The mechanism of the natriuresis of fasting.

@article{Sigler1975TheMO,
  title={The mechanism of the natriuresis of fasting.},
  author={Miles H. Sigler},
  journal={The Journal of clinical investigation},
  year={1975},
  volume={55 2},
  pages={
          377-87
        }
}
  • M. Sigler
  • Published 1 February 1975
  • Medicine
  • The Journal of clinical investigation
This study tests the hypothesis than obligatory cation coverage of metabolicaly generated anions is the mechanism for the sodium diuresis of fasting. Nine obese female subjects were equilibrated on a constant sodium and caloric intake and then fasted while sodium intake was maintianed. Particular activity schedule during fasting as during control. Consecutive 3-h increases in urinary sodium , ammonium, and potassium excretion during fasting were matched against simultaneously determined… 
View on PubMed
jci.org
76 Citations
Background Citations
8

Figures and Tables from this paper

76 Citations

Role of ketogenesis in urinary sodium excretion: elucidation by nicotinic acid administration during fasting.
TLDR
The relationship between UKBV and UNBV was examined after 1 week of starvation in 24 subjects on ad libitum water intake and 77 meq NaHCO3 and 40 meq KCl⁄day and there was a significant rise in both UKBv and UNaV during the 2 daytime periods compared to the baseline morning period.
Sodium balance and renal tubular sensitivity to aldosterone during total fast and carbohydrate refeeding in the obese.
TLDR
3 sets of facts indicate a definite biological activity of aldosterone during the initial phase of fasting with factor(s) interfering at the renal level with the normal expression of the hormonal action on sodium balance: a marked sodium-retaining effect of glucose can be demonstrated after ald testosterone action is blocked by spironolactone, and another indication that glucose stimulates sodium retention through mechanism(s).
On the relationship between ketonuria and natriuresis during fasting and upon refeeding in obese patients *
TLDR
The renal excretion of sodium, 3‐hydroxybutyrate (3‐OHB) and ammonium was determined in non‐diabetic obese subjects submitted to total fast according to the following protocols.
Renal concentrating ability in obesity. Effect of modified fasting and the supplementation of T3, sodium chloride and carbohydrate.
Hypotension and bradycardia during caloric restriction in mice are independent of salt balance and do not require ANP receptor.
TLDR
The data indicate that the hypotension induced by CR does not depend on increased sodium excretion, and it appears that the mouse responds to the low BP induced byCR with an increase in sodium reabsorption.
Natriuresis of fasting: the possible role of leptin-neuropeptide Y system.
TLDR
It is claimed that natriuresis of fasting is not only caused by diminished insulin resistance and hyperinsulinaemia with the subsequent reduction of renal sodium retention but it can also be attributed to the function of the leptin-NPY system.
Natriuresis in rats acutely depleted of chloride.
TLDR
It is postulated that chloride depletion imposes limitations on sodium reabsorption in the ascending limb of the loop of Henle.
Fasting-Induced Natriuresis and SGLT: A New Hypothesis for an Old Enigma
TLDR
A role is proposed for enhanced post-prandial proximal tubular sodium uptake, mediated by increased glucose–sodium co-transport, as daily filtered glucose increases, and reduced sodium uptake when glucose reabsorption diminishes, which may provide a physiologic basis for fasting-related reduced blood pressure in hypertension.
Changes in blood pressure and in vasoactive and volume regulatory hormones during semistarvation in obese subjects.
Increased ketone utilization by the kidney reduces renal lactate uptake but does not affect tubular sodium reabsorption.
...
...

References

SHOWING 1-10 OF 40 REFERENCES
Studies on the natriuresis of fasting. I. Effect of prefast intake.
Glucose-induced alkalosis in fasting subjects. Relationship to renal bicarbonate reabsorption during fasting and refeeding.
TLDR
Investigation of the development of alkalosis in patients returning to caloric intake after a period of starvation finds that changes in bicarbonate reabsorption during fasting and refeeding may be secondary to alterations in the renal re absorption of sodium.
The mechanisms by which sodium excretion is increased during a fast but reduced on subsequent carbohydrate feeding.
TLDR
The patterns of electrolyte excretion indicated that a major factor responsible for the increased excretion of Sodium on fasting and for the retention of sodium on refeeding was a failure of ammonium excretion to keep pace with the changing output of organic acid.
The natriuresis of fasting: relationship to changes in plasma renin and plasma aldosterone concentrations.
TLDR
The relationship of changes in plasma renin and plasma aldosterone concentration to electrolyte balance was studied during total fasting and during sodium deprivation followed by total fasting, and there was a failure of PRC to increase in the expected manner despite a marked negative sodium balance.
Metabolic studies in prolonged fasting
The effect of carbohydrates on ammonium and ketoacid excretion during starvation.
TLDR
The excretion of ketoacids and ammonium in starving man is exquisitely sensitive to minute amounts of ingested carbohydrate; the change in ketonuria appears to be due to increased renal ketoacid reabsorption after carbohydrate ingestion; and the nitrogen-sparing effect of reducing renal ammonium output in starvation can be dissociated from nitrogen sparing occurring because of changes in urine urea excretion.
Postural naturiuresis and urine osmotic concentration in hydropenic subjects.
Pattern of sodium excretion accompanying starvation.
Salt excretion of fasting patients.
TLDR
It is suggested that early in fasting there was a loss of extracellular fluid, loss of water from reduction in cell volume and water loss from metabolism of cell substance, and these multiple factors accounted for the weight loss in excess of caloric expenditure.
Studies on the natriuresis of fasting. II. Relationship to acidosis.
...
...