pituitrin and Hypokalemia

Topics: Cushing Syndrome; Edema; Humans; Hyperaldosteronism; Hypertension; Hypokalemia; Hyponatremia; Inappropriate ADH Syndrome; Mineralocorticoid Excess Syndrome, Apparent; Renin-Angiotensin System; Vasopressins

The use of diuretics leads to a negative sodium and fluid balance without primary effects on serum sodium concentration. This parameter is regulated by the activity of the antidiuretic hormone (ADH) system. Secondary changes in other electrolyte systems and in acid base homeostasis also are induced by diuretic therapy. Especially diuretic induced hypokalemia is important as it is responsible for the excess mortality observed in patients with diuretic treated essential hypertension and cardiac abnormalities. All adverse metabolic effects of diuretic therapy are, in contrast to the antihypertensive action, dose dependent. Changes in fluid and electrolyte metabolism induced by diuretics occur within the first 2 or 3 weeks after initiation of medication. Counterregulatory mechanisms are activated and a new steady state is established. Serial laboratory determinations after this period are not necessary as long as this steady state is not affected by additional events (like a change in therapy or diet as well as the occurrence of vomiting or diarrhea).

Topics: Acid-Base Equilibrium; Antihypertensive Agents; Diuretics; Dose-Response Relationship, Drug; Humans; Hypertension; Hypokalemia; Risk Factors; Vasopressins; Water-Electrolyte Balance

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

Topics: Antineoplastic Agents; Diuretics; Drug-Related Side Effects and Adverse Reactions; Humans; Hypokalemia; Hyponatremia; Natriuresis; Potassium; Sodium; Vasopressins; Water-Electrolyte Balance

Topics: Acidosis, Renal Tubular; Aldosterone; Ascites; Diuretics; Hepatic Encephalopathy; Humans; Hypokalemia; Kidney Failure, Chronic; Kidney Transplantation; Kidney Tubules, Distal; Liver Cirrhosis; Liver Transplantation; Sodium; Transplantation, Homologous; Uremia; Vasopressins; Water-Electrolyte Imbalance

Topics: Adrenal Gland Diseases; Adrenal Glands; Adrenalectomy; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Humans; Hydrocortisone; Hyperaldosteronism; Hypertension; Hypokalemia; Kidney; Obesity; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; 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: Brain Diseases; Female; Humans; Hypernatremia; Hypokalemia; Hyponatremia; Male; Metabolic Diseases; Vasopressins; Water-Electrolyte Balance

Topics: Bloodletting; Carbonic Anhydrase Inhibitors; Chlorides; Diet, Sodium-Restricted; Digitalis Glycosides; Diuresis; Diuretics; Ethacrynic Acid; Furosemide; Heart Failure; Humans; Hyperkalemia; Hypokalemia; Hyponatremia; Kidney Glomerulus; Kidney Tubules; Mineralocorticoid Receptor Antagonists; Organomercury Compounds; Spironolactone; Steroids; Thiazines; Triamterene; Uracil; Vasopressins; Water-Electrolyte Balance; Xanthenes

Topics: Extracellular Space; Humans; Hypercalcemia; Hyperkalemia; Hypernatremia; Hyperparathyroidism; Hypokalemia; Kidney; Magnesium; Vasopressins; Water-Electrolyte Balance

Topics: Aldosterone; Digitalis; Digitalis Glycosides; Diuretics; Edema; Electrolytes; Heart Failure; Hypokalemia; Physiology; Potassium; Sodium; Toxicology; Vasopressins

Topics: Arginine Vasopressin; Humans; Hypokalemia; Kidney Diseases; Pathology; Physiology; Proteins; Urine; 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

Topics: Accidents, Traffic; Adult; Brain Edema; Brain Injuries; Catecholamines; Fatal Outcome; Glasgow Coma Scale; Hematoma, Subdural; Humans; Hyperglycemia; Hyperkalemia; Hypokalemia; Hypothermia; Insulin; Intracranial Hypertension; Male; Mannitol; Norepinephrine; Potassium; Vasopressins

Topics: Acetazolamide; Acid-Base Imbalance; Biological Transport; Diuretics; Drug Resistance; Ethacrynic Acid; Furosemide; Humans; Hydrochlorothiazide; Hyperkalemia; Hypernatremia; Hypokalemia; Hyponatremia; Indapamide; Kidney Tubules, Distal; Kidney Tubules, Proximal; Loop of Henle; Metolazone; Osmolar Concentration; Spironolactone; Triamterene; Vasopressins

The effects of potassium depletion on urine concentration ability, renal PGE2 excretion, and ADH release were studied in 28 female dogs made K depleted by oral K-exalate and a K-free diet. After K depletion was established (serum K 2.9 +/- 0.1 mEq/L), urine volume increased from control measurements, 596.4 +/- 34.0 to 1201.5 +/- 96.9 ml/24 hr (p less than 0.001); urine PGE2 excretion increased, 985.4 +/- 91.1 to 2122.0 +/- 328.5 ng/24 hr, (p less than 0.001); and Umax decreased, 2006 +/- 74.0 to 1186 +/- 71.9 mOsm/kg H2) (p less than 0.001). Indomethacin (5 mg/kg/day, s.c.) administered on 3 consecutive days after K depletion had been established, resulted in no significant improvement in Umax, 1186.8 +/- 71.9 to 1341.8 +/- 105.6 mOsm/kg H2O. Release of ADH from the neurohypophysis was evaluated by measuring plasma ADH during graded increases in serum tonicity with intravenous hypertonic saline before and after K depletion. Although ADH increased with increasing serum tonicity during both control and K depletion periods, there was a blunting of ADH release during K depletion. The regression coefficient of plasma ADH and serum tonicity was significantly lower during K depletion, 0.24, than in the control period, 0.65, (p less than 0.01). After 3 days of indomethacin (5 mg/kg/day, s.c.) ADH release from the neurohypophysis in response to graded increases in serum tonicity was partially normalized in the K-depleted animals without changes in serum K (regression coefficient, 0.53). K depletion in dogs therefore leads to an increase in the urine volume and an increase in renal PGE synthesis associated with a decrease in Umax. The increase in PGE2 synthesis is not responsible for the defect in Umax, since it is not corrected with indomethacin. The release of ADH in response to raising serum tonicity is blunted during K depletion, which is partially corrected by indomethacin. These data suggest an inhibiting role for PGE2 in the release of ADH from the neurohypophysis during K depletion.

Topics: Animals; Dinoprostone; Diuresis; Dogs; Female; Hypokalemia; Indomethacin; Kidney; Kidney Concentrating Ability; Pituitary Gland, Posterior; Polyuria; Prostaglandins E; Saline Solution, Hypertonic; Sodium Chloride; Vasopressins

1. The influence of ADH and the state of potassium balance on the renin-angiotensin system was studied in rats with hereditary diabetes insipidus (DI rats). 2. Plasma renin concentration in DI rats was higher than in control Long-Evans rats. 3. Spontaneous reversal of the hypokalaemia normally found in DI rats did not reduce plasma renin concentration (p.r.c.), suggesting that potassium deficiency does not contribute significantly to the elevation of p.r.c. in DI rats. Similarly, a low potassium diet failed to further increase p.r.c. in DI rats. 4. In contrast, the p.r.c. of DI rats was significantly diminished by a high potassium intake both in the presence and absence of ADH. A highly significant inverse correlation was found between p.r.c. and urinary potassium excretion in both ADH-treated and untreated DI rats on low, normal and high potassium diets. 5. Plasma renin concentration was significantly lower in ADH-treated than in untreated DI rats on a high potassium intake, suggesting that the inhibitory effects of ADH and potassium are additive. 6. ADH consistently reduced p.r.c. in DI rats independent of the state of potassium balance. 7. ADH and potassium may inhibit renin secretion via different mechanisms of action.

Topics: Animals; Arginine Vasopressin; Diabetes Insipidus; Diet; Female; Hypokalemia; Male; Potassium; Rats; Rats, Inbred Strains; Renin; Renin-Angiotensin System; Vasopressins

A case is described of a patient with an oat cell carcinoma of the bronchus with moderately elevated levels of plasma corticotrophin (ACTH) and antidiuretic hormone (ADH). Ectopic secretion of ACTH induced severe hypokalaemia and concealed the effects of concomitant ADH secretion on renal function. Normal renal responsiveness was restored following correction of hypokalaemia. The hypokalaemia was associated with evidence of a marked increase in corticosteroid secretion but plasma ACTH concentrations did not show a proportionate elevation. Chromatographic studies on tumour extracts suggest that the presence of a large fraction of high molecular weight ACTH in plasma could explain this discrepancy.

Topics: Adrenocorticotropic Hormone; Aged; Carcinoma, Small Cell; Electrolytes; Female; Humans; Hypokalemia; Lung Neoplasms; Syndrome; Vasopressins

Potassium-depleted subjects regularly excrete dilute urine with a high free-water clearance which cannot be suppressed either by solute loading or by water deprivation. In man, as in the dog and rat, potassium depletion impairs the ability of the kidney to achieve maximal urinary solute concentration and vasopressin is unsuccessful in overcoming this defect. In man and in the dog, potassium depletion induces a rise in urinary prostaglandin E2, an effect which can be reversed with indomethacin, a cyclo-oxygenase inhibitor. To evaluate the role of prostaglandins on the renal action of vasopressin in hypokalemia, six subjects with hypokalemia of various etiologies were studied in a control, drug-free condition and again after 3 to 6 days of indomethacin (100 mg/day). Renal clearance studies to measure the maximal free-water excretion in response to an intravenous water load (10 ml/min) and to a superimposed infusion of arginine vasopressin (40 mU/hr) were performed. The results in six patients are as follows: maximal free-water clearance (control) 8.03 +/- 0.8 ml/min (mean +/- S.E.), with the addition of vasopressin, .14 +/- 0.8; after 3 to 6 days of indomethacin, 8.55 +/- 1.33; with vasopressin 0.91 +/- 1.23 ml/min. There was no statistically significant difference between the maximal free water clearance with or without indomethacin. Vasopressin exerted an equally great response in both conditions and prostaglandins did not appear to play a role in free-water formation.

Topics: Adult; Body Water; Female; Glomerular Filtration Rate; Humans; Hypokalemia; Indomethacin; Kidney Tubules; Male; Middle Aged; Osmolar Concentration; Potassium; Vasopressins

The diffusional water permeabilities of collecting ducts in the presence and absence of antidiuretic hormone have been measured in isolated papillae from normal, hypokalaemic and hypercalcaemic rats. In a similar in vitro situation the effect of antidiuretic hormone on the papillary content of cyclic AMP has been measured. The diffusional water permeability of collecting ducts in the absence of antidiuretic hormone did not differ significantly in papillae taken from the different groups of rats. The diffusional water permeability in the presence of ADH was 7.4 +/- 0.2 (S.E.M.) mum s-1 in collecting ducts taken from normal rats. In collecting ducts taken from hypokalaemic or hypercalcaemic rats the corresponding values were 5.9 +/- 0.3 and 5.8 +/- 0.5 mum s-1 respectively. This significant decrease (P less than 0.01) in the response to antidiuretic hormone would shift the point at which distal tubule fluid first attains isotonicity with the interstitium. If this shifts from cortex to medulla a greater amount of water enters the interstitium of the medulla and produces an impairment of maximal urinary concentrating ability and this defect could explain most of the observed results in hypokalaemic and hypercalcaemic. Cyclic AMP content of the tissue after the addition of ADH was reduced in papillae taken from hypokalaemic rats. This reduced activation of adenyl cyclase could be the mechanism responsible for the impaired response in water permeability but it is also possible that there is interference, with the chain of reactions mediating permeability changes, at a separate site.

Topics: Animals; Cell Membrane Permeability; Cyclic AMP; Female; Hypercalcemia; Hypokalemia; Kidney Concentrating Ability; Kidney Medulla; Rats; Vasopressins; Water

1. In order to study the effect of overhydration on body potassium, experiments were performed on pair-fed rabbits, one of which was maintained continuously on vasopressin and given extra water (60-90 ml day-1 kg-1) for 6-8 days, while the other served as control. 2. Overhydrated rabbits excreted significantly more potassium (53%) in their urine than control rabbits and accumulated a mean potassium deficit of 65-0 mmol, significantly higher than the mean value of 37-1 mmol in the control rabbits. 3. In the overhydrated rabbits, potassium fell significantly in both erythrocytes, from 266 to 173 mmol/kg of dry cells, and also in muscle, from 435 to 341 mmol/kg of fat-free dry solids. Neither changed significantly in the control animals. 4. Overhydration in the presence of vasopressin leads to potassium depletion in the rabbit and a similar phenomenon might be expected in man. Potassium depletion due to overhydration might account for the hypokalaemia and reduction in exchangeable potassium observed in some patients with the syndrome of inappropriate secretion of antidiuretic hormone.

Topics: Animals; Body Weight; Erythrocytes; Hypokalemia; Muscles; Osmolar Concentration; Potassium; Rabbits; Sodium; Urine; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Adult; Arrhythmias, Cardiac; Central Nervous System Diseases; Dehydration; Diabetes Insipidus; Electrocardiography; Female; Humans; Hypokalemia; 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: Aldosterone; Catecholamines; Heart Failure; Hemodynamics; Humans; Hyperaldosteronism; Hypokalemia; Hyponatremia; Kidney; Potassium; Renin; Sodium; Vasopressins; Water; Water-Electrolyte Balance

Topics: Acid-Base Equilibrium; Acidosis, Respiratory; Chlorides; Diuretics; Electrolytes; Glucose; Humans; Hyperkalemia; Hypokalemia; Hyponatremia; Respiratory Insufficiency; Respiratory Tract Diseases; Vasopressins; Water-Electrolyte Balance

Topics: Coma; Diet Therapy; Electroencephalography; Endocrine System Diseases; Female; Humans; Hypokalemia; Hyponatremia; Injections, Intravenous; Kidney Function Tests; Middle Aged; Natriuresis; Potassium; Psychophysiologic Disorders; Sodium; Vasopressins; Water

Topics: Adult; Aged; Autopsy; Beer; Blood Urea Nitrogen; Coma; Diarrhea; Electroencephalography; Feeding and Eating Disorders; Female; Hemiplegia; Humans; Hypokalemia; Hyponatremia; Male; Middle Aged; Nutrition Disorders; Sodium; Tremor; Vasopressins; Vomiting; Water Intoxication

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: Biological Transport, Active; Humans; Hypokalemia; Kidney Tubules; Potassium; Sodium; Vasopressins

Topics: Acute Disease; Adult; Amino Acids; Chlorides; Extracellular Space; Female; Humans; Hypokalemia; Hyponatremia; Levulinic Acids; Male; Nitrogen; Porphobilinogen; Porphyrias; Porphyrins; Uremia; Vasopressins; Water-Electrolyte Balance

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

Topics: Acetates; Acute Disease; Adult; Chlorides; Coma; Cortisone; Craniopharyngioma; Diabetes Insipidus; Diet Therapy; Electrocardiography; Humans; Hypernatremia; Hypokalemia; Male; Natriuresis; Osmolar Concentration; Paralysis; Pituitary Neoplasms; Postoperative Complications; Potassium; Sodium; Thirst; Thyroxine; Vasopressins

Topics: Cephalothin; Chloramphenicol; Humans; Hypokalemia; Male; Meningoencephalitis; Middle Aged; Oxacillin; Penicillin G; Penicillin Resistance; Polyuria; Potassium; Sepsis; Staphylococcal Infections; Vancomycin; Vasopressins

Topics: Electroencephalography; Hormones, Ectopic; Humans; Hypernatremia; Hypokalemia; Hyponatremia; Metabolic Diseases; Penicillins; Uremia; Vasopressins

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

Topics: Blood Urea Nitrogen; Craniocerebral Trauma; Hematocrit; Humans; Hyperkalemia; Hypernatremia; Hypokalemia; Hyponatremia; Natriuresis; Osmosis; Potassium; Sodium; Vasopressins; Water-Electrolyte Balance

Topics: Aged; Female; Humans; Hypokalemia; Hyponatremia; Intracranial Aneurysm; Vasopressins

Topics: Arginine Vasopressin; Hypokalemia; Pharmacology; Rats; Research; Vasopressins

Topics: Antidiuretic Agents; Arginine Vasopressin; Humans; Hypokalemia; Leadership; Potassium; Potassium Deficiency; Vasopressins

Topics: Aldosterone; Animals; Hyperaldosteronism; Hypokalemia; Potassium; Potassium Deficiency; Rats; Vasopressins