The diuretic and natriuretic response to water immersion, which is known to increase effective central blood volume, was studied in eight edematous children with nephrotic syndrome. The rise in central blood volume was indicated by a decrease in hematocrit from preimmersion median of 40.2% to 38.6% during water immersion (P<0.05, Friedman test). Similarly, serum protein concentration fell from 36.7 gm/L to 33.5 gm/L (P<0.05). Water Immersion induced diuresis from a preimmersion median of 0.33 ml/min/1.73 m2 to 1.52 ml/min/1.73 m2 (P<0.05). Osmolar clearance rose, as did sodium and potassium excretion. Urine osmolality fell during water immersion (P<0.05). Serum sodium concentration and plasma osmolality did not change. Plasma arginine vasopressin values fell from 11.1 pg/ml to 3.0 pg/ml (P<0.05), as did renin activity (8.5 ng to 5.2 ng angiotensin l/ml/hr, P<0.01), aldosterone (18.0 ng/dl to 10.1 ng/dl), and norepinephrine (344 pg/ml to 213 pg/ml, P<0.05). Water immersion produces a potent natriuretic and diuretic response in children with nephrotic syndrome.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health