STUDIES ON WATER AND ELECTROLYTE-REGURATING HORMONESII. CLINICAL OBSERVATIONS ON THE DIURETIC EFFECTS OF ACTH, GLUCOCORTICOIDS, ADRENAL CORTICAL INHIBITOR, AMPHENONE OR ALDOSTERONE ANTAGONIST, SC-9420

摘要

Clinical observations were made on the diuretic effects of ACTH, gluco-corticoids, adrenal cortical inhibitor, amphenone or aldosterone antagonist, SC-9420. The following results were obtained.1. In patients with nephrotic syndrome treated with ACTH or some kind of glucocorticoids, three patterns of diuresis were noted, namely one preceding, others in parallel with and still others following the improvement of proteinuria.2. In patients with cirrhosis of the liver treated with amphenone or SC-9420, diureses of water, sodium and chloride were noted without the significant increase of potassium excretion. Sometimes a delayed onset of diuresis was noted.3. In nephrotic patients treated with glucocorticoids in combination with either amphenone or SC-9420, a rather prompt and marked diuresis was noted without any improvement of proteinuria.4. Balance studies for internal fluid shift during diureses induced by ACTH, some kind of glucocorticoids, SC-9420 or SC-9420 plus prednisolone demonstrated an increased excretion of water and sodium derived from both extra-and intracellular compartment, and also a transportation of potassium into intracellular compartment. Similar results were obtained during diureses induced by rest alone or rest with salt-free diet in normal subjects.5. Decreased urinary 17-ketosteroids and chemocorticoids in edematous patients were observed.On the basis of our observations, a working-hypothesis concerning the mecha-nisms of action of these agents was presented.