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ALDOSTERONE AND THE CIRCULATION
Author(s) -
STUART-HARRIS C. H.,
COX J. R.,
LEONARD P. J.,
SINGER BERTHA
Publication year - 1962
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1962.11.4.226
Subject(s) - aldosterone , extracellular fluid , sodium , chemistry , extracellular , endocrinology , intracellular fluid , medicine , intracellular , vasopressin , natriuresis , blood volume , biochemistry , organic chemistry
Summary Studies have been made in Sheffield on volunteers placed on a dietary regime inducing sodium depletion, in order to observe the effect of alteration in the volume of the body fluid compartments on the measured output of aldosterone in the urine. Fluid volumes decreased during sodium depletion. Subsequent treatment with vasopressin injections and free fluids during continued sodium restriction induced an increase of fluid volumes in some only of the volunteers. Aldosterone output increased during salt depletion and fell during hydration, but continued to increase in those who failed to retain excess water. Changes in the extracellular fluid volume, but not in the plasma volume, were inversely correlated with changes in aldosterone output. Total exchangeable sodium measured before and after sodium depletion and after attempted hydration permitted an estimate of the intracellular sodium by means of the calculated extracellular sodium. The latter decreased and increased pari passu with changes in the extracellular fluid volume to a much greater extent than did the total exchangeable sodium. Changes probably occur therefore in the electrolyte composition of the cells during hydration and salt depletion. The view is expressed that intracellular electrolyte changes rather than fluid volumes may trigger the mechanism which controls the release of aldosterone. The paper reviews the changes observed in aldosterone output in patients with heart failure and also discusses the therapeutic use of aldosterone antagonists.