects ◽  
Protein Catabolism ◽  
Lysosomal Hydrolase ◽  
Urinary Potassium ◽  
The Mean ◽  
Urinary Nitrogen

Four very fat and four moderately fat ewes were undernourished for 33 days, during which time the mean decrement of body weight was 8%. The sheep were then shorn and two each of the fat and moderately fat sheep were exposed to an air temperature of 3°C while the others remained at 21 ± 5°C. The same limited quantity of food was offered at both temperatures.Three out of the four cold ewes died, whereas none of the ewes at 21°C died. The moderately fat cold ewes died within 110 hr. They showed marked protein catabolism for 24–48 hr prior to death and rapid losses in body weight accompanied by large losses in body water, urinary nitrogen, creatine, and potassium. Both animals contained substantial amounts of fat at death. One of the fat ewes died on the 10th day of cold, showing an increase in urinary nitrogen but no elevation of uninary volwne or urinary potassium. The other cold, undernourished fat ewe survived after showing increased protein catabolism during the first 10 days of cold.Transaminase activity was elevated in all cold-stressed ewes; lysosomal hydrolase activity was elevated in the circulation of animals in the cold, especially in the fat ewe that died.These results suggest that previous undernutrition alters the response of sheep to a cold stress and that a cold stress and a degree of undernutrition, each alone readily tolerated by the sheep, may together prove fatal.

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