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      Renal Hemodynamic and Tubular Response to Furosemide in Man during Normal and Restricted Sodium Intake


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          To investigate the factors determining the natriuretic response to furosemide (F) during Na restriction, we performed clearance studies in 7 healthy humans on a daily Na intake of 200 and 20 mmol. The maximum urine flow during water loading (V<sub>max</sub>) and simultaneous F administration was used as index of tubular fluid output from the proximal tubules. The F-induced natriuresis was only moderately reduced during Na restriction (Na excretion on low vs. normal Na intake: 4.28 ± 0.25 vs. 4.94 ± 0.25 mmol/min; p < 0.05). The diminished natriuresis was mainly due to a significant fall in Na delivery to Henle’s loop of 0.51 ± 0.10 mmol/min which was either caused by a decrease in filtered Na load or a rise in fractional proximal reabsorption. Fractional distal Na reabsorption was less suppressible by F during Na restriction, but this contributed relatively little (0.15 ± 0.11 mmol/min) to the total reduction in Na excretion (0.66 ± 0.10 mmol/min). The F-induced increases in uric acid, phosphate, and bicarbonate excretion suggest an additional proximal site of action of F. This was confirmed by a rise in lithium clearance (C<sub>Li</sub>), another alleged index of tubular fluid delivery from the proximal tubules. However, the magnitude of the rise in C<sub>Li</sub> to values markedly exceeding V<sub>max</sub> suggest that C<sub>Li</sub> overestimates tubular fluid delivery to Henle’s loop during F administration.

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          Author and article information

          S. Karger AG
          10 December 2008
          : 54
          : 3
          : 208-213
          Department of Nephrology and Hypertension, University Hospital Utrecht, The Netherlands
          185856 Nephron 1990;54:208–213
          © 1990 S. Karger AG, Basel

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          : 10 July 1989
          Page count
          Pages: 6
          Original Paper

          Cardiovascular Medicine,Nephrology
          Water diuresis,Furosemide,Glomerular filtration rate,Lithium clearance,Natriuresis,Sodium intake


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