Angiotensin-induced Natriuresis in Cirrhosis in the Absence of Endogenous Aldosterone Secretion (1966)

Case Studies1 June 1966Angiotensin-induced Natriuresis in Cirrhosis in the Absence of Endogenous Aldosterone SecretionRANDOLPH M. MCCLOY, M.D., WILLIAM P. BALDUS, M.D., W. H. J. SUMMERSKILL, D.M., FRANK T. MAHER, M.D., F.A.C.P.RANDOLPH M. MCCLOY, M.D.Search for more papers by this author, WILLIAM P. BALDUS, M.D.Search for more papers by this author, W. H. J. SUMMERSKILL, D.M.Search for more papers by this author, FRANK T. MAHER, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-6-1271 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFluid retention accompanying advanced cirrhosis is characterized by secondary hyperaldosteronism and increased reabsorption of sodium by the kidney; the nature of the stimulus to increased aldosterone production is uncertain. The augmentation of aldosterone secretion in health resulting from infusion of angiotensin suggests that the latter may function as a trophic hormone for aldosterone (1-3). Whereas infusion of angiotensin causes sodium retention in normal man, patients with cirrhosis may exhibit a natriuretic and diuretic response (2). This paradoxical effect of angiotensin on sodium excretion in cirrhosis has not been explained. An opportunity to investigate the effects of angiotensin on renal function...References1. LARAGH JH: Interrelationships between angiotensin, norepinephrine, epinephrine, aldosterone secretion, and electrolyte metabolism in man. Circulation 25: 203, 1962. CrossrefMedlineGoogle Scholar2. LARAGHCANNONBENTZELSICINSKIMELTZER JHPJCJAMJI: Angiotensin II, norepinephrine, and renal transport of electrolytes and water in normal man and in cirrhosis with ascites. J. Clin. Invest. 42: 1179, 1963. CrossrefMedlineGoogle Scholar3. BIRONCHRETIENKOIWGENEST PMEJ: Effects of angiotensin infusions on aldosterone and electrolyte excretion in normal subjects and patients with hypertension and adrenocortical disorders. Brit. Med. J. 1: 1569, 1962. CrossrefMedlineGoogle Scholar4. EDELMANLEIBMAN ISJ: Anatomy of body water and electrolytes. Amer. J. Med. 27: 256, 1959. CrossrefMedlineGoogle Scholar5. SMITH HW: Principles of Renal Physiology. 237 pages. Oxford University Press, New York, 1956. Google Scholar6. MATTOXLEWBART VRML: The determination of aldosterone in urine. J. Clin. Endocr. 19: 1151, 1959. CrossrefGoogle Scholar7. BALDUSFEICHTERSUMMERSKILLHUNTWAKIM WPRNWHJCKG: The kidney in cirrhosis. II. Disorders of renal function. Ann. Intern. Med. 60: 366, 1964. LinkGoogle Scholar8. BROWNPEART JJWS: The effect of angiotensin on urine flow and electrolyte excretion in hypertensive patients. Clin. Sci. 22: 1, 1962. MedlineGoogle Scholar9. VAN EPSSMORENBERG-SCHOORLZÜRCHER-MULDERDEVRIESBORST LWMEALAJG: Identical changes in renal excretion pattern induced by angiotensin and orthostasis in normal and adrenalectomized subjects. Acta Med. Scand. 171: 153, 1962. CrossrefGoogle Scholar10. BIRON P: Angiotensin infusions in an adrenalectomized patient. Rev. Canad. Biol. 23: 473, 1964. MedlineGoogle Scholar11. DEL GRECO F: Effects of valine-5 angiotensin II on excretion of water and salt in primary and secondary hypertension. Proc. Soc. Exp. Biol. Med. 107: 943, 1961. CrossrefMedlineGoogle Scholar12. AMESBORKOWSKISICINSKILARAGH RPAJAMJH: Prolonged infusions of angiotensin II and norepinephrine and blood pressure, electrolyte balance, and aldosterone and cortisol secretion in normal man and in cirrhosis with ascites. J. Clin. Invest. 44: 1171, 1965. CrossrefMedlineGoogle Scholar13. PETERS G: Renal tubular effect of val-5-angiotensin II amide in rats. Proc. Soc. Exp. Biol. Med. 112: 771, 1963. CrossrefMedlineGoogle Scholar14. GROSSSCHAECHTELINBRUNNERPETERS FGHG: The role of the renin-angiotensin system in blood pressure regulation and kidney function. Canad. Med. Ass. J. 90: 258, 1964. MedlineGoogle Scholar15. EARLEYFRIEDLER LERM: Changes in renal blood flow and possibly the intrarenal distribution of blood during the natriuresis accompanying saline loading in the dog. J. Clin. Invest. 44: 929, 1965. CrossrefMedlineGoogle Scholar16. SCHROEDERSANCETTGABUZDA ETSMGJ: Effects of angiotensin on renal hemodynamics in patients with cirrhosis and ascites. Clin. Res. 12: 258, 1964. Google Scholar17. SELKURT EE: Effect of pulse pressure and mean arterial pressure modification on renal hemodynamics and electrolyte and water excretion. Circulation 4: 541, 1951. CrossrefMedlineGoogle Scholar18. TOBIANCOFFEEFERREIRAMEULI LKDJ: The effect of renal perfusion pressure on the net transport of sodium out of distal tubular urine as studied with the stop-flow technique. J. Clin. Invest. 43: 118, 1964. CrossrefMedlineGoogle Scholar19. VANDER AJ: Inhibition of distal tubular sodium reabsorption by angiotensin II. Amer. J. Physiol. 205: 133, 1963. CrossrefMedlineGoogle Scholar20. LANGFORD HG: Tubular action of angiotensin. Canad. Med. Ass. J. 90: 332, 1964. MedlineGoogle Scholar21. LARAGHCANNONAMES JHPJRP: Interaction between aldosterone secretion, sodium and potassium balance, and angiotensin activity in man: studies in hypertension and cirrhosis. Ibid., p. 248. Google Scholar22. LEYSSACLASSENTHAYSEN PPUVJH: Inhibition of sodium transport in isolated renal tissue by angiotensin (abstract). Biochim. Biophys. Acta 48: 602, 1961. CrossrefMedlineGoogle Scholar23. VAGNUCCILAULERHICKLERTHORN AIDPRBGW: Acute infusion of synthetic angiotensin II in patients with essential hypertension: its effect on renal hemodynamics and on electrolyte and water excretion. Circulation (Supplement) 29: 523, 1964. CrossrefGoogle Scholar24. DAVISHOLMANCARPENTERURQUHARTHIGGINS JOJECCJJT: An extra-adrenal factor essential for chronic renal sodium retention in presence of increased sodium-retaining hormone. Circ. Res. 14: 17, 1964. CrossrefMedlineGoogle Scholar25. RECTORVAN GIESENKIILSELDIN FCGFDW: Influence of expansion of extracellular volume on tubular reabsorption of sodium independent of changes in glomerular filtration rate and aldosterone activity. J. Clin. Invest. 43: 341, 1964. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the Gastrointestinal Research Unit, Section of Medicine, and Section of Clinical Pathology, Mayo Clinic and Mayo Foundation, and the Mayo Graduate School of Medicine, Rochester, Minn.This study was supported in part by research grant AM-06908, National Institutes of Health, Bethesda, Md.Dr. McCloy was the recipient of grant AM-5259, National Institutes of Health, Bethesda, Md.Requests for reprints should be addressed to 200 First St. S.W., Rochester, Minn. 55901. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByInappropriately low angiotensin II generation: a factor determining reduced kidney function and survival in patients with decompensated cirrhosis 1 June 1966Volume 64, Issue 6Page: 1271-1276KeywordsAldosteroneCirrhosisDiureticsExcretionGraduate medical educationHormonesKidneysNatriuretic peptidesResearch grantsSodium Issue Published: 1 June 1966 PDF DownloadLoading ...