EFFECTS OF POSTURE ON THE PLASMA HORMONAL AND RENAL WATER-ELECTROLYTEEXCRETORY RESPONSES TO ACUTE WATER LOADING IN DIABETIC SUBJECTS WITH HYPOADRENERGIC ORTHOSTATIC HYPOTENSION
S. Nakano et al., EFFECTS OF POSTURE ON THE PLASMA HORMONAL AND RENAL WATER-ELECTROLYTEEXCRETORY RESPONSES TO ACUTE WATER LOADING IN DIABETIC SUBJECTS WITH HYPOADRENERGIC ORTHOSTATIC HYPOTENSION, Journal of diabetes and its complications, 10(5), 1996, pp. 274-279
The effects of posture on the plasma hormonal and renal water-electrol
yte excretory responses to acute water loading (20 mL/kg BW, orally) w
ere studied in six non-insulin-dependent diabetes mellitus (NIDDM) sub
jects with hypoadrenergic orthostatic hypotension (HOH), eight NIDDM s
ubjects without HOW, and seven nondiabetic subjects. The three groups
were similar with respect to basal levels of mean blood pressure (MBP)
, serum sodium and osmolality, plasma renin activity (PRA), the plasma
volume regulatory hormones alpha-atrial natriuretic peptide (ANP), ar
ginine vasopressin (AVP) and aldosterone, and urinary water and sodium
excretion. In the supine state, while allowing the subjects to stand
only to void, water loading resulted in no changes in MBP and similar
responses of these plasma and urinary parameters in the three groups.
In the standing state, water loading produced responses of MBP, and pl
asma and urinary parameters comparable to those in the supine state in
the diabetic group without HOH and the nondiabetic group. In the diab
etic group with HOH, however, MBP and hourly urinary water and sodium
excretion rates were low compared to those in the other two groups. Du
ring water loading plasma ANP decreased, and, despite the fall of MBP,
plasma AVP remained unchanged, and PRA and plasma aldosterone increas
ed normally in the diabetic group with HOH. These results demonstrate
that, in NIDDM subjects with HOH, changing from lying to standing indu
ces deranged renal water and sodium handling after water loading, acco
mpanied by a decrease in plasma ANP, and inadequate responses of plasm
a AVP, PRA, and plasma aldosterone to hypotension.