Proximal tubular transport and urinary excretion of sodium after renal denervation in sodium depleted rats

The effect of unilateral renal denervation on renal handling of water, sodium and potassium was studied with clearance and micropuncture techniques in sodium depleted anaesthetized rats in the nondiuretic state. In clearance experiments renal denervation resulted in a +140 and +320% increase in urine flow and potassium excretion, but sodium excretion of innervated (I) and denervated (D) kidneys was similar (I: 12.0±2.0, D: 14.0±3.6 nM·min^–1·g^–1; NS). However, upon the loop diuretic furosemide (1 mg·kg^–1), a marked denervation natriuresis was observed (I: 2.8±0.9, D: 5.9±1.0 M·min^–1;P<0.05) and denervation diuresis and kaliuresis persisted, too (+95 and +60%, respectively). Micropuncture results revealed that fractional reabsorption of filtrate to late proximal puncture site was depressed by renal denervation from 62 to 49% while no change in time control rats was seen (64±2 vs. 64±1%; NS). In micropuncture experiments besides augmented urine flow (+82%) from D kidneys also a small denervation natriuresis was present (I: 21.6±6.4, D: 29.2±7.0 nM·min^–1;P<0.05). It is concluded that the lack or marked attenuation of denervation natriuresis in sodium depleted rats were the result of an almost complete compensatory distal reabsorption of the excess sodium (but not of water and potassium) leaving the proximal tubule after denervation. The distal adaptive response can be overcome by furosemide.     

The role of the adrenergic nervous system in sodium and water excretion

Summary There is considerable evidence that the renal nerves contribute to the regulation of salt and water excretion by a direct effect on tubular reabsorption, independent of changes in renal hemodynamics. Whereas the effect of the adrenergic nervous system on sodium reabsorption appears to be established in anesthetised animals, it has been suggested that the basal activity of the renal sympathetic nerves in conscious dogs is too low to have a significant effect on sodium reabsorption by the proximal tubules. However, denervation natriuresis and diuresis has recently been demonstrated in conscious euvolemic and conscious volume expanded rats. The effects of renal nerve stimulation on the handling of sodium and water by the proximal tubule can be mimicked by infusion of the-adrenergic agonist norepinephrine and prevented by infusion of an-adrenergic antagonist. This confirms that it is mediated by-receptors. The adrenergic nervous system may have an independent role in the control of sodium excretion or may be complementary to other systems such as the renin-angiotensin-aldosterone system.     

Prostaglandin in renin release during sodium deprivation

This study was designed to examine the role of prostaglandins in the macula densa-mediated increase in plasma renin activity (PRA) during dietary sodium deprivation in rats. Micropuncture collections of early distal (ED) tubular fluid (TF) and measurements of PRA, arterial pressure (AP), and renal blood flow (RBF) were obtained in four groups of animals. Groups I and II received a normal Na diet and groups II and IV received a low Na diet; groups II and IV received indomethacin. Studies were performed after surgical denervation of the kidneys; AP and RBF were not different among the four groups of animals. EDTFna delivery was lower in groups III (0.20 +/- 0.04 neq/min) and in group IV (0.16 +/- 0.01 neq/min) animals on the low Na diet as compared with group I (0.34 +/- 0.02 neq/min) and group II (0.32 +/- 0.05 neq/min) animals on the normal Na diet. In association with the lower EDTFna delivery, the animals receiving vehicle in group III had an elevated PRA (31.46 +/- 8.81 ng/ml) as compared with group I animals on the normal Na diet receiving vehicle (4.78 +/- 1.64 ng/ml). This rise in PRA was abolished in the animals in group IV (4.06 +/- 0.81 ng/ml) that received indomethacin. We conclude that the increase in PRA, possibly resulting from macula densa receptor stimulation, during dietary Na deprivation is dependent on prostaglandin synthesis.     

Renal and hormonal responses to atrial natriuretic peptide infusions in goats on high and low sodium intake

Synthetic atrial natriuretic peptide (ANP) was infused intravenously (1 microgram min-1; 60 min) in five goats during two series of experiments. For at least 4 weeks before the ANP infusions the goats received either no salt supplementation (= low sodium diet), or were given 16 g NaCl mixed with the food each day (Na = 274 mmol day-1; high sodium intake). The goats were changed between the treatments at random. ANP infusions caused diuresis, natriuresis and haemoconcentration during both diets. The urinary Na excretion increased about four-fold during the high sodium intake, and about 10 times during the low sodium intake. The urinary K excretion increased significantly during the low sodium diet, but decreased slightly during the high sodium intake. During both diets the K excretion became significantly lowered after the infusions. The mean glomerular filtration rate (GFR) was generally lower during the low sodium diet, but increased significantly during ANP infusions on both diets. The GFR returned to baseline immediately after the infusions, in contrast to urine flow and urinary Na excretion. Renal free water clearance increased slightly at the end of the infusion during the low sodium diet, but did not change during the high salt diet. Plasma renin activity (PRA) and plasma aldosterone concentration fell during ANP infusions in goats on the low sodium intake, but did not change significantly during the high sodium diet. These results indicate that the diuresis and natriuresis observed during intravenous ANP infusions in goats are mainly due to increased GFR.(ABSTRACT TRUNCATED AT 250 WORDS)     

Supersensitivity of the renal tubule to catecholamines in the chronically denervated canine kidney

Experiments were performed on anesthetized dogs to study whether or not renal tubules of the chronically denervated kidney show supersensitivity toward circulating catecholamines. In one kidney the influence of plasma catecholamines was inhibited by intrarenal administration of the alpha adrenergic receptor blocker phenoxybenzamine (POB, 2 g/min), and renal parameters of the infused kidney were compared to those of the contralateral noninfused organ. Before POB infusion urine flow (V), urinary sodium and potassium excretion (U_NaV, U_KV) as well as clearance of inulin and PAH (GFR, C_PAH) were similar in infused and contralateral kidneys in all the groups studied. In dogs (n=8) with two innervated kidneys POB infusion elevated V and U_NaV by 53±13% and 102±34% (p<0.05). In dogs (n=8) with acute bilateral renal denervation POB administration failed to alter any of the measured parameters. In contrast, V and U_NaV from chronically denervated kidneys (n=7) were increased after POB infusion by 40±9% and 103±34% (p<0.05). Glomerular filtration rate, C_PAH and U_KV were not changed by alpha adrenoceptor blockade in any of the groups. In an additional group of animals (n=8) acute unilateral renal denervation increased V and U_NaV to a significantly higher extent (by 282±85% and 330±106%) than POB administration did in the innervated kidney and elevated U_KV (44±10%), too. It is concluded that supersensitivity to catecholamines developed in renal tubules of the chronically denervated dog kidney and, in consequence, circulating catecholamines at elevated plasma levels caused by surgery were capable of increasing tubular reabsorption of sodium and water.     

CNS-induced natriuresis and renal hemodynamics in conscious rats

Sodium excretion was studied following experimental elevation of cerebrospinal fluid (CSF) sodium in heterozygous and homozygous (DI) Brattleboro rats given exogeneous antidiuretic hormone. Sodium excretion increased 4.5-fold in heterozygous and 3.5-fold in DI rats. The natriuresis in both groups was rapid in onset and occurred with a simultaneous kaliuresis. Blood pressure increased approximately 10 mmHg in the heterozygous but not in the DI rats. Accordingly, increased blood pressure may contribute to the natriuresis but is not the sole mechanism. Plasma renin concentration did not change in the DI rats during high Na CSF infusion, and chronic bilateral renal denervation did not abolish the natriuresis. Glomerular filtration rate increased during the high Na period in both the intact and renally denervated rats. These data provide evidence that a natriuretic mechanism exists that is not mediated by changes in antidiuretic hormone, renal nerve activity, mean arterial pressure, aldosterone, or angiotensin II, and thus may be due to another circulating substance or natriuretic hormone. This hormone may act totally or in part by increasing glomerular filtration rate.     

Hepatic portal vein infusion of glucose on sodium excretion in the rat

Anesthetized rats were prepared with catheters in the hepatic portal (HPV) and femoral (FEM) veins and in the bladder or ureters. In some experiments the left kidney was denervated. HPV infusion of 1 M glucose at 2 ml/h for 20 min increased Na excretion by the kidney when given as a second infusion. Bilateral cervical vagotomy eliminated the increase in Na excretion during glucose infusion and uncovered a delayed decrease in Na and K excretion. Renal denervation attenuated the increase in Na excretion to HPV glucose. FEM infusion of glucose had variable effects, increasing Na excretion only after vagotomy. The results are interpreted to suggest that central and vagal receptors tend to enhance Na excretion whereas splanchnic nerve afferents and humoral mediator(s) have the opposite effect.     

Renal dopamine and noradrenaline excretion during CNS-induced natriuresis in spontaneously hypertensive rats: influence of dietary sodium

Abnormalities in dopamine (DA) and noradrenaline (NA) activities and sodium handling may be involved in the pathogenesis of hypertension. The present study was designed to investigate whether any differences exist between normotensive Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR) in urinary excretion of DA, NA and sodium after 15 weeks on a low, medium or high sodium diet and during a subsequent elevation of the cerebroventricular fluid sodium concentration (CNS-induced natriuresis). Seven features were noted: (1) Basal sodium and DA excretion after the diet regimen was correlated to the dietary sodium content in both strains, except that sodium and DA excretion in SHR showed no further increase after the high sodium diet over and above that after medium sodium diet. (2) For any given sodium diet, SHR excreted more DA and NA as compared with WKY. (3) Blood pressure in SHR, as opposed to that in WKY, was higher after medium and high sodium diet than after low sodium diet. (4) During CNS-induced natriuresis NA excretion decreased or remained unchanged in WKY, but increased in SHR. (5) The DA/NA excretion ratio during CNS-induced natriuresis increased in WKY while decreased in SHR, which would not favour a natriuretic/vasodilatory response in the latter. (6) The ability of SHR to respond with CNS-induced natriuresis was attenuated after high sodium diet. (7) The magnitude of CNS-induced natriuresis was in both strains correlated to the sodium diet; the higher the dietary sodium content, the greater the natriuretic response. In conclusion, the study shows some clear differences in the catecholamine and sodium handling between WKY and SHR which may be involved in the pathogenesis of hypertension in SHR. Furthermore, increased sodium in the diet sensitizes the brain and kidney to increase the ability to respond with natriuresis for a given sodium stimulus.     

Renal dopamine and noradrenaline excretion during CNS‐induced natriuresis in spontaneously hypertensive rats: influence of dietary sodium

Abnormalities in dopamine (DA) and noradrenaline (NA) activities and sodium handling may be involved in the pathogenesis of hypertension. The present study was designed to investigate whether any differences exist between normotensive Wistar–Kyoto rats (WKY) and spontaneously hypertensive rats (SHR) in urinary excretion of DA, NA and sodium after 15 weeks on a low, medium or high sodium diet and during a subsequent elevation of the cerebroventricular fluid sodium concentration (CNS‐induced natriuresis). Seven features were noted: (1) Basal sodium and DA excretion after the diet regimen was correlated to the dietary sodium content in both strains, except that sodium and DA excretion in SHR showed no further increase after the high sodium diet over and above that after medium sodium diet. (2) For any given sodium diet, SHR excreted more DA and NA as compared with WKY. (3) Blood pressure in SHR, as opposed to that in WKY, was higher after medium and high sodium diet than after low sodium diet. (4) During CNS‐induced natriuresis NA excretion decreased or remained unchanged in WKY, but increased in SHR. (5) The DA/NA excretion ratio during CNS‐induced natriuresis increased in WKY while decreased in SHR, which would not favour a natriuretic/vasodilatory response in the latter. (6) The ability of SHR to respond with CNS‐induced natriuresis was attenuated after high sodium diet. (7) The magnitude of CNS‐induced natriuresis was in both strains correlated to the sodium diet; the higher the dietary sodium content, the greater the natriuretic response. In conclusion, the study shows some clear differences in the catecholamine and sodium handling between WKY and SHR which may be involved in the pathogenesis of hypertension in SHR. Furthermore, increased sodium in the diet sensitizes the brain and kidney to increase the ability to respond with natriuresis for a given sodium stimulus.     

On the importance of CSF Na in the regulation of renal sodium excretion and renin release

Infusions (20 microliters/min) of isotonic (0.27 M) mannitol dissolved in Na-free artificial cerebrospinal fluid (CSF) were made for 2 h into the lateral cerebral ventricle (IVT) of conscious 68 h dehydrated sheep. The IVT infusion induced a conspicuous drop in renal sodium excretion and marked rise in plasma renin concentration (PRC). The antinatriuretic response to the IVT infusion was not altered by the intravenous administration of ADH or te converting enzyme blocker (SQ 14225, Captopril). Surgical bilateral renal denervation did not change the antinatriuretic response while the increase in PRC was extinguished. Samples of CSF were collected prior to, and 15 min after the end of the infusion. These showed a reduction in CSF [Na], while CSF osmolality remained unchanged. The study supports the view that sodium sensitive receptors close to the cerebral ventricular system participate in the regulation of renal sodium excretion and renin release, it also suggests that renal sodium excretion is affected by an unknown hormonal factor of cerebral origin, while the release of renin seen in response to a reduction in CSF [Na] is mediated by the renal nerves.     

Hemodynamic mechanisms influencing sodium excretion during angiotensin infusion.

To examine mechanisms of transition between antinatriuresis and natriuresis, angiotensin II was first infused intrarenally (0.001-0.07 mug/kg-min) in anesthetized dogs; glomerular filtration rate (GFR), sodium excretion, and intrarenal pressure (IRP), indicating tubular pressure, fell as during mechanical aortic constriction. During supplementary intravenous infusion (0.10-0.30 mug/kg-min), renal blood flow (RBF) rose toward control (tachyphylaxis). Tubular reabsorption increased but was still 17.1% below control. Filtration fraction averaging 0.31 remained constant. Sodium excretion and IRP exceeded control but were normalized by restoring renal arterial pressure mechanically. During intrarenal angiotensin infusion, carotid constriction increased blood pressure more, but RBF, IRP, and sodium excretion less than intravenous angiotensin. Intrarenal infusion of angiotensin at 0.10-0.20 mug/kg-min increased RBF and sodium excretion more in infused than in contralateral kidneys. Thus, angiotensin natriuresis depends on increased perfusion pressure and is augmented as tachyphylaxis develops. High correlation between sodium excretion and IRP at unchanged filtration fraction suggests a regulation of sodium excretion by hydrostatic rather than oncotic pressures in glomerular and peritubular capillaries.     

Abnormal relationship between sodium excretion and hypertension in spontaneously hypertensive rats

Summary Inulin clearance, single nephron glomerular filtration rate (SNGFR), Na and K excretion were studied following an acute saline infusion in spontaneously hypertensive (Okamoto strain) rats (SH). 1. Hypertonic saline load: experiments were performed in adult and young SH rats. As compared to control normotensive Wistar rats (NT), the sodium excretion rose much less following the load in SH. During the 75 min following the beginning of the load, adult SH excreted 15% (NT: 58%) and young SH 9% (NT=38%) of the sodium load (P<0.01 in both cases). Cin were similar in SH and NT during control period, and a similar increase was observed following the load. The superficial to juxtamedullary SNGFR ratio was 0.80±0.05 in 5 non diuretic adult SH, a value not different from that found in normal rats, and 0.87±0.07 in 3 salt loaded SH, indicating that no significant intrarenal GFR redistribution occurs in SH following an acute hypertonic saline load. 2. Following an isotonic saline load, the results were not different: the percentage of the sodium load excreted was 44±5% and 10±2% in NT and SH adult rats respectively.The possibility that the observed defect in sodium excretion of SH rats involves distal tubular function is suggested by the pattern of evolution in Na and K excretion.This work was partially presented at the Symposium on Current problems of Hypertension, 1973, Mainz (Germany).Maître de Recherches INSERM.     

Renal nerves in renal adaptation to dietary sodium restriction

To assess the physiologic importance of the renal nerves in the renal mechanisms for the maintenance of body sodium balance, renal adaptation to normal and low sodium diet was evaluated in conscious Sprague-Dawley male rats before and 8 days after recovery from bilateral surgical-pharmacological renal denervation. Renal denervation was confirmed in every rat at the end of the study by absence of renal vasoconstriction to splanchnic nerve stimulation and loss of renal tissue norepinephrine content. Daily sodium balance, defined as the difference between dietary sodium intake and urinary sodium excretion, was positive with the normal sodium diet before and after bilateral renal denervation. Prior to bilateral renal denervation, changing to the low sodium diet was associated with a diminishingly negative sodium balance for 3 days that became progressively positive thereafter. After bilateral renal denervation, changing to the low sodium diet was associated with a continuous and progressively negative sodium balance. We conclude that intact renal innervation is required for normal renal sodium conservation and maintenance of body sodium balance during dietary sodium restriction.     

Renal sodium excretion after oral or intravenous sodium loading in sodium-deprived normotensive and spontaneously hypertensive rats

Spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats that had been on a low sodium diet for 3 days were given 1.5 mmol sodium chloride kg^-1 body weight either orally or intravenously. The rats receiving an oral sodium load showed a greater natriuresis than those receiving the same saline load intravenously. No increase of renal sodium excretion was observed when the rats received a hypertonic mannitol solution orally. The cumulative sodium excretion during the 8 h following oral loading was two to three times larger in SHR than in WKY, whereas no difference between strains could be demonstrated after giving saline intravenously. Furthermore, after switching from normal to low sodium diet the rate of decrease of renal sodium excretion was greater in SHR than in WKY rats. It is proposed that there exists a gastrointestinal sensory mechanism for sodium controlling the renal sodium excretion. Furthermore, it is suggested that the function of this mechanism differs between SHR and WKY.     

Change of tubular reabsorption of sodium and water after denervation

1. Renal function was compared in dogs before and after denervation, with normal or reduced glomerular filtration rate (GFR). GFR was reduced by one of two means, aortic clamping or injection of plastic microspheres into one renal artery.

2. The data showed that the tubular rejection fraction of denervated kidneys increased at a time when the same value for the control kidney decreased, indicating that denervation diuresis is not simply a result of increased filtered load of Na and water.

3. Changes in excretion after aortic clamping are not due solely to reduced filtered load. A reduction in renal blood pressure itself appears to have a direct effect on Na transport since Na excretion was significantly decreased before there were any changes in GFR, renal plasma flow and urine volume.

4. When GFR in a denervated kidney was reduced by microsphere injection it was demonstrated that a significant natriuresis (U_Na V) and diuresis (V) occurred when. GFR was reduced by as much as 40%.

5. These experiments support the hypothesis that denervation diuresis does not result solely from increased filtered load, but entails altered Na transport.

     

Intrarenal distribution of blood flow and cortico-medullary sodium gradient after unilateral splanchnicotomy in the dog

1. Intrarenal distribution of blood flow and cortico-medullary sodium gradients have been studied in anaesthetized dogs, previously subjected to unilateral splanchnicotomy. Experiments were carried out on hydropoenic, normal, isotonic and hypotonic volume expanded animals.2. Polyuria and natriuresis were present under all experimental conditions after denervation.3. Denervation resulted in an increase in medullary blood flow, particularly in hydropoenic and normal dogs. In isotonic and hypotonic volume expansion, the increases in the medullary circulation were smaller despite a greater increase in urine flow and sodium excretion of the denervated side.4. Under no experimental condition did the cortico-medullary sodium gradient of denervated kidneys differ significantly from that of the intact kidneys.5. It is concluded that denervation polyuria might be attributed in part to an increase in medullary blood flow; the natriuresis, however, could not be accounted for by these circulatory changes. Other possibilities are discussed.     

Sodium balance during development of hypertension in the spontaneously hypertensive rat (SHR)

Sodium balance was studied in 7 and 16 week old male spontaneously hypertensive rats (SHR), in matched normotensive Wistar rats (NCR) and in Wistar Kyoto rats (WKR). The animals were placed in metabolic cages and given diets with either normal sodium content (5.35 mmol sodium/100 g food) or with a sodium content 3 or 10 times the normal. Whether on normal or increased sodium diet we did not observe any increased sodium retention in either SHR age group. However, in both SHR groups urinary sodium excretion was significantly decreased, while faecal sodium excretion was correspondingly increased compared with the controls. This shift of sodium excretion from kidneys to gastrointestinal tract in SHR did not reflect any ‘primary’ inability of the SHR kidneys to excrete sufficient sodium amounts since on high sodium diet they excreted the increased sodium load as readily as the normotensive controls. The present results do not support the concept that a primary renal retention of sodium and water should be of pathogenetic importance for the SHR variant of primary hypertension.     

Role of prostaglandin cyclooxygenase and cytochrome P450 pathways in the mechanism of natriuresis which follows hypertonic saline infusion in the rat

AIM: The prostaglandin cyclooxygenase (COX) and P450 cytochrome (CYP450) pathways of arachidonic acid metabolism are functionally interrelated and both engaged in control of sodium excretion; the study focused on their contribution to the natriuresis which follows hypertonic saline infusion in the rat. METHODS: In anaesthetized rats, clearance studies were conducted, supplemented with laser-Doppler measurements of the cortical and medullary blood flow (CBF, MBF), and measurement of medullary tissue admittance (Y), an index of interstitial ion concentration. RESULTS: Indomethacin (Indo), 5 mg kg(-1) i.v. paradoxically enhanced the natriuresis secondary to intra-aortic suprarenal 5% saline load, further increasing sodium excretion by 385 +/- 73% (P < 0.01). After acute clotrimazole, 10 mg kg(-1) i.v. an inhibitor of CYP450 epoxygenase, the increase in natriuresis was smaller and did not differ from that observed after the drug's ethanol solvent. In rats pre-treated with clotrimazole for 3 days, hypertonic saline loading increased sodium excretion (U(Na)V) to 0.94 +/- 0.22 micromol min(-1) , compared with a significantly greater (P < 0.05) increase to 2.76 +/- 0.48 micromol min(-1) measured in untreated controls. Indo increased U(Na)V twofold, similarly in the clotrimazole and in the control group; in the absence or presence of clotrimazole treatment, COX blockade significantly decreased MBF and increased Y. CONCLUSION: The data indicate that blockade of the CYP450 epoxygenase significantly impairs excretion of sodium in rats acutely loaded with hypertonic NaCl solution. The paradoxical post-Indo natriuresis is preserved in clotrimazole treated rats, which speaks against the role of CYP450 pathway in the response.     

A central osmosensitive receptor for renal sodium excretion.

1. The effect on renal Na and water excretion of increasing the NaCl concentration of blood supplying the brain was investigated in conscious water-loaded sheep. Intracarotid infusion ot 4 M-NACl at 0-8 ml./min for 60 min was compared with equivalent intrajugular infusion. 2. A more rapid increase in renal Na excretion and urine osmolality occurred with the intracarotid infusions than with intrajugular infusions. 3. Intracarotid infusions of 2 M sucrose or fructose at 1-6 ml./min for greater increase in renal Na excretion, urine osmolality and a decrease in urine flow rate. 4. The results suggest that there are receptors in the brain sensitive to changes in extracellular tonicity which influence renal Na excretion. It is possible that changes in ADH secretion alone mediate the early natriuresis seen with intracarotid hypertonic infusions although an alternative concurrent mechanism cannot be ruled out.     

Renal sodium handling in intact and renal denervated dogs

The ability to retain sodium was investigated in six conscious dogs before and after surgical renal denervation. Dietary sodium and water intake were kept constant (2.5 mmol Na X kg-1 bw X day-1 and 91 ml water X kg-1 bw X day-1). Balance experiments were performed from 6 days before to 8 days after having produced a sodium deficit of 6.4 +/- 0.4 (intact dogs) and 5.8 +/- 0.2 (renal denervated dogs) mmol Na X kg-1 bw by means of a peritoneal dialysis (PD). Having the same sodium excretion before PD, intact and renal denervated dogs demonstrated a similar striking decrease of sodium excretion and a similar increase of plasma renin activity after PD until the amount of sodium lost had been replenished (4th day after PD). In intact and renal denervated dogs plasma sodium concentration (PNa) decreased and renal water excretion increased on the first day after PD, indicating a homeostatic response to the fall of PNa. After dietary sodium restriction (from 2.5 to 0.5 mmol Na X kg-1 bw X day-1) a similar striking decrease of renal sodium excretion occurred in intact and renal denervated dogs. It therefore is concluded that in conscious dogs the presence of the renal nerves is not essential in order to maintain body sodium homeostasis after an acute sodium loss or after dietary sodium restriction.