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  • 1
    Electronic Resource
    Electronic Resource
    Central role for sodium in the pathogenesis of blood pressure changes independent of angiotensin, aldosterone and catecholamines in Type 1 (insulin-dependent) diabetes mellitus (1987)
    Springer
    Diabetologia 30 (1987), S. 610-617 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes ; urinary albumin excretion ; exchangeable sodium ; blood pressure ; extracellular volume ; plasma volume ; catecholamines ; renin ; converting enzyme ; angiotensin II
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied 73 Type 1 (insulin-dependent) diabetic patients, 18 to 50 years of age, with a diabetes duration of more than five years. Group 1: normal urinary albumin excretion below 30 mg per 24 h (n=19); group 2: microalbuminuria, 30–300 mg per 24 h (n=36); and group 3: diabetic nephropathy, above 300 mg per 24 h (n=18). Fifteen non-diabetic persons matched for sex and age served as control subjects. The sodium intake evaluated on the basis of 24-h urine sodium excretion was similar in patients and control subjects. Blood pressure in groups 1 and 2 and control subjects was below 160/95 mmHg. The blood pressure was increased in group 3 as compared with the other groups (systolic/diastolic 161±22/101±9 mmHg vs 131±13/84±10, mean±SD, p〈0.0001). Exchangeable sodium was increased in patients (p〈0.01) and correlated to the mean blood pressure (n=70, r=0.41, p〈0.01). Extracellular volume was increased in patients (p〈0.05), whereas plasma volume was normal. Supine serum angiotensin II was suppressed in the patients (p〈0.001). A negative correlation was found between mean blood pressure and supine serum aldosterone (n=68, r=-0.24, p〈0.05), and exchangeable sodium and aldosterone (n=66, r=-0.36, p〈0.002) in all patients. The catecholamine levels were also suppressed or normal in the patients. These data suggest that sodium retention plays a major role and that the aldosterone, angiotensin II and catecholamine levels are suppressed during the blood pressure rise observed in the very early stages of diabetic renal disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00277316
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  • 2
    Electronic Resource
    Electronic Resource
    Effects of insulin on kidney function and sodium excretion in healthy subjects (1989)
    Springer
    Diabetologia 32 (1989), S. 694-699 
    Details
    ISSN: 1432-0428
    Keywords: lithium clearance ; glomerular filtration rate ; sodium excretion ; insulin ; normal subjects ; distal renal tubules
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin action on kidney function was evaluated in 8 healthy subjects, (mean age 27 years) using the euglycaemic clamp technique. Insulin was infused at rates of 0, 20 and 40 mU·min−1·m−2 over consecutive periods of 120 min resulting in plasma insulin concentrations of 8±2, 29±7 and 66±14 mU/l. The renal clearance of 51Cr-EDTA, lithium, sodium and potassium was determined during the last 90 min of each period. Sodium clearance declined with increasing plasma insulin concentrations (1.3±0.4, 1.0±0.3 and 0.5±0.2 ml·min−1·1.73 m−2, p〈0.001), while glomerular filtration rate (108±21, 104±21 and 108±20ml·min−1·1.73 m−2) and lithium clearance (a marker of fluid flow rate from the proximal tubules) 29±5, 29±4 and 30±4 ml·min−1·1.73 m−2) remained unchanged. Calculated proximal tubular reabsorption of sodium and water was unchanged, while calculated distal fractional sodium reabsorption increased (95.5±1.5, 96.4±1.2 and 98.1±0.7%, p〈0.001). Potassium clearance and plasma potassium concentration declined, whereas plasma aldosterone and plasma renin concentrations were unchanged. In conclusion, elevation of plasma insulin concentration within the physiological range has a marked antinatriuretic action. This effect is located distally to the proximal renal tubules.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00274259
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  • 3
    Electronic Resource
    Electronic Resource
    Effects of combined therapy with amiloride and hydrochlorothiazide on plasma and total body potassium, blood pressure, and the renin-angiotensin-aldosterone system in hypertensive patients (1986)
    Springer
    European journal of clinical pharmacology 30 (1986), S. 151-156 
    Details
    ISSN: 1432-1041
    Keywords: amiloride ; hydrochlorothiazide ; hypertension ; total body potassium ; plasma potassium ; renin-angiotensin-aldosterone system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary After a run-in period of 8 weeks on a regimen of hydrochlorothiazide (HCT, median dosage 75 mg/day), patients with essential hypertension were randomly allocated to continued hydrochlorothiazide therapy (Group I) or additional treatment with amiloride (Group II, median dosage 15 mg/day, or 5 mg per 25 mg hydrochlorothiazide) for the following 12 weeks. Thereafter all the patients were changed to treatment with a fixed combination tablet containing 5 mg amiloride and 50 mg hydrochlorothiazide (Moduretic), keeping the thiazide dosage unchanged for an additional 12 weeks. In Group I patients there was no change in plasma potassium, total body potassium content or the renin-angiotensin-aldosterone system during the 12 weeks on HCT. When the treatment was changed to Moduretic, significant increases were found of 10% in plasma potassium and 3% in total body potassium content. No important stimulation of the renin-angiotensin-aldosterone system was found. In Group II patients addition of an average of 15 mg amiloride to the hydrochlorothiazide treatment led to significant increases in plasma potassium and total body potassium content of approximately 15% and 4%, respectively. There was also a significant increase in the plasma concentrations of renin, angiotensin II and aldosterone. Reducing the average dose of amiloride to 7.5 mg/day by use of Moduretic did not lead to decrease in plasma potassium or total body potassium content. Plasma concentrations of renin, angiotensin II, and aldosterone were decreased, but the individual changes varied markedly and no significant overall change was found.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00614293
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    Paper (German National Licenses)
    Fulltext
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