Exaggerated natriuresis in the hypertensive man: Clinical evidence for intrarenal hemodynamic heterogeneity

A. Dal Canton, G. Conte, G. Fuiano, R. Guasco, V. E. Andreucci

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Abstract

Seven hypertensive patients (H) and 8 normotensive volunteers (N) were loaded with NaCl (4.5 mEq Na +/kg body weight i.v.) during water diuresis (A) and antidiuresis (B). In 6 antidiuretic subjects (3H and 3N) urine volume (V) was progressively raised up to over 30 ml/min, by intravenous infusion (12 ml/min) of hypertonic (3%) saline (C). It is assumed that in (A) CH 2O is an index of Na + reabsorption in short Henle's loop. In (B) and (C) T(c)/H 2O is proportional to Na + reabsorption in long Henle's loops. In (A) C(c)/H 2O was significantly lower in H. In (B) T(c)/H 2O was similar in H and N. In (C), T(c)/H 2O reached an earlier plateau in H than in N. These results demonstrate that exaggerated natriuresis depends on defective Na + reabsorption in Henle's loops, suggesting that the defect depends upon the transmission of hypertension to medullary circulation. The increase in hemodynamic pressure in vasa recta opposes Na + reabsorption both in short and in long Henle's loops. However, the effects on T(c)/H 2O of the decrease in Na + reabsorption in long loops is blunted by the greater Na + delivery, secondary to the increase in GFR, that follows the rise in filtration pressure.

Original languageEnglish
Pages (from-to)122-126
Number of pages5
JournalNephron
Volume27
Issue number3
Publication statusPublished - 1981

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ASJC Scopus subject areas

  • Nephrology

Cite this

Dal Canton, A., Conte, G., Fuiano, G., Guasco, R., & Andreucci, V. E. (1981). Exaggerated natriuresis in the hypertensive man: Clinical evidence for intrarenal hemodynamic heterogeneity. Nephron, 27(3), 122-126.