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Renal Response in Sepsis
Arlo S. Hermreck, MD, PhD;
Richard A. Berg, MD;
James R. Ruhlen, MD;
Richard I. MacArthur, MD
AMA Arch Surg. 1973;107(2):169-175.
Abstract
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A significant diuresis was associated with early sepsis in dogs allowed food and water at will, even though water intake was below or near control levels. This occurred at a time of fever (39.9 C) and of increased fluid losses in the region of inflammation. Acute plasma volume expansion with dextran 75 (Dextran 6%) in normal saline before and after sepsis resulted in a higher peak urine flow 193µl/min/kg) in the septic state than under control conditions (147µl/min/kg). Administration of vasopressin injection during acute plasma volume expansion resulted in a reduction in the diuresis during sepsis (84µl/min/kg), but not under control conditions. Acute pretreatment of animals with desoxycorticosterone acetate (DOCA) was ineffective in dampening the diuresis of sepsis (218µl/min/kg), whereas, chronic treatment (eight days) with DOCA augmented the peak diuresis seen in sepsis (258µl/min/kg) during acute plasma volume expansion. Thus, in this laboratory model, sepsis resulted in an early diuresis, a phenomenon that may be related to a disturbance in the antidiuretic hormone system.
Author Affiliations
Kansas City, Kan
From the Department of Surgery, University of Kansas Medical Center, Kansas City, Kan.
Footnotes
Accepted for publication March 30, 1973.
Read before the 30th annual meeting of the Central Surgical Association, Toronto, Feb 22, 1973.
Reprint requests to Department of Surgery, University of Kansas Medical Center, 39th and Rainbow Blvd, Kansas City, KS 66103 (Dr. Hermreck).
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