FACTORS INFLUENCING THE COURSE OF MERCURIAL DIURESIS DURING PITRESSIN® INFUSION IN NORMAL SUBJECTS 12

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Abstract
Mercurial diuresis during the intravenous infusion of Pitressin (1-3 [mu]g/kg/hour) reduces the hitherto highly concentrated urine nearly to isotonicity, suggesting that a small hypertonic moiety has been diluted by a relatively large volume of isotonic tubular fluid. This further implies that the tubular site of action of the mercurial is located at some point proximal to that of final elaboration of an isotonic tubular fluid or onset of anisosmotic absorption. On calculation, the Na and osmotic concentrations of the fluid unresorbed as a result of the mercurial''s effect are very slightly hypertonic relative to plasma during rising diuresis, and even more so during decreasing flows, suggesting that an even greater tubular re-absorption of water occurs after peak diuresis. This is corroborated by calculation of the "free water clearance," and implies that the subsidence of mercurial diuresis is not simply a dissipation of the drug effect, but, in part, is due to activation of compensatory counter-mechanisms promoting fluid retention.

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