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Circulation May 2018
Topics: Creatinine; Cystatin C; Diuresis; Glomerular Filtration Rate; Heart Failure; Humans; Kidney; Troponin
PubMed: 29735590
DOI: 10.1161/CIRCULATIONAHA.118.033343 -
PloS One 2019In the rat, oxytocin (OT) produces dose-dependent diuretic and natriuretic responses. Post-translational enzymatic conversion of the OT biosynthetic precursor forms both...
In the rat, oxytocin (OT) produces dose-dependent diuretic and natriuretic responses. Post-translational enzymatic conversion of the OT biosynthetic precursor forms both mature and C-terminally extended peptides. The plasma concentrations of these C-terminally extended peptides (OT-G; OT-GK and OT-GKR) are elevated in newborns and pregnant rats. Intravenous injection of OT-GKR to rats inhibits diuresis, whereas injection of amidated OT stimulates diuresis. Since OT and OT-GKR show different effects on the urine flow, we investigated whether OT-GKR modulates renal action by inhibition of the arginine-vasopressin (AVP) receptor V2 (V2R), the receptor involved in renal water reabsorption. Experiments were carried out in the 8-week-old Wistar rats receiving intravenous (iv) injections of vehicle, OT, OT-GKR or OT+OT-GKR combination. OT (10 μmol/kg) increased urine outflow by 40% (P<0.01) and sodium excretion by 47% (P<0.01). Treatment with OT-GKR (10 μmol/kg) decreased diuresis by 50% (P<0.001), decreased sodium excretion by 50% (P<0.05) and lowered potassium by 42% (P<0.05). OT antagonist (OTA) reduced diuresis and natriuresis exerted by OT, whereas the anti-diuretic effect of OT-GKR was unaffected by OTA. The treatment with V2R antagonist (V2A) in the presence and absence of OT induced diuresis, sodium and potassium outflow. V2A in the presence of OT-GKR only partially increased diuresis and natriuresis. Autoradiography and molecular docking analysis showed potent binding of OT-GKR to V2R. Finally, the release of cAMP from CHO cells overexpressing V2 receptor was induced by low concentration of AVP (EC50:4.2e-011), at higher concentrations of OT (EC50:3.2e-010) and by the highest concentrations of OT-GKR (EC50:1.1e-006). OT-GKR potentiated cAMP release when combined with AVP, but blocked cAMP release when combined with OT. These results suggest that OT-GKR by competing for the OT renal receptor (OTR) and binding to V2R in the kidney, induces anti-diuretic, anti-natriuretic, and anti-kaliuretic effects.
Topics: Animals; Autoradiography; Binding, Competitive; CHO Cells; Cell Line; Cricetinae; Cricetulus; Cyclic AMP; Diuresis; Electrolytes; Humans; Kidney; Molecular Docking Simulation; Natriuresis; Oxytocin; Peptides; Rats; Rats, Wistar; Receptors, Vasopressin; Urination; Vasopressins
PubMed: 31269062
DOI: 10.1371/journal.pone.0219205 -
International Urology and Nephrology Oct 2021To investigate 50 week ultrasound imaging and ultrastructure changes of bladder in diuresis and diabetes rats.
PURPOSE
To investigate 50 week ultrasound imaging and ultrastructure changes of bladder in diuresis and diabetes rats.
METHODS
Forty-two healthy male Sprague-Dawley rats were randomly divided into control group, sugar-induced diuresis group and streptozotocin-induced diabetes group. The 24 h drinking and urine volume were calculated from 21 to 31 weeks. Using ultrasound to assess bladders after 49 weeks. Bladders were examined by transmission electron microscope after 50 weeks.
RESULTS
The drinking and urine volume significantly increased in the diuresis and diabetes groups. The bladder morphology and bladder wall thickness increased in the diuresis and diabetes groups. Bladder stones, bladder overdistension and urinary retention were seen in the diuresis and diabetes groups. Urothelium manifested degeneration, denudation and necrosis in the diuresis and diabetes groups. The mitochondrial vacuolar degeneration in the urothelial cells was seen in the diabetes group. The subepithelial vascular endothelial cells hyperplasia with a narrowed lumen were observed in the diabetes group. Abnormal mitochondria were rarely seen in the control group. The mitochondrial vacuolar degeneration in the detrusor was more severe in the diabetes group than in the diuresis group. The detrusor muscle and axon degeneration were observed in the diuresis and diabetes groups. Two rats in the diuresis group share similarities with diabetes group (2/6).
CONCLUSION
Long-term diabetes mellitus can cause increments of urinary bladder morphology and bladder wall thickness, urinary retention and bladder stones. Ultrastructural degeneration of the bladder might be the morphological bases of diabetic cystopathy.
Topics: Animals; Diabetes Mellitus; Diuresis; Male; Random Allocation; Rats; Rats, Sprague-Dawley; Sugars; Time Factors; Ultrasonography; Urinary Bladder
PubMed: 34110574
DOI: 10.1007/s11255-021-02911-w -
Pflugers Archiv : European Journal of... Jul 2016The collecting duct (CD) is the final segment of the kidney involved in the fine regulation of osmotic and ionic balance. During dehydration, arginine vasopressin (AVP)...
The collecting duct (CD) is the final segment of the kidney involved in the fine regulation of osmotic and ionic balance. During dehydration, arginine vasopressin (AVP) stimulates the expression and trafficking of aquaporin 2 (AQP2) to the apical membrane of CD principal cells, thereby allowing water reabsorption from the primary urine. Conversely, when the secretion of AVP is lowered, as for instance upon water ingestion or as a consequence of diabetes insipidus, the CD remains water impermeable leading to enhanced diuresis and urine dilution. In addition, an AVP-independent mechanism of urine dilution is also at play when fasting. Piezo1/2 are recently discovered essential components of the non-selective mechanically activated cationic channels. Using quantitative PCR analysis and taking advantage of a β-galactosidase reporter mouse, we demonstrate that Piezo1 is preferentially expressed in CD principal cells of the inner medulla at the adult stage, unlike Piezo2. Remarkably, siRNAs knock-down or conditional genetic deletion of Piezo1 specifically in renal cells fully suppresses activity of the stretch-activated non-selective cationic channels (SACs). Piezo1 in CD cells is dispensable for urine concentration upon dehydration. However, urinary dilution and decrease in urea concentration following rehydration are both significantly delayed in the absence of Piezo1. Moreover, decreases in urine osmolarity and urea concentration associated with fasting are fully impaired upon Piezo1 deletion in CD cells. Altogether, these findings indicate that Piezo1 is critically required for SAC activity in CD principal cells and is implicated in urinary osmoregulation.
Topics: Animals; Aquaporin 2; Arginine Vasopressin; Cell Line; Dehydration; Diuresis; Ion Channels; Kidney Tubules, Collecting; Mice; Osmolar Concentration; Water-Electrolyte Balance
PubMed: 27023350
DOI: 10.1007/s00424-016-1811-z -
The Israel Medical Association Journal... Feb 2019Hyperchloremia is frequent in adult surgical patients and is associated with renal dysfunction. Studies in surgical pediatric patients are lacking.
BACKGROUND
Hyperchloremia is frequent in adult surgical patients and is associated with renal dysfunction. Studies in surgical pediatric patients are lacking.
OBJECTIVES
To identify both the incidence of postoperative hyperchloremia in children undergoing surgery for idiopathic and non-idiopathic scoliosis, and the association of postoperative hyperchloremia with intraoperative fluid management and postoperative diuresis.
METHODS
The records of 74 children and adolescents who underwent elective scoliosis surgery were retrospectively evaluated. The primary endpoint was the incidence of serum chloride level ≥ 110 mEq/L at the end of surgery and 12 hours postoperatively. Secondary endpoints were the type and volume of administered fluids, 12 hours postoperative diuresis, and the incidence of postoperative oliguria.
RESULTS
Hyperchloremia occurred in 55% of the patients at the end of surgery and in 52% 12 hours postoperatively. Hyperchloremic patients received larger intraoperative volume of 0.9% NaCl diluted cell-saver blood and 10% HAES than did normochloremic patients [median (interquartile range) 6.8 (2.5-11.0) ml/kg vs. 0 (0-7.3), P = 0.003 and 10.0 (0-12.8) vs. 4.4 (0-9.8), P = 0.02, respectively]. Additionally, when compared with normochloremic patients, diuresis during the first 12 hours postoperatively was lower in hyperchloremic patients. Postoperative oliguria (urine output < 0.5 ml/kg/hr for 12 hours) was diagnosed in 7 children (9%), of whom 6 were hyperchloremic at the end of surgery.
CONCLUSIONS
Early postoperative hyperchloremia is common in children undergoing scoliosis repair surgery and may be attributed to the administration of 0.9% NaCl diluted cell-saver blood and 10% HAES. Postoperative hyperchloremia might be associated with postoperative oliguria.
Topics: Adolescent; Child; Cohort Studies; Comorbidity; Diuresis; Female; Fluid Therapy; Humans; Incidence; Intraoperative Care; Israel; Male; Postoperative Complications; Retrospective Studies; Scoliosis; Water-Electrolyte Imbalance
PubMed: 30772959
DOI: No ID Found -
Circulation. Heart Failure Nov 2021Animal models implicate FGF-23 (fibroblast growth factor-23) as a direct contributor to adverse cardiorenal interactions such as sodium avidity, diuretic resistance, and...
BACKGROUND
Animal models implicate FGF-23 (fibroblast growth factor-23) as a direct contributor to adverse cardiorenal interactions such as sodium avidity, diuretic resistance, and neurohormonal activation, but this has not been conclusively demonstrated in humans. Therefore, we aimed to evaluate whether FGF-23 is associated with parameters of cardiorenal dysfunction in humans with heart failure, independent of confounding factors.
METHODS
One hundred ninety-nine outpatients with heart failure undergoing diuretic treatment at the Yale Transitional Care Center were enrolled and underwent blood collection, and urine sampling before and after diuretics.
RESULTS
FGF-23 was associated with several metrics of disease severity such as higher home loop diuretic dose and NT-proBNP (N-terminal pro-B-type natriuretic peptide), and lower estimated glomerular filtration rate, serum chloride, and serum albumin. Multivariable analysis demonstrated no statistically significant association between FGF-23 and sodium avidity measured by fractional excretion of sodium, or proximal or distal tubular sodium reabsorption, either before diuretic administration or at peak diuresis (≥0.11 for all). Likewise, FGF-23 was not independently associated with parameters of diuretic resistance (diuretic excretion, cumulative urine and sodium output, and loop diuretic efficiency [≥0.33 for all]) or neurohormonal activation (plasma or urine renin [≥0.36 for all]). Moreover, the upper boundary of the 95% CI of all the partial correlations were ≤0.30, supporting the lack of meaningful correlations. FGF-23 was not associated with mortality in multivariable analysis (=0.44).
CONCLUSIONS
FGF-23 was not meaningfully associated with any cardiorenal parameter in patients with heart failure. While our methods cannot rule out a small effect, FGF-23 is unlikely to be a primary driver of cardiorenal interactions.
Topics: Aged; Aged, 80 and over; Diuresis; Diuretics; Female; Fibroblast Growth Factor-23; Heart Failure; Humans; Male; Middle Aged; Renin; Sodium; Sodium Potassium Chloride Symporter Inhibitors
PubMed: 34689571
DOI: 10.1161/CIRCHEARTFAILURE.121.008385 -
Journal of Critical Care Aug 2018Amanita phalloides poisoning with a high mortality is a serious health problem in the world. The typical clinical manifestations are usually characterized by the absence... (Review)
Review
Amanita phalloides poisoning with a high mortality is a serious health problem in the world. The typical clinical manifestations are usually characterized by the absence of any symptoms followed by severe gastrointestinal disorders and acute liver failure. Inhibition of RNA polymeraseII (RNAP II) activity, apoptosis, and oxidative stress are considered as the major mechanism of amatoxins intoxication. The current treatment measures mainly include prevention of amatoxins absorption, elimination of absorbed amatoxins, potential antidotes therapy, and liver transplantation. Nevertheless, there are no widely accepted treatment criteria for Amanita phalloides poisoning. This paper will focus on the treatment measures based on the previous studies and provide the currently available information for clinicians.
Topics: Acetylcysteine; Amanita; Amanitins; Antidotes; Bile Ducts; Charcoal; Diuresis; Gastric Lavage; Humans; Liver; Liver Failure, Acute; Liver Transplantation; Mushroom Poisoning; Penicillin G; Silymarin
PubMed: 29627659
DOI: 10.1016/j.jcrc.2018.03.028 -
Blood Purification 2019A significant subset of patients with heart failure (HF) experience small to moderate rise in serum creatinine (RSC) in the setting of otherwise beneficial therapies...
A significant subset of patients with heart failure (HF) experience small to moderate rise in serum creatinine (RSC) in the setting of otherwise beneficial therapies such as aggressive diuresis or renin-angiotensin-aldosterone system (RAAS) inhibition. Accumulating data suggest that RSC in this setting is dissimilar from conventional causes of renal insult in that it has a negligible impact on the outcomes. There is also emerging evidence on the lack of association between biomarkers of renal injury and RSC in the setting of aggressive diuresis. A similar pattern has been observed in recent hypertension trials where the RSC in patients with intensive blood pressure control has not been associated with biomarker evidence of renal injury or adverse outcomes. Based on these findings, RSC, rather than acute kidney injury, appears to be the preferred terminology in HF (and possibly in hypertension) because of its purely descriptive nature that lacks any potentially inaccurate implication of mechanistic or prognostic reference. From a pragmatic viewpoint, we believe that small to moderate RSC is to be anticipated and tolerated with RAAS inhibition and/or aggressive diuresis in acute or chronic HF and should not prompt discontinuation of the therapy unless complications such as hypotension and severe hyperkalemia develop.
Topics: Creatinine; Diuresis; Heart Failure; Humans; Prognosis; Renin-Angiotensin System
PubMed: 31216531
DOI: 10.1159/000500409 -
American Journal of Physiology.... Sep 2014The American Physiological Society officially recognized the area of research in Water and Electrolyte Homeostasis (WEH) over 30 years ago when the Section of WEH was... (Review)
Review
The American Physiological Society officially recognized the area of research in Water and Electrolyte Homeostasis (WEH) over 30 years ago when the Section of WEH was established. This minireview illuminates the importance of WEH research to the physiology community. By the narrowest definition, WEH research studies the regulation of body fluids; however, this research area is much broader and more relevant today than when this subdiscipline was first recognized because of the translational and systemic "point of view" of WEH research. This minireview highlights how WEH research serves as a balanced force between the full range of other more traditional organ-based physiological and pathophysiological concepts. The breadth of research in which WEH investigators engage is on full display with the publication of minireviews from the annual Data Diuresis session at Experimental Biology.
Topics: Animals; Body Fluids; Diuresis; Electrolytes; Homeostasis; Humans; Physiological Phenomena; Water-Electrolyte Balance
PubMed: 25031231
DOI: 10.1152/ajpregu.00246.2014 -
Life Sciences Jan 2018Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) differ in their renin-angiotensin system function and sympathetic tone. The metabolism of angiotensins and... (Comparative Study)
Comparative Study Review
AIMS
Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) differ in their renin-angiotensin system function and sympathetic tone. The metabolism of angiotensins and vasopressin depends on the action of certain aminopeptidases whose activity may be influenced by the autonomic nervous system. Their regulation may differ between WKY and SHR in hypothalamus and plasma according to the sympathetic tone. We analyzed aminopeptidases responsible for the hydrolysis of certain angiotensins, vasopressin, cholecystokinin or enkephalins in hypothalamus and plasma of WKY and SHR in untreated controls rats and under beta-adrenoceptor blockade. Systolic blood pressure, food intake, water intake and diuresis were measured as parameters modulated by the autonomic nervous system and the above mentioned peptides.
MAIN METHODS
Glutamyl-, aspartyl-, cystinyl- and alanyl-aminopeptidase activities were analyzed fluorimetrically in plasma and hypothalamus of control and propranolol-treated (100mg/kg/day administered in drinking water for 1month) WKY and SHR, using arylamide derivatives as substrates.
KEY FINDINGS
An opposite response of aminopeptidases to propranolol treatment between plasma and hypothalamus was observed in either WKY and SHR. Furthermore, the behavior of aminopeptidases was inversed between WKY and SHR either in hypothalamus and plasma: while the activity increased in hypothalamus and decreased in plasma of WKY, it decreased in hypothalamus and increased in plasma of SHR.
SIGNIFICANCE
These results revealed an inverse response of aminopeptidases between hypothalamus and plasma and also an opposite behavior of these enzymes between WKY and SHR in hypothalamus and plasma. These observations support the involvement of the sympathetic system in the modulation of aminopeptidase activities.
Topics: Adrenergic beta-Antagonists; Aminopeptidases; Animals; Blood Pressure; Diuresis; Drinking; Eating; Hypertension; Hypothalamus; Male; Propranolol; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Species Specificity
PubMed: 29155297
DOI: 10.1016/j.lfs.2017.11.022