Inappropriate Renal Sodium Loss Reverted by Vena Cava Obstruction
Authors: HENRY O. HEINEMANN
Journal: Annals of Internal Medicine (1966)

Article1 October 1966Inappropriate Renal Sodium Loss Reverted by Vena Cava ObstructionHENRY O. HEINEMANN, M.D., JOHN H. LARAGH, M.D., F.A.C.P.HENRY O. HEINEMANN, M.D.Search for more papers by this author, JOHN H. LARAGH, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-4-708 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSodium balance is normally regulated by the interaction of the kidneys, the adrenal cortex, and one or several additional regulatory mechanisms, at present poorly defined (1-3). Excessive renal sodium loss, if not drug-induced, may occur in certain types of renal disease (salt-losing nephritis) (4-8) and in adrenal insufficiency. Renal sodium loss in the face of hyponatremia also occurs in a syndrome linked to overhydration secondary to inappropriate antidiuretic hormone release (9-14). Sodium loss is not correctable in renal disease but can be overcome by appropriate substitution therapy in adrenal insufficiency and by fluid restriction when it is associated with overhydration....References1. SMITH HW: Salt and water volume receptors. Amer. J. Med. 23: 623, 1957. CrossrefMedlineGoogle Scholar2. GAUERHENRY OHJP: Circulatory basis of fluid volume control. Physiol. Rev. 43: 423, 1963. CrossrefMedlineGoogle Scholar3. WELT LG: Volume receptors. Circulation 21 (suppl.): 1002, 1960. CrossrefMedlineGoogle Scholar4. THORNKOEPFCLINTON GWGFJ: Renal failure simulating adrenocortical insufficiency. New Eng. J. Med. 231: 76, 1944. CrossrefGoogle Scholar5. JOINERTHORNE CLMG: Salt-losing nephritis. Lancet 2: 454, 1952. CrossrefMedlineGoogle Scholar6. DANOWSKIFERGUSMATEER TSEBFM: The low salt syndromes. Ann. Intern. Med. 43: 643, 1955. LinkGoogle Scholar7. KLEEMANHEWITTGUZE CRWLLB: Pyelonephritis. Medicine (Balt.) 39: 3, 1960. MedlineGoogle Scholar8. FALSETTIKUNIN HAS: Bacteriuria in sodium-losing nephritis. New Eng. J. Med. 268: 598, 1963. CrossrefGoogle Scholar9. SCHWARTZBENNETTCURELOPBARTTER WBWSFC: A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. Amer. J. Med. 23: 529, 1957. CrossrefMedlineGoogle Scholar10. SCHWARTZTASSELBARTTER WBDFC: Further observations on hyponatremia and renal sodium loss probably resulting from inappropriate secretion of antidiuretic hormone. New Eng. J. Med. 262: 743, 1960. CrossrefMedlineGoogle Scholar11. ROBERTS HJ: The syndrome of hyponatremia and renal sodium loss probably resulting from inappropriate secretion of antidiuretic hormone. Ann. Intern. Med. 51: 1420, 1959. LinkGoogle Scholar12. DOSSETORVENNINGBECK JBEHJC: Hyponatremia associated with superior vena cava obstruction. Metabolism 10: 149, 1961. Google Scholar13. SCHWARTZFOGELCHOKASPANARIELLO ERLWVVA: Unstable osmolar homeostasis with and without renal sodium wastage. Amer. J. Med. 33: 39, 1962. CrossrefMedlineGoogle Scholar14. LEAFBARTTERSANTOSWRONG AFCRFO: Evidence in man that urinary electrolyte loss induced by pitressin is a function of water retention. J. Clin. Invest. 32: 868, 1953. CrossrefMedlineGoogle Scholar15. FARBERBECKEREICHNA SJWHLW: Electrolyte and water excretions and renal hemodynamics during induced congestion of the superior and inferior vena cava of man. Ibid., p. 1145. Google Scholar16. SCHILLINGMCCOORDCLAUSENTROUPMCKEE JAABSWSBFW: Experimental ascites. Studies of electrolyte balance in dogs with partial and complete occlusion of the portal vein and of the vena cava above and below the liver. J. Clin. Invest. 31: 702, 1952. CrossrefMedlineGoogle Scholar17. DAVISKLIMANYANKOPOULOSPETERSON JOBNARE: Increased aldosterone secretion following acute constriction of the inferior vena cava. J. Clin. Invest. 37: 1783, 1958. CrossrefMedlineGoogle Scholar18. CARPENTERDAVISHOLMANAYERSBAHN CCJOJECRRC: Studies on the response of the transplanted kidney and the transplanted adrenal gland to thoracic inferior vena caval constriction. J. Clin. Invest. 40: 196, 1961. CrossrefMedlineGoogle Scholar19. LARAGHVAN DYKEJACOBSONADAMSONSENGEL JHHBJKSL: The experimental production of ascites in the dog with diabetes insipidus. J. Clin. Invest. 35: 897, 1956. CrossrefMedlineGoogle Scholar20. 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 Scholar21. LARAGHSEALEYKLEIN JHJEPD: The presence and effect of isotope fractionation in isotope dilution analysis: a factor in the measurement of aldosterone secretory rates in man, in Radiochemical Methods of Analysis, Vol. II. International Atomic Energy Agency, Vienna, 1965. Google Scholar22. BOWMANTRANTHAMCAULFIELD RLHVPA: An instrument and method for rapid, dependable determination of freezing-point depression. J. Lab. Clin. Med. 43: 310, 1954. MedlineGoogle Scholar23. BOSNESTAUSSKY RWHM: On the colorimetric determination of creatinine by the Jaffe reaction. J. Biol. Chem. 158: 581, 1945. CrossrefGoogle Scholar24. EK J: The influence of heavy hydration on the renal function in normal and hypertensive man. Scand. J. Clin. Lab. Invest. 7 (suppl.): 19, 1955. MedlineGoogle Scholar25. COTTIERWELLERHOOBLER PTJMSW: Effect of an intravenous sodium chloride load on renal hemodynamics, and electrolyte excretion in essential hypertension. Circulation 17: 750, 1958. CrossrefMedlineGoogle Scholar26. BALDWINBIGGSGOLDRINGHULETCHASIS DSMWWWHH: Exaggerated natriuresis in essential hypertension. Amer. J. Med. 24: 893, 1958. CrossrefMedlineGoogle Scholar27. VAAMONDESPORNLANCESTREMEREBELSKYPAPPER CANRGJLS: Augmented natriuretic response to acute sodium infusion after blood pressure elevation with metaraminol in normotensive subjects. J. Clin. Invest. 43: 496, 1964. CrossrefMedlineGoogle Scholar28. DAVISHOWELLGOODKINDHYATT JODSMJRE: Accumulation of ascites during maintenance of adrenalectomized dogs with thoracic inferior vena cava constriction on a high sodium diet without hormone therapy. Amer. J. Physiol. 185: 230, 1956. CrossrefMedlineGoogle Scholar29. DE WARDENERMILLSCLAPHAMHAYTER HEIHWFCJ: Studies on the efferent mechanism of the sodium diuresis which follows the administration of intravenous saline in the dog. Clin. Sci. 21: 249, 1961. MedlineGoogle Scholar30. LEVINSKYLALONE NGRC: Sodium excretion during acute saline loading in dogs with vena caval constriction. J. Clin. Invest. 44: 565, 1965. CrossrefMedlineGoogle Scholar31. 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 Scholar32. DAVIS JO: The control of aldosterone secretion. Physiologist 5: 65, 1962. MedlineGoogle Scholar33. AUGUSTNELSONTHORN JTDHGW: Response of normal subjects to large amounts of aldosterone. J. Clin. Invest. 37: 1549, 1959. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New YorkFrom the Department of Medicine, Francis Delafield Hospital, and the College of Physicians and Surgeons, Columbia University, New York, N. Y.This work was supported in part by grants R10-CA-02332, the National Cancer Institute, and H-1275, the National Heart Institute, the National Institutes of Health, Bethesda, Md.Dr. Heinemann is a Career Scientist under the Health Research Council of the City of New York, supported by grant I-189.Requests for reprints should be addressed to Henry O. Heinemann, M.D., Institute of Cancer Research of Columbia University, 630 W. 168th St., New York, N. Y. 10032. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEFFECTS OF NEOPLASMS ON RENAL ELECTROLYTE FUNCTIONThe Role of Adrenocorticoids in the Inappropriate Antidiuretic Hormone SyndromeMARSHAL P. FICHMAN, M.D., JOHN E. BETHUNE, M.D., F.A.C.P.Abnormal antidiuresis in bronchogenic carcinomaThe syndrome of inappropriate secretion of antidiuretic hormone 1 October 1966Volume 65, Issue 4Page: 708-721KeywordsEdemaHospital medicineHyponatremiaKidneysNephritisRenal cancerRenal diseasesScientistsSodiumSurgeons Issue Published: 1 October 1966 PDF DownloadLoading ...