Distribution, conjugation, and excretion of labeled aldosterone in congestive heart failure and in controls with normal circulation: development and testing of a model with an analog computer.

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Abstract
Distribution, conjugation and excretion of 3H-aldosterone have been studied in 21 patients. The results can be accurately simulated by compartmental analysis. When compared with normal controls, patients with congestive failure have a small initial volume of distribution and reduced clearance of aldosterone into liver, kidneys, and other tissues. In a steady state, the observed changes tend to increase the concentrations of the hormone and its metabolites in plasma; but large and rapid changes in plasma aldosterone follow variations in the rate of administration or secretion in patients with heart failure. The kidneys extract about 20% of arterial aldosterone in the steady state. Only a small fraction is excreted unchanged, while a large fraction is conjugated by the kidneys in a form which releases aldosterone on standing at pH 1 (acid-labile conjugate, ALC). ALC is rapidly excreted in urine, but flow from the kidneys to plasma can also be demonstrated in the first 10 minutes after giving an intravenous load of 3H- aldosterone. The average renal production of ALC is about 58% of the total ALC excreted in urine. Hepatic production accounts for the remainder.