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Studies in patients with diabetes insipidus
Author(s) -
Ramos Guadalupe,
Rivera Alfonso,
Peña Jose Carlos,
Dies Federico
Publication year - 1967
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt196784557
Subject(s) - thiazide , endocrinology , diabetes insipidus , medicine , antidiuretic , diuretic , diuresis , vasopressin , renal sodium reabsorption , reabsorption , hydrochlorothiazide , natriuresis , tonicity , chemistry , sodium , urine osmolality , free water clearance , aquaporin 2 , polyuria , renal function , kidney , diabetes mellitus , blood pressure , organic chemistry , mechanical engineering , water channel , engineering , inlet
In patients with diabetes insipidus who remained on a low salt diet, antidiuresis following the administration of saluretic drugs persisted long after the drugs were discontinued. Sodium repletion terminated the antidiuresis. The antidiuretic phenomenon occurred with mercurial diuretics, several thiazide derivatives, quinethazone, and ethacrynic acid. Antidiuresis was partially or totally inhibited by prevention of sodium or potassium losses during saluretic therapy. There was a significant correlation between antidiuresis and body fluid volume contraction. Urine was transiently concentrated by acute administration of vasopressin to a greater extent during poly thiazide therapy than during a control period. This is taken as evidence that the medullary interstitium is more hypertonic after diuretic treatment. The observed antidiuresis appeared to be secondary to the contraction of body fluid volume. The renal mechanism for antidiuresis seems to be related to enhanced proximal sodium and water reabsorption in the renal tubules and to increased medullary hypertonicity, with a larger tubular clearance of free water. The formation of free water in the urine is an important phYSiological phenomenon, which is regulated by several ontrol mechanisms and not ;ust by antidiuretic hormone activity.