COMPARATIVE-STUDY OF 2 TESTS OF RENAL DILUTING ABILITY IN BARTTERS-SYNDROME

COMPARATIVE-STUDY OF 2 TESTS OF RENAL DILUTING ABILITY IN BARTTERS-SYNDROME

Author Ferreira, Sandra Roberta Gouvea Autor UNIFESP Google Scholar
Kater, Claudio Elias Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract 1. Different results concerning distal NaCl reabsorption have been reported for patients with Bartter's syndrome in tests of renal diluting ability. We describe clearance studies performed on 3 patients with Bartter's syndrome using different routes for body fluid content expansion: water was given orally and 0.45% NaCl solution intravenously. The impact of fluid composition was evaluated in one patient who additionally underwent a ''reverse test'': i.e., intravenous 5% glucose in water and an oral load of 0.45% NaCl solution.2. Urine flow per ml glomerular filtration rate (GFR) reached higher levels when the iv route was used (20.6 +/- 1.8 vs 11.8 +/- 5.7%, P<0.05). Fractional excretion of Na+, Cl- and osmoles increased during NaCl infusion but not during the oral load. Also, distal delivery of solute increased and was greater than that observed in the oral test (21.9 +/- 5.5 vs 11.4 +/- 2.1%, P<0.05).3. In contrast, fractional distal chloride reabsorption in the iv test reached subnormal values which were lower than in the oral load test (65.0 +/- 11.2 vs 86.8 +/- 11.0%, P<0.05). A positive correlation was observed between distal delivery and Cl- fractional excretion (r = 0.87; P<0.005). In one patient, the 5% glucose infusion resulted in greater urine flow and distal delivery when compared to distilled water or 0.45% NaCl taken orally (28.1 vs 13.3 ml/min and 27.3 vs 12.8%, respectively). These values were as high as those observed during iv administration of hypotonic saline.4. The iv route was always associated with lower rates of fractional distal chloride reabsorption (70.7 vs 89.1%) regardless of the solute composition and should be recommended when testing the renal diluting ability of patients suspected of Bartter's syndrome.
Keywords BARTTERS SYNDROME
RENAL DILUTING ABILITY
FRACTIONAL DISTAL CHLORIDE REABSORPTION
Language English
Date 1994-05-01
Published in Brazilian Journal Of Medical And Biological Research. Sao Paulo: Assoc Bras Divulg Cientifica, v. 27, n. 5, p. 1181-1191, 1994.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Assoc Bras Divulg Cientifica
Extent 1181-1191
Access rights Closed access
Type Article
Web of Science ID WOS:A1994NN03700011
URI http://repositorio.unifesp.br/11600/43063

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account