Effects of angiotensin II on renal sodium handling and diluting capacity in man pretreated with high-salt diet and enalapril

Nephrol Dial Transplant. 1992;7(10):991-6.

Abstract

The antinatriuretic effect of angiotensin II (Ang II) is generally attributed to a decreased glomerular filtration rate (GFR) and an increased proximal tubular sodium reabsorption. We studied this by infusion of increasing amounts (1, 4, and 8 pmol/kg per min) of Ang II in seven water-loaded volunteers who were pretreated with enalapril and a high-salt diet. While mean arterial pressure increased from 92 +/- 3 mmHg to respectively 98 +/- 3, 110 +/- 2, and 116 +/- 2 mmHg, sodium excretion fell from 331 +/- 40 to 135 +/- 23, 65 +/- 17, and 63 +/- 22 mumol/min, and GFR from 138 +/- 9 to 128 +/- 6, 111 +/- 6, and 104 +/- 8 ml/min (P < 0.05 for each variable). At 1 pmol/kg per min, Ang II decreased maximal urine flow and the fractional excretions of lithium and uric acid. Urine sodium concentration decreased, whereas minimal urine osmolality remained unchanged. At 4 pmol/kg per min, these effects were more pronounced. Moreover, minimal urine osmolality increased from 58 +/- 4 to 72 +/- 8 mosm/kg, but sodium concentration decreased further. The step to 8 pmol/kg per min did not decrease sodium, lithium, or uric acid excretion further, but induced a further increase in minimal urine osmolality to 99 +/- 16 mosm/kg. These data suggest that the antinatriuretic effect of modestly hypertensive dosages of Ang II is not only due to a decrease in GFR and an increase in proximal sodium reabsorption, but also involves a rise in fractional reabsorption in a distal nephron segment. In addition Ang II decreases renal diluting capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin II / pharmacology*
  • Blood Pressure / drug effects
  • Dose-Response Relationship, Drug
  • Enalapril / pharmacology*
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Kidney / drug effects*
  • Kidney / physiology
  • Male
  • Renin / blood
  • Sodium / metabolism*
  • Sodium, Dietary / administration & dosage*

Substances

  • Sodium, Dietary
  • Angiotensin II
  • Enalapril
  • Sodium
  • Renin