pituitrin and Alkalosis

Topics: Alabama; Alkalosis; Animals; Arginine Vasopressin; Awards and Prizes; Desoxycorticosterone; Drug Synergism; Female; History, 20th Century; Homeostasis; Humans; Hypertension; Hypokalemia; Kidney Tubules, Collecting; Kidney Tubules, Proximal; Male; Mice; Natriuretic Agents; Nephrology; New York; Potassium; Rabbits; Rats; Signal Transduction; Societies, Medical; Sodium; Sodium-Potassium-Exchanging ATPase; Species Specificity; Syndrome; Vasopressins; Water-Electrolyte Balance

The rate of acid excretion by the kidney appears to be determined by factors regulating the site and the rate of sodium reabsorption, rather than by a homeostatic mechanism that responds to systemic pH. This hypothesis, although unconventional, is supported by much experimental evidence, and it accounts for a wide variety of clinical and physiologic findings that heretofore have been difficult or impossible to explain.

Topics: Absorption; Acid-Base Imbalance; Acidosis; Alkalosis; Ammonia; Animals; Bicarbonates; Carbon Dioxide; Cations; Chronic Disease; Dogs; Homeostasis; Humans; Hydrogen-Ion Concentration; Hypercapnia; Kidney; Kidney Tubules; Minerals; Nephrons; Sodium; Vasopressins

Topics: Acidosis; Acute Kidney Injury; Alkalosis; Amyloidosis; Hodgkin Disease; Humans; Hyperkalemia; Hypernatremia; Hypertension, Renal; Hypokalemia; Kidney; Kidney Concentrating Ability; Kidney Diseases; Multiple Myeloma; Neoplasms; Nephritis; Nephrotic Syndrome; Osmolar Concentration; Urine; Vasopressins; Water-Electrolyte Balance

Topics: Accidents, Traffic; Acidosis; Acute Kidney Injury; Adult; Aged; Alkalosis; Aortic Diseases; Aortic Rupture; Body Composition; Calorimetry; Cholecystectomy; Convalescence; Craniocerebral Trauma; Dehydration; Duodenal Ulcer; Endocrine Glands; Female; Homeostasis; Humans; Iliac Artery; Infusions, Parenteral; Kidney; Lung Neoplasms; Male; Metabolism; Middle Aged; Natriuresis; Pancreatitis; Peptic Ulcer Perforation; Postoperative Care; Postoperative Complications; Thoracic Injuries; Thrombosis; Vasopressins; Water-Electrolyte Balance

Topics: Adenoma, Islet Cell; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Alkalosis; Cushing Syndrome; Electrolytes; Endocrinology; Humans; Hypernatremia; Hypokalemia; Hyponatremia; Neoplasms; Pancreatic Neoplasms; Vasopressins; Water-Electrolyte Balance

The Na-Cl cotransporter (NCC), which is the target of inhibition by thiazides, is located in close proximity to the chloride-absorbing transporter pendrin in the kidney distal nephron. Single deletion of pendrin or NCC does not cause salt wasting or excessive diuresis under basal conditions, raising the possibility that these transporters are predominantly active during salt depletion or in response to excess aldosterone. We hypothesized that pendrin and NCC compensate for loss of function of the other under basal conditions, thereby masking the role that each plays in salt absorption. To test our hypothesis, we generated pendrin/NCC double knockout (KO) mice by crossing pendrin KO mice with NCC KO mice. Pendrin/NCC double KO mice displayed severe salt wasting and sharp increase in urine output under basal conditions. As a result, animals developed profound volume depletion, renal failure, and metabolic alkalosis without hypokalemia, which were all corrected with salt replacement. We propose that the combined inhibition of pendrin and NCC can provide a strong diuretic regimen without causing hypokalemia for patients with fluid overload, including patients with congestive heart failure, nephrotic syndrome, diuretic resistance, or generalized edema.

Topics: Alkalosis; Animals; Anion Transport Proteins; Body Weight; Diuresis; Kidney; Kidney Function Tests; Mice; Mice, Knockout; Models, Biological; Potassium; Receptors, Drug; Renal Insufficiency; Sodium; Sodium Chloride; Sodium Chloride, Dietary; Solute Carrier Family 12, Member 3; Sulfate Transporters; Symporters; Vasopressins; Water-Electrolyte Balance

Renal electrolyte and net acid excretion were characterized during generation and maintenance of hypochloremic metabolic alkalosis in a ruminant model. Two phases of renal response with regard to sodium and net acid excretion were documented. An initial decrease in net acid excretion was attributable to increase in bicarbonate excretion with associated increase in sodium excretion. As the metabolic disturbance became more advanced, a second phase of renal excretion was observed in which sodium and bicarbonate excretion were markedly decreased, leading to increase in net acid excretion and development of aciduria. Throughout the metabolic disturbance, chloride excretion was markedly decreased; potassium excretion also decreased. These changes were accompanied by increase in plasma renin and aldosterone concentrations. There was apparent failure to concentrate the urine optimally during the course of the metabolic disturbance, despite increasing plasma concentration of antidiuretic hormone.

Topics: Aldosterone; Alkalosis; Animals; Bicarbonates; Carbonates; Chlorine; Duodenum; Electrolytes; Female; Hydrogen-Ion Concentration; Ligation; Renin; Sheep; Sheep Diseases; Sodium; Time Factors; Vasopressins

A decrease in extracellular pH is well known to inhibit vasopressin stimulated water flow in the toad bladder. It remains unclear whether this inhibition is the result of the effect of extracellular pH per se or the consequence of altered intracellular pH. In the present study we evaluated the effect of several maneuvers capable of altering intracellular pH on vasopressin or cyclic AMP stimulated water flow in the toad bladder in the absence of alterations of extracellular pH. In the presence of a normal extracellular pH, bladders subjected to a high partial pressure of CO2 or bladders from acidotic toads had a significant decrease in vasopressin or cyclic AMP stimulated water flow as compared to controls. We also examined the effect of maneuvers capable of increasing intracellular pH on vasopressin and cyclic AMP stimulated water flow. Intracellular alkalosis was induced by exposing the bladders in vitro to NH4Cl at pH 8 or to acetazolamide. Both maneuvers resulted in a significant decrease in vasopressin, but not in cyclic AMP stimulated water flow. Bladders removed from alkalotic toads, incubated in a normal extracellular pH also showed a decrease in AVP stimulated water flow. Intracellular muscle pH assessed with phosphorus nuclear magnetic resonance, was not different among bladders from control, acidotic and alkalotic toads. It is concluded that alterations of intracellular pH, in the absence of alterations of extracellular pH, are important in regulation of water transport in the toad bladder in response to vasopressin or cyclic AMP. In addition, metabolic acidosis or alkalosis alters AVP or cyclic AMP stimulated water flow by a mechanism independent of the intracellular pH.

Topics: Acetazolamide; Acid-Base Equilibrium; Acidosis; Alkalosis; Animals; Biological Transport; Body Water; Bufonidae; Cyclic AMP; Hydrogen-Ion Concentration; Hypercapnia; In Vitro Techniques; Urinary Bladder; Vasopressins

Topics: Acid-Base Imbalance; Acidosis; Alkalosis; Animals; Body Water; Bucladesine; Bufo marinus; Drug Interactions; Female; Indomethacin; Male; Urinary Bladder; Vasopressins

Diuretic features of 1,4-dimorpholino-7-phenylpyrido[3,4-d]pyridazine (DS-511) were studied in rats and mice. DS-511 was similar in diuretic effect to that of hydrochlorothiazide (HC) in both species, but was more water diuretic and less potassium-releasing than HC. After oral administration of DS-511 to rats the diuretic effect promptly appeared and lasted for 4 to 5 h. These patterns on onset and duration were similar to those of furosemide and acetazolamide (AZ). DS-511 was effective in experimentally induced acidotic and alkalotic rats. When DS-511 was used in combinations with other diuretics such as HC, AZ and triamterene at their maximum effective doses, urine volume and sodium excretion further increased, but potassium did not. Diuretic activity of DS-511 was not reduced by daily oral administration for 10 days to rats. In rats DS-511 reversed antidiuretic hormone (ADH)-induced antidiuresis. These findings suggest that DS-511 differs in mode and/or site of action from the known diuretics.

Topics: Acidosis; Alkalosis; Animals; Diuretics; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Interactions; Electrolytes; Male; Mice; Morpholines; Pyridazines; Rats; Time Factors; Vasopressins

Topics: Adrenocorticotropic Hormone; Alkalosis; Bicarbonates; Breast Neoplasms; Calcium; Carcinoma, Bronchogenic; Carcinoma, Small Cell; Female; Gentamicins; Hodgkin Disease; Hormones, Ectopic; Humans; Hydrocortisone; Hyponatremia; Hypothalamus; Lung Neoplasms; Paraneoplastic Endocrine Syndromes; Phosphates; Potassium; Vasopressins

Topics: Aldosterone; Alkalosis; Angiotensin II; Biopsy; Blood Pressure; Child, Preschool; Diet Therapy; Female; Follow-Up Studies; Growth Disorders; Humans; Hyperaldosteronism; Hyperplasia; Hypertrophy; Hypokalemia; Juxtaglomerular Apparatus; Kidney Concentrating Ability; Kidney Diseases; Norepinephrine; Potassium; Renin; Secretory Rate; Sodium Chloride; Spironolactone; Syndrome; Vasopressins

Topics: Adult; Aged; Alkalosis; Bendroflumethiazide; Biological Assay; Blood Urea Nitrogen; Bromine; Carbon Dioxide; Chlorides; Chlorpropamide; Chlorthalidone; Creatinine; Diagnosis, Differential; Diuretics; Female; Furosemide; Humans; Hydrochlorothiazide; Hypokalemia; Hyponatremia; Hypopituitarism; Hypothyroidism; Male; Methyclothiazide; Middle Aged; Natriuresis; Osmolar Concentration; Polythiazide; Potassium Isotopes; Radioisotope Dilution Technique; Radioisotopes; Sodium Isotopes; Tritium; Vasopressins; Vomiting; Water-Electrolyte Balance

Topics: Adrenocorticotropic Hormone; Alkalosis; Carcinoma, Bronchogenic; Diabetes Complications; Humans; Hyperthyroidism; Hypokalemia; Male; Middle Aged; Smoking; Vasopressins

Topics: Adrenalectomy; Adrenocorticotropic Hormone; Alkalosis; Autoimmune Diseases; Bone Diseases; Carcinoma, Bronchogenic; Cushing Syndrome; Endocrine System Diseases; Hypercalcemia; Hyperparathyroidism; Hyponatremia; Lung Neoplasms; Metabolic Diseases; Neoplasm Metastasis; Neurologic Manifestations; Neuromuscular Diseases; Skin Diseases; Skin Manifestations; Vascular Diseases; Vasopressins

Topics: Alkalosis; Bicarbonates; Blood Pressure; Blood Urea Nitrogen; Diet, Sodium-Restricted; Diuresis; Edema; Ethacrynic Acid; Female; Furosemide; Humans; Hyponatremia; Hypotension, Orthostatic; Kidney Concentrating Ability; Middle Aged; Potassium Deficiency; Sodium; Vasopressins; Water-Electrolyte Balance

Topics: Adrenal Cortex Hormones; Alkalosis; Blood Urea Nitrogen; Blood Volume; Diuretics; Edema; Ethacrynic Acid; Furosemide; Glomerular Filtration Rate; Humans; Hyperaldosteronism; Hyperkalemia; Hypokalemia; Hyponatremia; Kidney Failure, Chronic; Kidney Tubules; Liver Cirrhosis; Spironolactone; Triamterene; Vasopressins

Topics: Acid-Base Equilibrium; Adult; Aged; Aging; Alkalosis; Aminohippuric Acids; Blood Glucose; Glomerular Filtration Rate; Glucose; Homeostasis; Humans; Hydrogen-Ion Concentration; Injections, Intravenous; Inulin; Male; Methods; Middle Aged; Vasopressins

Topics: Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Aldosterone; Alkalosis; Bronchial Neoplasms; Carcinoma; Endocrine System Diseases; Fludrocortisone; Humans; Hypercalcemia; Hypokalemia; Hyponatremia; Male; Plasma Volume; Vasopressins