scholarly journals Water metabolism disturbances at different stages of primary thyroid failure

2001 ◽  
Vol 168 (3) ◽  
pp. 435-445 ◽  
Author(s):  
M Sahun ◽  
C Villabona ◽  
P Rosel ◽  
MA Navarro ◽  
JM Ramon ◽  
...  
Keyword(s):  
Plasma Osmolality ◽  
Free Water ◽  
Plasma Renin ◽  
Primary Hypothyroidism ◽  
Plasma Aldosterone ◽  
Water Metabolism ◽  
Loading Test ◽  
Free Water Clearance ◽  
Natriuretic Hormone ◽  
Replacement Treatment

The aim of the present study was to study salt and water metabolism in thyroid deficiency. We performed an oral water loading test (OWL) and a hypertonic 5% saline infusion test (HSI) in 16 patients with overt primary hypothyroidism before replacement treatment (PRE group) and after, in eight patients with subclinical hypothyroidism (SUB group) and in 16 normal individuals (CG group). In the PRE group, a lower free water clearance was detected in the OWL (P < 0.022), with lower plasma osmolality (OWL: P < 0.005; HSI: P < 0.001) and arginine vasopressin (AVP) (OWL: P < 0.001; HSI: P < 0.001) than the CG group, across both tests; they normalized with the replacement treatment. The same plasma abnormalities were detected in the SUB group with the HSI. Although the AVP and thirst thresholds did not differ between the groups, the lag between them was lower in the PRE (4.1+/-3.2 mOsm/kg) and SUB group (2.6+/-2.1 mOsm/kg) than in the CG group (13.3+/-9.2 mOsm/kg) (P < 0.05). There were no differences in atrial natriuretic hormone (ANH), plasma renin activity (PRA) and plasma aldosterone among the groups. These results indicate that plasma hypo-osmolality and low levels of AVP are present in primary hypothyroidism, and indeed are already present in the subclinical phase of the disease. An overlap between the thresholds of thirst and AVP seem to play a role in these abnormalities, but ANH, PRA and plasma aldosterone do not appear to contribute.

Osmoregulation of thirst and vasopressin during normal menstrual cycle

1988 ◽  
Vol 254 (4) ◽  
pp. R641-R647 ◽  
Author(s):  
T. J. Vokes ◽  
N. M. Weiss ◽  
J. Schreiber ◽  
M. B. Gaskill ◽  
G. L. Robertson
Keyword(s):  
Menstrual Cycle ◽  
Luteal Phase ◽  
Plasma Osmolality ◽  
Free Water ◽  
Urine Osmolality ◽  
Free Water Clearance ◽  
Vasopressin Release ◽  
Plasma Vasopressin ◽  
Normal Menstrual Cycle ◽  
Basal Plasma

Changes in osmoregulation during normal menstrual cycle were examined in 15 healthy women. In 10 women, studied repetitively during two consecutive menstrual cycles, basal plasma osmolality, sodium, and urea decreased by 4 mosmol/kg, 2 meq/l, and 0.5 mM, respectively (all P less than 0.02) from the follicular to luteal phase. Plasma vasopressin, protein, hematocrit, mean arterial pressure, and body weight did not change. In five other women, diluting capacity and osmotic control of thirst and vasopressin release were assessed in follicular, ovulatory, and luteal phases. Responses of thirst and/or plasma vasopressin, urine osmolality, osmolal and free water clearance to water loading, and infusion of hypertonic saline were normal and similar in the three phases. However, the plasma osmolality at which plasma vasopressin and urine osmolality were maximally suppressed as well as calculated osmotic thresholds for thirst and vasopressin release were lower by 5 mosmol/kg in the luteal than in the follicular phase. This lowering of osmotic thresholds for thirst and vasopressin release, which occurs in the luteal phase, is qualitatively similar to that observed in pregnancy and should be taken into account when studying water balance and regulation of vasopressin secretion in healthy cycling women.

Volume-homeostatic mechanisms in humans during a 12-h posture change

1993 ◽  
Vol 75 (1) ◽  
pp. 349-356 ◽  
Author(s):  
P. Norsk ◽  
C. Stadeager ◽  
L. B. Johansen ◽  
J. Warberg ◽  
P. Bie ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Venous Pressure ◽  
Free Water ◽  
Plasma Renin ◽  
Arterial Pulse ◽  
Free Water Clearance ◽  
Water Handling ◽  
Renal Sodium Excretion ◽  
Male Subjects ◽  
Peak Value

On one day six male subjects underwent an upright seated (SEAT) study, and on another day they were subjected to a head-down tilt of 3 degrees (HDT). Compared with SEAT, HDT induced prompt increases in central venous pressure (CVP) from -0.5 +/- 0.8 to 8.3 +/- 0.3 mmHg (P < 0.001) and in arterial pulse pressure of 8–18 mmHg (P < 0.001). CVP stabilized after 6 h at levels 2.4–2.8 mmHg below the peak value. Simultaneously, renal sodium excretion gradually increased over the initial 5 h of HDT and stabilized at a level approximately 125 mumol/min over that of SEAT (P < 0.001). Urine flow rate and solute free water clearance increased during the initial 2–6 h of HDT (P < 0.001) but returned to the level of SEAT thereafter. We concluded that CVP is slightly reduced over 12 h of HDT and that a clear temporal dissociation exists between renal sodium and water handling. We suggest that the combined effect of the sustained suppressions of plasma renin activity and plasma aldosterone and norepinephrine concentrations constitutes a mechanism of the increase in renal sodium excretion.

Morphological and functional comparisons of normal and hypertrophied kidneys of adult domestic fowl (Gallus gallus)

1990 ◽  
Vol 258 (2) ◽  
pp. F403-F413
Author(s):  
C. M. Gregg ◽  
R. F. Wideman
Keyword(s):  
Domestic Fowl ◽  
Renal Mass ◽  
Plasma Osmolality ◽  
Free Water ◽  
Urine Osmolality ◽  
Osmotic Diuresis ◽  
Free Water Clearance ◽  
Permanent Loss ◽  
The Right ◽  
Water Clearance

Similar to mammals, kidneys of domestic fowl undergo compensatory hypertrophy after loss of functional renal mass. Because this species continues to develop new nephrons for up to 12-wk posthatch, renal hyperplasia might play a significant role in compensatory growth. Either transient or permanent loss of approximately 60% of the right kidney was produced in 2- to 3-wk-old roosters by simple ureteral transection or by removing a 1-mm segment of ureter at the level of the ischiadic artery, respectively. In the latter (experimental) group, right anterior and medial divisions atrophied leaving only the posterior division intact. Spontaneous reanastomosis occurred in the former (reconnected) group, and all three divisions were present at death. Control birds were untouched as were the left kidneys of experimental and reconnected birds. At 40-50 wk, renal function was measured separately in right and left kidneys of all groups during five different infusion protocols. Compared with control kidneys, experimental kidneys had a 50-60% weight gain, and their glomerular size distribution profile was shifted to the right (larger glomeruli). Reconnected kidneys were not hypertrophied, and their profile was shifted to the left (smaller glomeruli). Neither group had significant formation of new nephrons. Once variations in kidney weight were taken into account, there were no differences between hypertrophied (experimental) and control kidneys in urine flow rate (UFR), glomerular filtration rate (GFR), paraaminohippuric acid (PAH) clearance, UFR/GFR, urine osmolality, urine/plasma osmolality, osmolal clearance, free water clearance, Na and K load, absolute Na and K excretion, and fractional Na and K excretion except as follows: 1) during infusion of isotonic mannitol-dextrose at 0.1 ml.min-1.kg body wt-1 experimental kidneys had a lower fractional excretion of K than control kidneys, and 2) during brisk osmotic diuresis (isotonic mannitol-dextrose at 0.4 ml.min-1.kg body wt-1) experimental kidneys had higher UFR and free water clearance and lower urine osmolality and urine/plasma osmolality than control kidneys. Reconnected kidneys differed from control kidneys in only 1 of 210 comparisons. Permanent loss of functional renal mass in young birds produces significant compensatory renal hypertrophy that is due to enlargement of existing nephrons rather than formation of new nephrons. Hypertrophied kidneys function like normal kidneys except under conditions of brisk osmotic diuresis.

Shift in body fluid compartments after dehydration in humans

1988 ◽  
Vol 65 (1) ◽  
pp. 318-324 ◽  
Author(s):  
H. Nose ◽  
G. W. Mack ◽  
X. R. Shi ◽  
E. R. Nadel
Keyword(s):  
Body Fluid ◽  
Extracellular Fluid ◽  
Plasma Osmolality ◽  
Free Water ◽  
Inverse Correlation ◽  
The Body ◽  
Free Water Clearance ◽  
Before And After ◽  
Body Fluid Compartments ◽  
Fluid Compartments

To investigate the influence of [Na+] in sweat on the distribution of body water during dehydration, we studied 10 volunteer subjects who exercised (40% of maximal aerobic power) in the heat [36 degrees C, less than 30% relative humidity (rh)] for 90-110 min to produce a dehydration of 2.3% body wt (delta TW). After dehydration, the subjects rested for 1 h in a thermoneutral environment (28 degrees C, less than 30% rh), after which time the changes in the body fluid compartments were assessed. We measured plasma volume, plasma osmolality, and [Na+], [K+], and [Cl-] in plasma, together with sweat and urine volumes and their ionic concentrations before and after dehydration. The change in the extracellular fluid space (delta ECF) was estimated from chloride distribution and the change in the intracellular fluid space (delta ICF) was calculated by subtracting delta ECF from delta TW. The decrease in the ICF space was correlated with the increase in plasma osmolality (r = -0.74, P less than 0.02). The increase in plasma osmolality was a function of the loss of free water (delta FW), estimated from the equation delta FW = delta TW - (loss of osmotically active substance in sweat and urine)/(control plasma osmolality) (r = -0.79, P less than 0.01). Free water loss, which is analogous to "free water clearance" in renal function, showed a strongly inverse correlation with [Na+] in sweat (r = -0.97, P less than 0.001). Fluid movement out of the ICF space attenuated the decrease in the ECF space.(ABSTRACT TRUNCATED AT 250 WORDS)

Osmoregulation of arginine-8-vasopressin secretion in primary hypothyroidism and in Addison's disease

1987 ◽  
Vol 114 (3) ◽  
pp. 389-395 ◽  
Author(s):  
F. Laczi ◽  
T. Janáky ◽  
T. Iványi ◽  
J. Julesz ◽  
F. A. László
Keyword(s):  
Healthy Volunteers ◽  
Plasma Osmolality ◽  
Addison’S Disease ◽  
Primary Hypothyroidism ◽  
Addison's Disease ◽  
Water Metabolism ◽  
Positive Correlation ◽  
Vasopressin Secretion ◽  
Impaired Water ◽  
Hypothyroid Patients

Abstract. The osmoregulation of arginine-8-vasopressin (AVP) was investigated in 14 patients with primary hypothyroidism and in 6 with Addison's disease. Plasma AVP was measured by radioimmunoassay. Patients with primary hypothyroidism were classified into subgroups with elevated (6.81 ± 1.12 pmol/l) or normal (3.92 ± 0.96 pmol/l) basal levels of plasma AVP. Following the infusion of 2.5% saline, a positive correlation was established between plasma AVP and plasma osmolality. A decreased osmotic threshold was found in hypothyroid patients with augmented basal AVP levels (pAVP = 0.37 (pOs-265), r = 0.71, P < 0.01) as compared with that in hypothyroid patients with a normal AVP level (pAVP = 0.42 (pOs-280), r = 0.93, P < 0.001). A relationship was demonstrated between the alteration in the AVP osmoregulation and the severity of the thyroid insufficiency. Patients with Addison's disease exhibited an increased basal level of plasma AVP (9.59 ± 1.25 pmol/l) and a decreased osmotic threshold (pAVP = 0.42 (pOs-261), r = 0.63, P < 0.01) contrasted to that of healthy volunteers (pAVP = 0.41 (pOs-280), r = 0.83, P < 0.001). The osmoregulation disturbance of the AVP secretion may play a major role in the impaired water metabolism in primary hypothyroidism and in Addison's disease.

Cardiovascular, renal, and endocrine responses in male quadriplegics during head-out water immersion

1990 ◽  
Vol 258 (6) ◽  
pp. R1424-R1430 ◽  
Author(s):  
F. Tajima ◽  
S. Sagawa ◽  
J. Iwamoto ◽  
K. Miki ◽  
B. J. Freund ◽  
...  
Keyword(s):  
Water Immersion ◽  
Urine Volume ◽  
Systolic Pressure ◽  
Free Water ◽  
Plasma Renin ◽  
Normal Subjects ◽  
Urine Flow ◽  
Cervical Cord ◽  
Free Water Clearance ◽  
Normal Men

The present study was undertaken to determine the relative influence of the action of the central nervous system on the mechanism of water-immersion-induced diuresis by comparing physiological responses of quadriplegic (QP) and normal subjects. After overnight fasting seven male QP subjects with complete cervical cord transections (C5-C8) and six normal men were tested before, during, and after 3 h of head-out immersion (HOI) in thermoneutral water (34.5-35.0 degrees C). The reversible increase in urine flow and the total urine volume (309 +/- 53 ml in 3 h) in QP subjects were comparable with that of the normal subjects (318 +/- 96 ml in 3 h). While osmolal excretion was increased in QP subjects, its magnitude was less when compared with that of normal subjects. Instead, the increased urine flow in QP subjects was characterized by increased glomerular filtration rate (GFR) and free water clearance, in contrast to a predominantly osmotic diuresis with no changes in GFR in the normal subjects. The HOI elevated (P less than 0.05) systolic pressure only in QP subjects, whereas the increase in cardiac output was the same in both groups. While plasma renin activity and aldosterone responses to HOI in QP subjects were comparable with those of normal individuals, plasma atrial natriuretic factor (ANF) in QP subjects was twofold higher (P less than 0.05) during HOI, and the approximately threefold increase in ANF (P less than 0.05) in QP subjects due to HOI was the same as that of normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

EFFECT OF HYPOTHALAMIC LESIONS ON WATER METABOLISM OF THE TOAD BUFO MARINUS

1977 ◽  
Vol 75 (1) ◽  
pp. 161-172 ◽  
Author(s):  
H. R. BAKKER ◽  
S. D. BRADSHAW
Keyword(s):  
Water Uptake ◽  
Functional Significance ◽  
Free Water ◽  
Fluid Retention ◽  
Water Metabolism ◽  
Free Water Clearance ◽  
Hypothalamic Lesions ◽  
Antidiuretic Effect ◽  
Saturated Atmosphere ◽  
Toad Bufo

The rate of cutaneous water uptake after dehydration was significantly depressed in functionally neurohypophysectomized toads (Bufo marinas), which consequently regained weight much more slowly than intact toads when returned to water. Toads bearing hypothalamic lesions were able to develop an antidiuresis when removed from water to a saturated atmosphere, but the antidiuresis was solely glomerular in origin and was established more slowly than in intact animals. The fractional reabsorption of filtrate increased significantly and the relative free water clearance decreased significantly in intact toads after removal from water. These changes in tubular function, which were not seen in lesioned toads, were responsible for the development of a more rapid and effective antidiuresis in intact animals. Injections of iso-osmotic saline, oxytocin (250 mu./100 g) and vasopressin (50 mu./100 g) had no significant effect on rates of cutaneous water uptake in both intact and lesioned toads. Injections of hyperosmotic saline, however, significantly increased rates of water uptake in both groups of toads, but to a much greater extent in the intact animals. Fluid retention arising from a marked antidiuresis occurred after the injection of vasopressin and hyperosmotic saline, and there was some evidence of an antidiuretic effect of oxytocin with the doses used here. These results and their bearing on the question of the functional significance of the neurohypophysis in anuran amphibians are discussed.

RADIOIMMUNOASSAY OF [8-ARGININE]-VASOPRESSIN

1975 ◽  
Vol 80 (3) ◽  
pp. 453-464 ◽  
Author(s):  
U. Merkelbach ◽  
P. Czernichow ◽  
R. C. Gaillard ◽  
M. B. Vallotton
Keyword(s):  
Arginine Vasopressin ◽  
Excretion Rate ◽  
Regression Line ◽  
Plasma Osmolality ◽  
Free Water ◽  
Bartter Syndrome ◽  
Total Output ◽  
Urinary Concentration ◽  
Free Water Clearance ◽  
Significant Difference

ABSTRACT A radioimmunoassay for [8-arginine]-vasopressin (AVP), previously described (Czernichow et al. 1975) has been used for the determination of antidiuretic hormone in a 4 ml urine sample. AVP is extracted from acidified urine with a cation exchanger (Amberlite CG 50) with an overall recovery of 72 %. The blank value measured in extracted samples of urine was 0.29 pg/ml ± 0.21 (sem) and calculated by extrapolation of the regression line of the recovery experiment was 0.49 pg/ml. The coefficient of variation within-assay was 13 % and between-assay 18%. Addition of the amounts of AVP found in each specimen of urine voided gave results nearly identical to those of the amounts found in 24 h pool of urine, indicating that the assay was not affected by changes in concentration of the other urinary components during the day. The daily urinary excretion of AVP measured in 34 subjects was found to be 34 ng in 17 women and 70 ng in 17 men, a significant difference. Urinary concentration and excretion rate of AVP rose during thirst test and during Carter-Robbins test performed in 13 healthy subjects. In the latter test it was observed that the women displayed a strikingly more pronounced AVP elevation after the osmolar stimulus than the men. In both sexes a significant correlation was found between AVP excretion rate and plasma osmolality as well as free water clearance. Three cases of complete or incomplete diabetes insipidus and potomania could be clearly differentiated according to the total output of AVP during the thirst test. Extremely high values of AVP were found in the urine of 5 subjects with Schwartz-Bartter syndrome associated with bronchogenic tumours.

Effect of water temperature on diuresis-natriuresis: AVP, ANP, and urodilatin during immersion in men

1994 ◽  
Vol 77 (4) ◽  
pp. 1919-1925 ◽  
Author(s):  
S. Nakamitsu ◽  
S. Sagawa ◽  
K. Miki ◽  
F. Wada ◽  
K. Nagaya ◽  
...  
Keyword(s):  
Water Temperature ◽  
Peripheral Resistance ◽  
Free Water ◽  
Plasma Renin ◽  
Urine Flow ◽  
Thoracic Impedance ◽  
Esophageal Temperature ◽  
Experimental Conditions ◽  
Free Water Clearance ◽  
Air Control

Effects of water temperature on diuresis, natriuresis, and associated endocrine responses during head-out immersion were studied in eight men (23.4 +/- 0.3 yr) during four 5-h experimental conditions: air control at 28 degrees C and immersion at 34.5 degrees C [thermoneutral (Tnt)], 36 degrees C [above Tnt (aTnt)], and 32 degrees C [below Tnt (bTnt)]. Esophageal temperature decreased by approximately 0.4 degrees C in bTnt and increased by approximately 0.5 degrees C in aTnt. Cardiac output increased by approximately 80% in aTnt and approximately 40% in bTnt while thoracic impedance, an index of central blood pooling, decreased by 7.5 omega in bTnt (NS vs. Tnt) and 8.8 omega in aTnt (P < 0.05 vs. Tnt and bTnt). Total peripheral resistance decreased at all temperatures (50% in aTnt, 20% in bTnt). Urine flow and Na+ excretion increased by sixfold in bTnt and Tnt but by only threefold in aTnt. Creatinine clearance was unchanged while osmolal clearance (but not free water clearance) increased two-fold with all immersions. Plasma atrial natriuretic peptide (ANP), urinary urodilatin, and urinary guanosine 3′,5′-cyclic monophosphate increased while plasma renin activity, aldosterone, and arginine vasopressin (AVP) decreased similarly at all temperatures. bTnt did not potentiate diuresis by selective attenuation of AVP. The overall natriuretic response exhibited a higher correlation with urodilatin (r = 0.45, P < 0.001) than with ANP (r = 0.26, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Application of the clearance concept to hyponatremic and hypernatremic disorders: a phenomenological analysis

1994 ◽  
Vol 40 (7) ◽  
pp. 1220-1227 ◽  
Author(s):  
A S Shoker
Keyword(s):  
Free Water ◽  
Phenomenological Analysis ◽  
Water Metabolism ◽  
Protective Mechanisms ◽  
Free Water Clearance ◽  
Water Homeostasis ◽  
Clinical Method ◽  
Clearance Concept ◽  
Water Clearance

Abstract The kidney and its response to the antidiuretic hormone (ADH) are the principal protective mechanisms necessary to maintain a normal plasma tonicity (osmolality). Hence, determination of the response of the ADH-renal axis to an abnormal plasma tonicity is an important step to understanding water homeostasis. Determination of free water clearance is the most direct clinical method to measure the ability of the kidney to reabsorb or excrete water; it can be used as a sensitive method to study water metabolism, describing the abnormal water homeostasis in simple quantitative terms. A positive electrolyte-free water clearance denotes the excretion of excess free water. A negative electrolyte-free water clearance indicates reabsorption of excess free water. During hypertonicity, an increased concentration of ADH enhances renal reabsorption of free water. With diminished ADH secretion and normal renal function, a substantial volume of free water is cleared in response to hypotonic stimuli. A positive free water clearance &gt; 0.4 L/day in hypertonic conditions or a negative free water clearance during hypotonicity confirms an abnormal ADH-renal axis response.

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