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PubMed1998

Pressure-natriuresis and -diuresis in transgenic rats harboring both human renin and human angiotensinogen genes.

The hypertensive double transgenic rat harboring both the human renin and human angiotensinogen genes (dTGR) offers a unique opportunity to study the human renin-angiotensin system in an experimental animal model. Since nothing is known about the control of sodium and water excretion in these rats, this study was performed to compare pressure-natriuresis relationships in hypertensive dTGR and normotensive control rats harboring only the human renin gene (hREN), in order to determine how the pressure-natriuresis relationship is reset in hypertensive dTGR. To differentiate between extrinsic and intrinsic renal mechanisms, experiments were performed with and without renal denervation, and with and without infusions of vasopressin, norepinephrine, 17-OH-corticosterone, and aldosterone. Human and rat angiotensinogen and renin mRNA expression were also determined. In hREN without controlled renal function, urine flow and sodium excretion increased from 13 to 169 microl/min per g kidney wet weight (kwt) and from 1 to 30 micromol/min per g kwt, respectively, as renal perfusion pressure was increased from 67 to 135 mmHg. Renal blood flow (RBF) and GFR ranged between 3 to 7 and 0.9 to 1.5 ml/min per g kwt. In dTGR, pressure-natriuresis-diuresis relationships were shifted approximately 40 mmHg rightward. RBF was lower in dTGR than in hREN; GFR was not different. In dTGR with neurohormonal factors controlled, RBF was decreased and pressure-natriuresis-diuresis curves were not different compared to dTGR curves without these interventions. By light microscopy, the kidneys of these 6-wk-old dTGR and hREN rats were normal and indistinguishable. Both human and rat renin and angiotensinogen mRNA were expressed in the kidneys of dTGR. The two renin mRNA were decreased in dTGR, indicating a physiologic downregulation of renin gene expression by high BP. It is concluded that the renal pressure-natriuresis mechanism is reset toward higher pressure levels in dTGR and participates in the maintenance of hypertension. The reduced excretory function in dTGR depends on hREN and human angiotensinogen gene expression and is intrinsic to the kidney as opposed to extrarenal regulators.

Aldosterone↗
PubMed1991

Hyperbaric diuresis is associated with decreased antidiuretic hormone and increased atrial natriuretic polypeptide in humans.

When men are exposed to a hyperbaric environment, urine flow increases. In order to elucidate the mechanism of this hyperbaric diuresis, a dry saturation dive experiment was carried out. Five male subjects were exposed to a 16-21 ATA (atmospheric pressure absolute) helium-oxygen (He-O2) environment for 4 days. Five blood samples were obtained in the early morning (0600-0630 h): once at predive 1 ATA air, 3 times at 16-21 ATA He-O2, and once at postdive 1 ATA air. Eight-hour timed urine samples, 0600-1400 h, 1400-2200 h, and 2200-0600 h (night urine), were collected throughout the experimental period. Urine flow markedly increased by the exposure to hyperbaria in the presence of constant creatinine clearance. The increase was mostly attributable to the urine flow during 2200-0600 h. The secretion of antidiuretic hormone (ADH) was suppressed at daytime and night during the exposure. On the other hand, the secretion of atrial natriuretic polypeptide (ANP) increased solely at night during hyperbaria and correlated with the increases of both the nocturnal urine flow and the nocturnal urinary excretion of sodium. These results suggest that both suppressed ADH secretion and stimulated ANP secretion cause hyperbaric diuresis.

Adult↗
PubMed1997

Effect of bolus injection versus continuous infusion of furosemide on diuresis and neurohormonal activation in patients with severe congestive heart failure.

Previous studies have demonstrated that continuous infusion of furosemide results in increased diuresis and natriuresis compared with bolus administration of the drug in patients with severe heart failure. We reasoned that continuous infusion of furosemide caused less activation of neurohumoral mechanisms, since other studies have shown that bolus administration of furosemide may activate this system. We therefore tested the hypothesis that continuous administration of furosemide would increase water and sodium excretion due to less activation of neurohormones. Eight patients with severe heart failure were studied during continuous infusion over 24 h and bolus injections of furosemide twice daily in a randomized cross-over study. Bolus administration of furosemide increased diuresis and natriuresis significantly in the first 4 h after administration compared with continuous administration, but this was later reversed, resulting in similar 24 h total output. The neurohormones measured at baseline were all markedly elevated. Neither regimens of furosemide caused any further significant changes in neurohumoral response except that pro-ANF decreased more during the first 8 h after bolus administration compared to continuous infusion. This study has demonstrated that bolus administration of furosemide in conventional doses is equally effective as continuous intravenous infusion in patients with severe heart failure. This may be due to maximal neurohormonal activation in severe heart failure (NYHA III-IV) which could not be further activated by bolus administration.

Atrial Natriuretic Factor↗
PubMed1995

Vesical-renal reflex: diuresis and natriuresis activated by intravesical capsaicin.

In the last years the role of capsaicin sensitive innervation, in the activation of the micturition reflex, has been reported in many papers. In our experience, upon the intravesical administration of capsaicin in humans, we noticed an increase of diuresis. No interaction is known about the sensory innervation of the bladder and renal function, so we studied the possibility of the existence of a vesical-renal reflex arc. Twenty-one patients (9 men and 12 women) were randomised to receive intravesical infusion of saline solution containing 10 microM capsaicin. Urine output, glomerular renal filtrate (GRF) and effective plasma renal flow (EPRF), measured by Technetium-99m diethylenetetramine-penta-acetic acid (DTPA) renal scintigraphy, were recorded over twenty minutes before and after the intravesical administration of capsaicin. Urine density, [Na+] and [K+] concentration, and prostaglandin E2 excretion were also determined before and after intravesical administration of capsaicin or vehicle. Installation of saline solution containing 10 microM capsaicin produced a significant increase of mean urine output, an increase of GRF, of EPRF and of [Na+] and [K+] urine concentration. An increase, not statistically significant, was observed of PgE2 excretion. None of the patients treated with vehicle showed any modification of parameters examined. The present findings demonstrate a hitherto unrecognized effect: increased diuresis following selective chemical stimulation of bladder efferents with capsaicin. The renal diuretic response to intravesical capsaicin represents a working hypothesis about the possible involvement of a vesical-renal reflex arc organized at spinal or supraspinal level.

Administration, Intravesical↗
PubMed1979

Biliary and urinary excretion of drug conjugates: effect of diuresis and choleresis on excretion of harmol sulphate and harmol glucuronide in the rat.

1. Harmol (7-hydroxy-1-methyl-9H-pyrido [3,4b] indole) is converted to harmol sulphate and harmol glucuronide in the rat in vivo. Harmol sulphate is excreted mainly in urine, while harmol glucuronide is excreted about equally in bile and urine, when harmol is given intravenously. 2. In rats with ligated kidneys, only choleresis produced by glycodehydrocholate and dehydrocholate caused enhanced biliary excretion of harmol sulphate; harmol glucuronide was unaffected. Several other bile salts had no effect. 3. Mannitol diuresis markedly increased urinary excretion of harmol sulphate, and decreased its biliary excretion. Harmol glucuronide was much less affected. 4. Nafenopin pretreatment increased liver weight and bile flow, and enhanced biliary excretion of harmol sulphate at the expense of its urinary excretion. 5. For harmol sulphate, urine and bile are compensatory pathways of elimination that can be influenced by urine and bile flow changes through diuresis and choleresis.

Alkaloids↗
PubMed1981

Thallium ingestion with survival: ineffectiveness of peritoneal dialysis and potassium chloride diuresis.

A 52-year-old man who ingested 20 g of thallium iodide and survived is reported. Therapy included gastrointestinal decontamination, peritoneal dialysis, and potassium chloride diuresis. Peritoneal dialysis removed 4% of the calculated ingested dose in a 24-h period and potassium chloride diuresis 2%, an insignificant amount in light of the ingested dose of thallium. The primary method of treatment of thallium poisoning remains prompt gastrointestinal decontamination.

Diuresis↗
PubMed1993

Renal nerves are involved in the natriuresis and diuresis produced by central administration of clonidine in the rat.

To determine whether renal nerves are involved in natriuresis or diuresis produced by the intracerebroventricular administration of clonidine (0.2, 2.0, and 8 micrograms/kg/min, and 2.0 microliters/min), urine flow, and sodium excretion were measured before and during clonidine administration from innervated and contralateral denervated kidneys in anesthetized (Inactin, 0.1 g/kg, ip) Sprague-Dawley rats. Baseline urine flow and sodium excretion were elevated after renal denervation prior to infusion of clonidine. Examining urine flow and sodium excretion before and during clonidine infusion indicated significant increases in urine flow and sodium excretion from the innervated kidneys but not from the denervated kidneys, possibly due to the renal sympatho-inhibition in the innervated kidney. However, the higher doses of clonidine (2 and 8 micrograms/kg/min) may have diffused out of the intracerebroventricular space into the peripheral circulation and produced their effect by a direct action on the kidney. Subsequently, two experiments were performed to distinguish between a central action and peripheral action. First, clonidine was administered centrally with concurrent administration of an alpha 2-blocker, yohimbine (8 micrograms/kg/min, i.v.), peripherally. In a second experiment the dose of clonidine was reduced 10-fold such that this reduced dose did not produce a peripheral action but still produced the renal responses to central administration. The results of the latter two studies further confirmed that natriuresis and diuresis produced by intracerebroventricular administration of clonidine is in part mediated by renal nerves.

Animals↗
PubMed1999

[Aqueous diuresis and prophylaxis of recurrent nephrolithiasis].

Crystal precipitation in urine results from factors such as ionic strength, pH, soluble complexes formation, formation site and retention of initial solid particle. Among the most frequent causes are poor diuresis and changes in urine pH, their influence being quantified in different ways. Effects of water diuresis such as prophylaxis for urinary calculi are due to the intrinsic properties of the water contained in the urine, solid particles dragging, action on urine infection and changes in urine pH. Urinary flow has an influence on pH, so that its decrease coincides with concentrate urine and low pH, whereas its increase involves the presence of dilute urine and high pH. The purpose of this study is to understand the relationship between increased urine volume due to greater water intake and changes in urine pH, as well as the physiological intervening mechanisms.

Diuresis↗
PubMed2000

[The effect of a kidney peptide complex on the secretory and reabsorption indices in induced diuresis].

The work presents of research of inner kidney processes of reabsorption and secretion under influence of peptide complex in the conditions of inducted diuresis. The research of kidneys functions has been carried out on 21 line Wistar white rats in the sharp experiment. Introduction of kidney peptide complex has noticeably influenced processes of secretion of natrium, titrated acids, ammonia. All the processes were followed by constant tangle filtration. Increase of natrium and chlorine has been observed in the fulfilled experiments. Diuresis has not changed either. This, the kidney peptide complex can contain. Substances that influence secretion and reabsorption processes and balance of action can be reached.

Absorption↗
PubMed2000

Radiotelemetered cystometry in pigs: validation and comparison of natural filling versus diuresis cystometry.

PURPOSE: Cystometry has previously been performed in awake animals using vesical and abdominal catheters, and artificial bladder filling. Conventional urodynamic recordings may be obtained in this manner, albeit under nonphysiological and potentially stressful conditions. Therefore, we developed a technique to perform continuous, ambulatory cystometric monitoring in pigs. MATERIALS AND METHODS: A dual pressure radiotelemetry device was surgically implanted in 22 large white pigs. Vesical and abdominal pressures were recorded and validated, subtracted detrusor pressures were derived and natural fill and diuresis cystometry was compared. RESULTS: Continuous recordings were obtained for 1 to 24 hours, and the devices remained in the animals for up to 3 months. There were few complications and incrustation of the intravesical catheter tip occurred but it did not appear to affect recorded pressures. The pressure data were validated by comparison with filling pressures during bladder distention and simultaneous conventional cystometry at the end of the experimental period. Comparison of natural filling and diuresis cystometrograms showed that natural bladder filling results in higher maximum detrusor pressure during voiding (38.1 versus 33.9 cm. H2O, p <0.05), higher detrusor pressure after contractions (42.6 versus 32.2 cm. H2O, p <0.05) and more frequent detection of unstable contractions in pigs with detrusor instability secondary to experimental manipulation of the lower urinary tract (77.8% versus 45.0%, p <0.05). CONCLUSIONS: This technique allows continuous cystometric monitoring in less stressed animals under more physiological conditions for relatively long periods and, thus, allows prolonged assessment of bladder function in pigs in response to pathological and pharmacological manipulations. Nonphysiological rates of bladder filling have been shown to result in detrusor inhibition, which emphasizes the importance of ambulatory cystometry when describing bladder function.

Animals↗
PubMed2000

Hourly diuresis in patients with extensive burns.

The values of hourly diuresis in 40 patients with extensive burns were investigated and expressed graphically during the stage of burn shock. By analysis of the values and the patient's condition, a marked effect of the mental state on the course of burn shock and further treatment at the intensive care unit of the Prague Burns Centre was found. On a preliminary basis the effects of some drugs on the values of hourly diuresis were investigated.

Burns↗
PubMedDate not supplied

[The reaction of the supraoptic nucleus of the hypothalamus and diuresis during thyroid gland restitution following discontinuation of 6-methylthiouracil].

There is a marked reduction of diuresis (revealed by water load) during the action of 6-methylthiouracil (MTU). In the course of the thyroid gland restitution (after the discontinuance of the 6-MTU action) the diuresis at first becomes intensified and then it repeatedly either becomes diminished or enhanced. Secretory activity of the cells of the supraoptic nucleus of the anterior hypothalamus also becomes alternately enhanced and diminished. Dynamics of the shifts in this activity failed to correlate with the "ricochet" enhancement of the thyrotropic function of the hypophysis, which occurred on the 11th restitution day and corresponded to the "ricochet" enhancement of iodine consumption by the thyroid gland. Thus, there was no association between the state of the cells of the supraoptic nucleus and the changes in the thyrotropic function of the hypophysis.

Animals↗
PubMed1975

Changes in urea clearance after a single dose of diuretics during water diuresis.

The action of various diuretics on the excretion fraction of urea (Curea/Ccr) was studied in 91 healthy volunteers under conditions of maintained maximal water diuresis. On the basis of previous data on transtubular transport or urea it should be expected that with an increase in the excretion fraction of water (V/Ccr) under the given experimental conditions we should find an increase in Curea/Ccr. After administration of polythiazide, which has a predominantly distal localisation of action in the nephron, Curea/Ccr did not change. After administration of chlorothiazide, furosemide and after i.v. administration of ethacrynic acid there was a marked increase in V/Ccr, ranging from 5.4 to 18%. Despite this there was no significant increase in Curea/Ccr. After i.v. administration of acetazolamide or oral administration of ethacrynic acid Curea/Ccr even showed a statistically significant decrease. These findings suggest that a decrease in proximal tubular reabsorption of water after administration of diuretics during maximal water diuresis is not a decisive factor for the renal excretion of urea. The data suggest that the diuretics affected the permeability of the distal segment of the nephron for urea in the sense of an increase of tubular reabsorption.

Acetazolamide↗
PubMed1975

[Effect of increased diuresis on the renal excretion of sulfamerazine].

The excretion velocity of sulfamerazine is very slow, caused by a high reabsortion rate in renal tubuli. An increased diuresis by i.p. administration of saline or p.o. load with water has no effect on the sulfamerazine excretion velocity. The enhanced diuresis is accompanied by a decrease of the urine pH-value and consequently by a decreased dissociation rate of sulfamerazine.

Animals↗
PubMed1975

[Intrarenal distribution of calcium and magnesium in the dog. Effect of an osmotic diuresis (author's transl)].

1 The determination of Na, Ca, Mg, and K concentrations was performed in four different regions of the dog kidney (cortex, outer medulla, inner medulla, and papilla) during antidiuresis and during an osmotic diuresis. 2 The results show a medullary concentration gradient for calcium. This gradient is much higher than that found for sodium. 3 An inverse concentration gradient from cortex to inner medulla for Mg and K is found. 4 An osmotic diuresis (hypertonic mannitol) decreases the corticomedullary gradient of Na, but does not alter significantly the intrarenal distribution of Ca, Mg and K. 5 These results consistent with an intracellular localization of Mg and K in the renal tissue. It is suggested that the medullary concentration gradient for Ca may be due either to a countercurrent multiplier system similar to that for Na, or to a higher tissular fixation of Ca in the inner medulla and papilla than in the outer medulla and cortex.

Animals↗
PubMed1976

Effect of chlorothiazide and furosemide diuresis on in vivo growth of Staphylococcus aureus in kidneys of mice.

In mice subcutaneous administration of the diuretics chlorothiazide or furosemide resulted in a prompt diuresis characterized by production of dilute urine within 30 min and lasting for 6 hr. In vivo proliferation or clearance of Staphylococcus aureus from the kidneys was only temporarily impaired during the time of maximum diuresis. When treatment was delayed until after phagocytosis was initiated, there was no effect on clearance. Clinically it would appear that bacterial proliferations in the renal parenchyma would not be promoted as a consequence of diuretic treatment.

Animals↗
PubMed2006

Forced diuresis improves the diagnostic accuracy of 18F-FDG PET in abdominopelvic malignancies.

UNLABELLED: Our aim was to evaluate the role of forced diuresis in improving the diagnostic accuracy of abdominopelvic (18)F-FDG PET. METHODS: Thirty-two patients were enrolled. Besides the presence of known intravesical tumors or undefined renal lesions on the initial PET scan, the inclusion criterion was the appearance of indeterminate or equivocal (18)F-FDG foci that extended along the course of the urinary tract and could not confidently be separated from urinary activity. For each patient, a second abdominopelvic PET study was performed after intravenous injection of 0.5 mg of furosemide per kilogram of body weight (maximum, 40 mg) coupled with parenteral infusion of physiologic saline. RESULTS: Forced diuresis coupled with parenteral hydration eliminated any significant (18)F-FDG activity from the lower urinary tract in 31 (97%) of 32 patients after the bladder had been voided 3 successive times. Twelve intravesical lesions were visualized with outstanding clarity, whereas radiologic suspicion of locally recurrent bladder tumors was ruled out in 3 patients. Among 14 indeterminate or equivocal extravesical foci, 7 were deemed of no clinical value because they disappeared after furosemide challenge, whereas 7 persisting foci were proven to be true-positive PET findings. The performance of (18)F-FDG PET in characterizing 3 renal-space-occupying lesions could not be improved by our protocol. CONCLUSION: Furosemide challenge has the potential to noninvasively resolve the inherent (18)F-FDG contrast handicap in the lower urinary tract.

Adult↗