尿崩症の臨床的観察-1-

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Water and electrolyte metabolism was studied in 25 cases with diabetes insipidus, and the following results were obtained:(1) Daily urinary volume in most of the cases (88%) did not exceed eight liters.(2) In the dilution and concentration test, their dilution capacity was not impaired, however, the urinary output per unit of hour was rather uniform, which was indicative of primary polyuria. On the contrary, there were variable degrees of severe impairment of their concentrating capacity.(3) Renal blood flow (RBF), renal plasma flow (RPF), glomerular filtration rate (GFR) and filtration fraction (FF) were not significantly different from those of normal subjects, whereas tubular reabsorption rate (TRR) was materially reduced (10 cases).(4) There was somewhat increased excretion rate of PSP (5 cases).(5) Serum antidiuretic substance (ADS) was at the lower range of that of normal in 6 out of 7 cases. There was also no daily or diurnal variation of ADS, and no decrease was observed following the water load by mouth.(6) By intravenous infusion of hypertonic saline solution, there was a slight decrease in urinary output in one of 4 cases, whereas there was a slight or moderate increase in urinary output in the rest of the cases without elevation of urinary and plasma chloride concentration ratio.(7) By intravenous administration of 0.8 to 2.0mg of nicotine, there was a slight decrease in urinary output in one of 3 cases, whereas no decrease in the rest of the cases.(8) There was no demonstrable change in serum electrolyte concentration (11 cases); there was, however, a marked increase in K/Ca as a result of increased serum potassium concentration following posterior pituitary transplantation.(9) Daily urinary output significantly decreased after posterior pituiatry transplantation, which was accompanied by increase in serum ADS, abolition of urinary dilution capacity and prolongation of time required for disappearance of the elevation produced by intradermally injected salt solution by method of McClure and Aldrich (2 cases). A slight decrease in RPF with increase in GFR, resulting in increase of FF, and elevation of TRR were observed following the transplantation (1 case).
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尿崩症の臨床的観察-1-

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