Commentary. Lysosomotropic agents.

The syndrome of inappropriate secretion of antidiuretic hormone

The effects of insulin on the renal handling of sodium, potassium, calcium, and phosphate were studied in man while maintaining the blood glucose concentration at the fasting level by negative feedback servocontrol of a variable glucose infusion. In studies on six water-loaded normal subjects in a steady state of water diuresis, insulin was administered i.v. to raise the plasma insulin concentration to between 98 and 193 muU/ml and infused at a constant rate of 2 mU/kg body weight per min over a total period of 120 min. The blood glucose concentration was not significantly altered, and there was no change in the filtered load of glucose; glomerular filtration rate (CIN) and renal plasma flow (CPAH) were unchanged. Urinary sodium excretion (UNaV) decreased from 401 plus or minus 46 (SEM) to 213 plus or minus 18 mueq/min during insulin administration, the change becoming significant (P smaller than 0.02) within the 30-60 min collection period. Free water clearance (CH2O) increased from 10.6 plus or minus 0.6 to 13 plus or minus 0.5 ml/min (P smaller than 0.025); osmolar clearance decreased and urine flow was unchanged. There was no change in plasma aldosterone concentration, which was low throughout the studies, and a slight reduction was observed in plasma glucagon concentration. Urinary potassium (UKV) and phosphate (UPV) excretion were also both decreased during insulin administration; UKV decreased from 66 plus or minus 9 to 21 plus or minus 1 mueq/min (P smaller than 0.005), and tupv decreased from 504 plus or minus 93 to 230 plus or minus 43 mug/min (P smaller than 0.01). The change in UKV was associated with a significant reduction in plasma potassium concentration. There was also a statistically significant but small reduction in plasma phosphate concentration which was not considered sufficient alone to account for the large reduction in UPV. Urinary calcium excretion (UCaV) increased from 126 plus or minus 24 to 200 plus or minus 17 mug/min (P smaller than 0.01). These studies demonstrate a reduction in UNaV associated with insulin administration that occurs in the absence of changes in the filtered load of glucose, glomerular filtration rate, renal blood flow, and plasma aldosterone concentration. The effect of insulin on CH2O suggests that insulin's effect on sodium excretion is due to enhancement of sodium reabsorption in the diluting segment of the distal nephron.

/pdf/the-effect-of-insulin-on-renal-handling-of-sodium-potassium-5gvkrkmzp2.pdf

The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man.

https://www.amjmed.com/article/0002-9343(57)90224-3/pdf

A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone

The intracellular pH (pHi) of squid giant axons has been measured using glass pH microelectrodes Resting pHi in artificial seawater (ASW) (pH 76-78) at 23 degrees C was 732 +/- 002 (728 if corrected for liquid junction potential) Exposure of the axon to 5% CO2 at constant external pH caused a sharp decrease in pHi, while the subsequent removal of the gas caused pHi to overshoot its initial value If the exposure to CO2 was prolonged, two additional effects were noted: (a) during the exposure, the rapid initial fall in pHi was followed by a slow rise, and (b) after the exposure, the overshoot was greatly exaggerated Application of external NH4Cl caused pHi to rise sharply; return to normal ASW caused pHi to return to a value below its initial one If the exposure to NH4Cl was prolonged, two additional effects were noted: (a) during the exposure, the rapid initial rise in pHi was followed by a slow fall, and (b) after the exposure, the undershoot was greatly exaggerated Exposure to several weak acid metabolic inhibitors caused a fall in pHi whose reversibility depended upon length of exposure Inverting the electrochemical gradient for H+ with 100 mM K-ASW had no effect on pHi changes resulting from short-term exposure to azide A mathematical model explains the pHi changes caused by NH4Cl on the basis of passive movements of both NH3 and NH4+ The simultaneous passive movements of CO2 and HCO3-cannot explain the results of the CO2 experiments; these data require the postulation of an active proton extrusion and/or sequestration mechanism

https://rupress.org/jgp/article-pdf/67/1/91/1246000/91.pdf

Intracellular pH Transients in Squid Giant Axons Caused by CO2, NH3, and Metabolic Inhibitors

/pdf/the-renal-clearance-of-alkali-stable-inulin-cs4uv0iss8.pdf

The renal clearance of alkali-stable inulin

/pdf/asymptomatic-hyponatremia-in-pulmonary-tuberculosis-y1z9utb43e.pdf

Asymptomatic hyponatremia in pulmonary tuberculosis

Abnormalities of water and electrolyte metabolism in rats with hypothalamic lesions

/pdf/an-example-of-cellular-hyperosmolarity-6f0fhvhfec.pdf

An example of cellular hyperosmolarity.

Regulation of ammonia excretion in the rat.

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