MECHANISMS OF IMPAIRED WATER EXCRETION IN ADRENAL AND PITUITARY INSUFFICIENCY. III. THE EFFECT OF EXTRACELLULAR OR PLASMA VOLUME EXPANSION, OR BOTH, ON THE IMPAIRED DIURESIS*

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Abstract
The effects of saline or albumin infusions on the impaired water diuresis of 13 subjects with pituitary or adrenal insufficiency were compared with the effects of steroid administration. The moderate improvement of the impaired diuresis caused by volume expansion was probably due to the concomitant increase in renal hemodynamics, or solute excretion, or both. The greater improvement in the diuresis that followed gluco-corticoid administration was probably due to a primary and direct effect on the renal tubule, as well as a concomitant increase in renal hemodynamics, or solute excretion, or both. The results suggest that the impaired excretion of water in primary and secondary adrenal insufficiency is not caused by an "aberrant volume stimulus" to the release of ADH.