Abstract
Potassium has been shown to suppress plasma renin activity (PRA). This study was designed to study the role of increased aldosterone production in the mediation of such a response. Five patients with adrenal insufficiency were placed on a diet of 60 meq potassium and 100-150 meq of sodium while receiving a constant amount of cortisone acetate and Florinef. Upright PRA was determined each day for 2-3 days in the control period and then for 3-4 days after potassium intake had been increased to 200-300 meq/day. Potassium loading induced a natriuresis. Hence, patients were either sodium replaced (six studies in four patients) or allowed to become sodium depleted (three patients). Potassium loading without replacement was associated with a decrease in weight, negative sodium balance, hyperkalemia, and a positive potassium balance. PRA rose during the experimental period. Potassium loading with sodium replacement was associated with little change in weight or sodium balance. Hyperkalemia and positive potassium balance were present to the same degree as found in the studies without sodium replacement. When all PRA values are considered (both morning and evening values) there was no significant change with potassium loading (+ 1.31 ng/ml per h; range + 6.9 to -2.0). We conclude that hyperkalemia or a positive potassium balance did not suppress PRA in Addisonian man in these studies when sodium balance was maintained, nor did it prevent a rise in PRA when sodium balance was negative.
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Selected References
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- Abbrecht P. H., Vander A. J. Effects of chronic potassium deficiency on plasma renin activity. J Clin Invest. 1970 Aug;49(8):1510–1516. doi: 10.1172/JCI106368. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brandis M., Keyes J., Windhager E. E. Potassium-induced inhibition of proximal tubular fluid reabsorption in rats. Am J Physiol. 1972 Feb;222(2):421–427. doi: 10.1152/ajplegacy.1972.222.2.421. [DOI] [PubMed] [Google Scholar]
- Brown R. D., Strott C. A., Liddle G. W. Site of stimulation of aldosterone biosynthesis by angiotensin and potassium. J Clin Invest. 1972 Jun;51(6):1413–1418. doi: 10.1172/JCI106937. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brunner H. R., Baer L., Sealey J. E., Ledingham J. G., Laragh J. H. The influence of potassium administration and of potassium deprivation on plasma renin in normal and hypertensive subjects. J Clin Invest. 1970 Nov;49(11):2128–2138. doi: 10.1172/JCI106430. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cain J. P., Tuck M. L., Williams G. H., Dluhy R. G., Rosenoff S. H. The regulation of aldosterone secretion in primary aldosteronism. Am J Med. 1972 Nov;53(5):627–637. doi: 10.1016/0002-9343(72)90158-1. [DOI] [PubMed] [Google Scholar]
- Cannon P. J., Ames R. P., Laragh J. H. Relation between potassium balance and aldosterone secretion in normal subjects and in patients with hypertensive or renal tubular disease. J Clin Invest. 1966 Jun;45(6):865–879. doi: 10.1172/JCI105402. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cohen E. L., Grim C. E., Conn J. W., Blough W. M., Jr, Guyer R. B., Kem D. C., Lucas C. P. Accurate and rapid measurement of plasma renin activity by radioimmunoassay. Results in normal and hypertensive people. J Lab Clin Med. 1971 Jun;77(6):1025–1038. [PubMed] [Google Scholar]
- Cooke C. R., Brown T. C., Zacherle B. J., Walker W. G. The effect of altered sodium concentration in the distal nephron segments on renin release. J Clin Invest. 1970 Sep;49(9):1630–1638. doi: 10.1172/JCI106380. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooke C. R., Horvath J. S., Moore M. A., Bledsoe T., Walker W. G. Modulation of plasma aldosterone concentration by plasma potassium in anephric man in the absence of a change in potassium balance. J Clin Invest. 1973 Dec;52(12):3028–3032. doi: 10.1172/JCI107501. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooke C. R., Ruiz-Maza F., Kowarski A., Migeon C. J., Walker W. G. Regulation of plasma aldosterone concentration in anephric man and renal transplant recipients. Kidney Int. 1973 Mar;3(3):160–166. doi: 10.1038/ki.1973.24. [DOI] [PubMed] [Google Scholar]
- Dluhy R. G., Axelrod L., Underwood R. H., Williams G. H. Studies of the control of plasma aldosterone concentration in normal man. II. Effect of dietary potassium and acute potassium infusion. J Clin Invest. 1972 Aug;51(8):1950–1957. doi: 10.1172/JCI107001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dluhy R. G., Underwood R. H., Williams G. H. Influence of dietary potassium on plasma renin activity in normal man. J Appl Physiol. 1970 Mar;28(3):299–302. doi: 10.1152/jappl.1970.28.3.299. [DOI] [PubMed] [Google Scholar]
- Flamenbaum W., Kotchen T. A., Nagle R., McNeil J. S. Effect of potassium on the renin-angiotensin system and HgCl 2 -induced acute renal failure. Am J Physiol. 1973 Feb;224(2):305–311. doi: 10.1152/ajplegacy.1973.224.2.305. [DOI] [PubMed] [Google Scholar]
- Gall G., Usher P., Melby J. C., Klein R. Effects of aldosterone and cortisol on human erythrocyte Na efflux. J Clin Endocrinol Metab. 1971 Apr;32(4):555–561. doi: 10.1210/jcem-32-4-555. [DOI] [PubMed] [Google Scholar]
- Gordon R. D., Wolfe L. K., Island D. P., Liddle G. W. A diurnal rhythm in plasma renin activity in man. J Clin Invest. 1966 Oct;45(10):1587–1592. doi: 10.1172/JCI105464. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jorgensen P. L. Regulation of the (Na+ equals K+)-activated ATP hydrolyzing enzyme system in rat kidney. II. The effect of aldosterone on the activity in kidneys of adrenalectomized rats. Biochim Biophys Acta. 1969 Nov 18;192(2):326–334. [PubMed] [Google Scholar]
- Kahn M., Bohrer N. K. Effect of potassium-induced diuresis on renal concentration and dilution. Am J Physiol. 1967 Jun;212(6):1365–1375. doi: 10.1152/ajplegacy.1967.212.6.1365. [DOI] [PubMed] [Google Scholar]
- Kotchen T. A., Mauli K. I., Luke R., Rees D., Flamenbaum W. Effect of acute and chronic calcium administration on plasma renin. J Clin Invest. 1974 Dec;54(6):1279–1286. doi: 10.1172/JCI107873. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LARAGH J. H. The effect of potassium chloride on hyponatremia. J Clin Invest. 1954 May;33(5):807–818. doi: 10.1172/JCI102952. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Laragh J. H., Sealey J., Brunner H. R. The control of aldosterone secretion in normal and hypertensive man: abnormal renin-aldosterone patterns in low renin hypertension. Am J Med. 1972 Nov;53(5):649–663. doi: 10.1016/0002-9343(72)90160-x. [DOI] [PubMed] [Google Scholar]
- Meyer P., Menard J., Papanicolaou N., Alexandre J. M., Devaux C., Milliez P. Mechanism of renin release following furosemide diuresis in rabbit. Am J Physiol. 1968 Oct;215(4):908–915. doi: 10.1152/ajplegacy.1968.215.4.908. [DOI] [PubMed] [Google Scholar]
- Robb C. A., Davis J. O., Johnston C. I., Hartroft P. M. Effects of deoxycorticosterone on plasma renin acitivity in conscious dogs. Am J Physiol. 1969 Apr;216(4):884–889. doi: 10.1152/ajplegacy.1969.216.4.884. [DOI] [PubMed] [Google Scholar]
- Schneider E. G., Lynch R. E., Willis L. R., Knox F. G. The effect of potassium infusion on proximal sodium reabsorption and renin release in the dog. Kidney Int. 1972 Oct;2(4):197–202. doi: 10.1038/ki.1972.95. [DOI] [PubMed] [Google Scholar]
- Sealey J. E., Clark I., Bull M. B., Laragh J. H. Potassium balance and the control of renin secretion. J Clin Invest. 1970 Nov;49(11):2119–2127. doi: 10.1172/JCI106429. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shade R. E., Davis J. O., Johnson J. A., Witty R. T. Effects of renal arterial infusion of sodium and potassium on renin secretion in the dog. Circ Res. 1972 Nov;31(5):719–727. doi: 10.1161/01.res.31.5.719. [DOI] [PubMed] [Google Scholar]
- Silva P., Hayslett J. P., Epstein F. H. The role of Na-K-activated adenosine triphosphatase in potassium adaptation. Stimulation of enzymatic activity by potassium loading. J Clin Invest. 1973 Nov;52(11):2665–2671. doi: 10.1172/JCI107460. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thurau K. W., Dahlheim H., Grüner A., Mason J., Granger P. Activation of renin in the single juxtaglomerular apparatus by sodium chloride in the tubular fluid at the macula densa. Circ Res. 1972 Sep;31(9 Suppl):182–186. [PubMed] [Google Scholar]
- Tuck M. L., Dluhy R. G., Williams G. H. A specific role for saline or the sodium ion in the regulation of renin and aldosterone secretion. J Clin Invest. 1974 Apr;53(4):988–995. doi: 10.1172/JCI107665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vander A. J. Control of renin release. Physiol Rev. 1967 Jul;47(3):359–382. doi: 10.1152/physrev.1967.47.3.359. [DOI] [PubMed] [Google Scholar]
- Vander A. J. Direct effects of potassium on renin secretion and renal function. Am J Physiol. 1970 Aug;219(2):455–459. doi: 10.1152/ajplegacy.1970.219.2.455. [DOI] [PubMed] [Google Scholar]
- Walker W. G., Cooke C. R. Plasma aldosterone regulation in anephric man. Kidney Int. 1973 Jan;3(1):1–5. doi: 10.1038/ki.1973.1. [DOI] [PubMed] [Google Scholar]
- Williams G. H., Dluhy R. G. Aldosterone biosynthesis. Interrelationship of regulatory factors. Am J Med. 1972 Nov;53(5):595–605. doi: 10.1016/0002-9343(72)90156-8. [DOI] [PubMed] [Google Scholar]
- Wright F. S., Strieder N., Fowler N. B., Giebisch G. Potassium secretion by distal tubule after potassium adaptation. Am J Physiol. 1971 Aug;221(2):437–448. doi: 10.1152/ajplegacy.1971.221.2.437. [DOI] [PubMed] [Google Scholar]
