Effect of a single test dose of lithium carbonate on sodium and potassium excretion in man

1991 ◽  
Vol 81 (1) ◽  
pp. 59-63 ◽  
Author(s):  
D. G. Shirley ◽  
D. R. J. Singer ◽  
G. A. Sagnella ◽  
M. G. Buckley ◽  
M. A. Miller ◽  
...  

1. The possible natriuretic and kaliuretic effects of a single dose of lithium, as used in lithium clearance studies, were investigated in 15 healthy subjects on fixed sodium (100 mmol/24 h) and potassium (70 mmol/24 h) intakes. Lithium carbonate (300 mg or 600 mg) or placebo tablets were administered, double-blind and in random order, midway through a 48 h urine collection (divided into six 8 h periods), at 23.00 hours. 2. During the three 24 h periods which preceded the administration of lithium or placebo (control days), rates of sodium and potassium excretion followed normal circadian patterns, but no differences in excretion rates between the 3 control days were observed. Placebo tablets did not affect excretion rates. 3. After the 300 mg dose of lithium carbonate, 24 h sodium excretion increased by approximately 17 mmol (P < 0.05); almost all of the natriuretic effect occurred during the first two 8 h periods. No effect on potassium excretion was observed. 4. After the 600 mg dose of lithium carbonate, 24 h sodium excretion increased by approximately 48 mmol (P < 0.001) and 24 h potassium excretion increased by approximately 19 mmol (P < 0.01). These effects were confined to the first two 8 h periods and thus occurred before and during the usual lithium clearance period. 5. Plasma renin activity, measured in 10 subjects, increased after the 600 mg dose of lithium carbonate (P < 0.005), but plasma concentrations of aldosterone and atrial natriuretic peptide were not significantly affected. Neither the 300 mg dose of lithium carbonate nor the placebo tablets affected hormone levels. 6. It is recommended that the test dose of lithium carbonate for use in lithium clearance studies should not exceed 300 mg.

1998 ◽  
Vol 275 (4) ◽  
pp. R1239-R1246 ◽  
Author(s):  
Thomas E. Lohmeier ◽  
Glenn A. Reinhart ◽  
H. Leland Mizelle ◽  
Maohao Han ◽  
Mark M. Dean

To determine whether the chronically denervated kidney is supersensitive to either physiological or pathophysiological plasma levels of norepinephrine (NE), studies were conducted in conscious dogs subjected to unilateral renal denervation and surgical division of the urinary bladder into hemibladders to allow separate 24-h urine collection from denervated and innervated kidneys. Plasma NE concentration was increased by chronic infusion of NE (4–5 days) at rates of 25, 100, and 200 ng ⋅ kg−1 ⋅ min−1. Twenty-four-hour control values for mean arterial pressure (MAP), plasma NE concentration, and ratios for urinary sodium and potassium excretion from denervated and innervated kidneys (Den/Inn) were 94 ± 4 mmHg, 145 ± 24 pg/ml, 1.05 ± 0.05, and 0.97 ± 0.07, respectively. With infusions of NE producing plasma levels of NE of up to ∼3,000 pg/ml or plasma concentrations of NE at least threefold greater than present under most pathophysiological conditions and during acute activation of the sympathetic nervous system, there were no significant long-term changes in MAP or relative excretion rates of sodium and potassium from denervated and innervated kidneys. In marked contrast, pharmacological plasma levels of NE (∼7,000 pg/ml) produced chronic increases in MAP (to 116 ± 2% of control) and sustained reductions in Den/Inn for urinary sodium and potassium excretion to 57 ± 4 and 68 ± 5% of control, respectively, indicating a lower excretion rate of these electrolytes from denervated vs. innervated kidneys. We conclude that the chronically denervated kidney does not exhibit an exaggerated antinatriuretic response to either physiological or pathophysiological levels of circulating NE. It is therefore unlikely that renal denervation supersensitivity is a confounding issue in studies employing chronic renal denervation to elucidate the role of the renal nerves in the regulation of sodium excretion.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaofu Du ◽  
Le Fang ◽  
Jianwei Xu ◽  
Xiangyu Chen ◽  
Yamin Bai ◽  
...  

AbstractThe direction and magnitude of the association between sodium and potassium excretion and blood pressure (BP) may differ depending on the characteristics of the study participant or the intake assessment method. Our objective was to assess the relationship between BP, hypertension and 24-h urinary sodium and potassium excretion among Chinese adults. A total of 1424 provincially representative Chinese residents aged 18 to 69 years participated in a cross-sectional survey in 2017 that included demographic data, physical measurements and 24-h urine collection. In this study, the average 24-h urinary sodium and potassium excretion and sodium-to-potassium ratio were 3811.4 mg/day, 1449.3 mg/day, and 4.9, respectively. After multivariable adjustment, each 1000 mg difference in 24-h urinary sodium excretion was significantly associated with systolic BP (0.64 mm Hg; 95% confidence interval [CI] 0.05–1.24) and diastolic BP (0.45 mm Hg; 95% CI 0.08–0.81), and each 1000 mg difference in 24-h urinary potassium excretion was inversely associated with systolic BP (− 3.07 mm Hg; 95% CI − 4.57 to − 1.57) and diastolic BP (− 0.94 mm Hg; 95% CI − 1.87 to − 0.02). The sodium-to-potassium ratio was significantly associated with systolic BP (0.78 mm Hg; 95% CI 0.42–1.13) and diastolic BP (0.31 mm Hg; 95% CI 0.10–0.53) per 1-unit increase. These associations were mainly driven by the hypertensive group. Those with a sodium intake above about 4900 mg/24 h or with a potassium intake below about 1000 mg/24 h had a higher risk of hypertension. At higher but not lower levels of 24-h urinary sodium excretion, potassium can better blunt the sodium-BP relationship. The adjusted odds ratios (ORs) of hypertension in the highest quartile compared with the lowest quartile of excretion were 0.54 (95% CI 0.35–0.84) for potassium and 1.71 (95% CI 1.16–2.51) for the sodium-to-potassium ratio, while the corresponding OR for sodium was not significant (OR, 1.28; 95% CI 0.83–1.98). Our results showed that the sodium intake was significantly associated with BP among hypertensive patients and the inverse association between potassium intake and BP was stronger and involved a larger fraction of the population, especially those with a potassium intake below 1000 mg/24 h should probably increase their potassium intake.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2345
Author(s):  
Masayuki Okuda ◽  
Satoshi Sasaki

The identification of sodium and potassium intake in youths is an important step to preventing the increase of blood pressure in childhood. We examined food intake and estimated mineral intake using a brief-type self-administered diet history questionnaire (BDHQ) to test its validity as a comparison with urinary excretion in Japanese youths. The subjects were 5th and 8th graders (n = 2377), who completed the BDHQ and permitted the use of their overnight urine specimens. Sodium intake was poorly associated with sodium excretion (Rho = 0.048), and the coefficients of dietary potassium and a sodium-to-potassium molar ratio were 0.091–0.130. Higher soybean paste (miso) intake and pickles were significantly associated with higher sodium excretion (p ≤ 0.005). However, these foods were positively associated with potassium excretion (p = 0.002–0.012), and not associated with an excreted sodium-to-potassium ratio. Fruits and dairy products were positively associated (p ≤ 0.048), whereas beverages were negatively associated with potassium excretion (p ≤ 0.004). The association of the sodium-to-potassium ratio was opposite to that of potassium (p ≤ 0.001). The choice of foods, potassium, and the sodium-to-potassium ratio assessed using the BDHQ are available as part of health education for youths, but the assessment of sodium intake in population levels should be carefully conducted.


1980 ◽  
Vol 59 (s6) ◽  
pp. 161s-164s ◽  
Author(s):  
P. S. Parfrey ◽  
P. Wright ◽  
J. M. Ledingham

1. The diurnal excretion of sodium and potassium was observed in young people, with and without a genetic predisposition to hypertension, both in the presence and absence of psychological stress. 2. In the absence of stress, the normal day/night sodium excretion ratio was reversed in the children of hypertensive parents. This was significantly less than day/night sodium excretion in children of normotensive parents. A similar finding was observed for day/night potassium excretion. 3. There was a significant negative correlation between systolic blood pressure and day/night sodium excretion in children of hypertensive parents but not in children of normotensive parents. 4. After the mental stress of a University examination day/night sodium reverted to normal in children of hypertensive parents.


BMJ ◽  
2019 ◽  
pp. l772 ◽  
Author(s):  
Martin O’Donnell ◽  
Andrew Mente ◽  
Sumathy Rangarajan ◽  
Matthew J McQueen ◽  
Neil O’Leary ◽  
...  

AbstractObjectiveTo evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults.DesignInternational prospective cohort study.Setting18 high, middle, and low income countries, sampled from urban and rural communities.Participants103 570 people who provided morning fasting urine samples.Main outcome measuresAssociation of estimated 24 hour urinary sodium and potassium excretion (surrogates for intake) with all cause mortality and major cardiovascular events, using multivariable Cox regression. A six category variable for joint sodium and potassium was generated: sodium excretion (low (<3 g/day), moderate (3-5 g/day), and high (>5 g/day) sodium intakes) by potassium excretion (greater/equal or less than median 2.1 g/day).ResultsMean estimated sodium and potassium urinary excretion were 4.93 g/day and 2.12 g/day, respectively. After a median follow-up of 8.2 years, 7884 (6.1%) participants had died or experienced a major cardiovascular event. Increasing urinary sodium excretion was positively associated with increasing potassium excretion (unadjusted r=0.34), and only 0.002% had a concomitant urinary excretion of <2.0 g/day of sodium and >3.5 g/day of potassium. A J-shaped association was observed of sodium excretion and inverse association of potassium excretion with death and cardiovascular events. For joint sodium and potassium excretion categories, the lowest risk of death and cardiovascular events occurred in the group with moderate sodium excretion (3-5 g/day) and higher potassium excretion (21.9% of cohort). Compared with this reference group, the combinations of low potassium with low sodium excretion (hazard ratio 1.23, 1.11 to 1.37; 7.4% of cohort) and low potassium with high sodium excretion (1.21, 1.11 to 1.32; 13.8% of cohort) were associated with the highest risk, followed by low sodium excretion (1.19, 1.02 to 1.38; 3.3% of cohort) and high sodium excretion (1.10, 1.02 to 1.18; 29.6% of cohort) among those with potassium excretion greater than the median. Higher potassium excretion attenuated the increased cardiovascular risk associated with high sodium excretion (P for interaction=0.007).ConclusionsThese findings suggest that the simultaneous target of low sodium intake (<2 g/day) with high potassium intake (>3.5 g/day) is extremely uncommon. Combined moderate sodium intake (3-5 g/day) with high potassium intake is associated with the lowest risk of mortality and cardiovascular events.


1984 ◽  
Vol 246 (2) ◽  
pp. F201-F204 ◽  
Author(s):  
J. D. Horisberger ◽  
J. Diezi

The effects of actinomycin D on short-term response to aldosterone on sodium and potassium urinary excretion were investigated in adrenalectomized glucocorticoid-substituted anesthetized rats. Aldosterone alone (1 microgram/kg followed by sustained intravenous infusion of 1 microgram X kg-1 X h-1) entailed a simultaneous antinatriuretic and kaliuretic effect after a latent period of 30-60 min. Actinomycin D (300 micrograms/kg) administered intravenously 30 min before aldosterone inhibited both the aldosterone-induced kaliuresis and antinatriuresis and the concomitant changes in plasma potassium concentration. The administration of actinomycin D alone enhanced sodium excretion in the first hour and then induced kaliuresis. These results favor the hypothesis that mineralocorticoid effects of aldosterone on sodium and potassium excretion are closely linked and may be dependent on the same mechanisms.


1978 ◽  
Vol 234 (5) ◽  
pp. F371-F375
Author(s):  
L. Rabinowitz ◽  
R. A. Gunther

The renal excretion of potassium by unanesthetized sheep was studied in clearance studies in which water and sodium excretion were elevated by intravenous infusion of isotonic sodium chloride, hypertonic sodium phosphate, or hypertonic sodium sulfate. Aldosterone was infused at 10 microgram/h in some experiments with sodium sulfate. Sodium excretion increased in all experiments, rising at times to equal 25% of the filtered load. Urine flow increased in most experiments. Glomerular filtration rate increased only with infusion of isotonic saline. No consistent change in potassium excretion occurred under any of these loading conditions. This finding contrasts with the increase in potassium excretion commonly seen in man, dogs, and rats intravenously loaded with sodium salts.


2019 ◽  
Vol 89 (3-4) ◽  
pp. 185-191
Author(s):  
Alireza Khosravi ◽  
Noushin Mohammadifard ◽  
Mojagn Gharipour ◽  
Zahra Abdollahi ◽  
Fatemeh Nouri ◽  
...  

Abstract. Introduction: Although difficult, the 24-hour urine sodium excretion is still considered as the gold standard method to estimate salt intake. The current study aimed to assess the validity of using spot urine samples in comparison with the standard 24-hour urine collection to estimate sodium and potassium intake in healthy Iranian adults. Methods and subjects: This cross-sectional study was performed on 1099 healthy Iranians aged 18–69 years. Samples of 24-hour and fasting morning spot urine were collected to measure sodium and potassium excretions. Tanaka’s formula was utilized to predict the 24-hour sodium and potassium urinary excretions based on the spot values. Results: The difference between measured and estimated sodium excretion values was 4265 mg/day (95% CI: 4106–4424; P < 0.001) and 2242 mg/day in case of potassium excretion (95% CI: 2140–2344; P < 0.001). There was a weak significant correlation between the 24-hour urine sodium and potassium excretion and the predicted values (intraclass correlations: 0.22 and 0.28, respectively; both P < 0.001). Conclusion: The weak association between the predicted and measured values of sodium and potassium along with the marked overestimation of daily sodium and potassium excretions based on the spot urine and using Tanaka formula indicates that Tanaka formula is not practical for the prediction of sodium and potassium or salt intake in Iranian adults. Using other spot urine sampling times and/or adopting a formula designed based on the characteristics of the Iranian population may increase the validity of spot urine tests.


1987 ◽  
Vol 252 (1) ◽  
pp. R1-R6 ◽  
Author(s):  
P. S. Cox ◽  
D. A. Denton ◽  
D. R. Mouw ◽  
E. Tarjan

Push-pull perfusion was performed at four different sites in the third cerebral ventricle of conscious sheep. The recovery of the infused solution was 75–90%, suggesting a localized change in the ionic composition and osmolality restricted to a relatively small area in the cerebrospinal fluid (CSF). Sodium and potassium excretion and urine flow were studied before, during, and after perfusion of 200, 150, and 100 mM Na-CSF. Localized perfusion in the anterior dorsal third ventricle (AD3V) of 200 mM Na-CSF caused an increase in sodium and potassium excretion, in urine flow, and a decrease in free water clearance. Perfusion of 200 mM Na-CSF at the other three perfusion sites, i.e., anterior ventral third ventricle, posterior dorsal third ventricle, and posterior ventral third ventricle, did not influence sodium excretion and urine flow. Perfusions with 150 and 100 mM Na-CSF did not cause any change in sodium, potassium excretion, or urine flow at any of the four perfusion sites. These results suggest that sensors sensitive to changes of sodium concentration are located close to the ventricular surface in the anterior dorsal part of the third cerebral ventricle. When stimulated with increased sodium concentration they will initiate increased sodium excretion.


1985 ◽  
Vol 3 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Sakina Hoosen ◽  
Yackoob K. Seedat ◽  
Ahmed I. Bhigjee ◽  
Rajeshkumar M. Neerahoo

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