THE RENAL EXCRETION OF CHLORIDE AND WATER IN DIABETES INSIPIDUS

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Abstract
The intraven. inj. of 2.5% NaCl soln. at 0.25 ml./kg./min. for 45 min. into normal subjects with a water diuresis caused a sharp reduction in urine flow. Inulin clearances revealed that the antidiuresis was the result of an increased tubular reabsorption of water. Similar treatment of 2 polyuric subjects with pituitary lesions (as suggested by other symptoms) augmented the diuresis. Since replacement therapy with pituitrin restored the responses of the polyuric patients to normal, it is concluded that the infusion of hypertonic saline causes a release of pituitrin in the normal subject and that it is ineffective in a subject whose neurohypophysis has been destroyed. An antidiuretic substance is excreted in the urine of a normal subject receiving hypertonic saline but is absent from the urine of the patients with pituitary disease. By this test, a polyuria resulting from habitual and excessive water drinking can be distinguished from a polyuria originating in a pituitary lesion. No consistent difference in Cl excretion by the 2 groups was disclosed.