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Renal, Endocrine, and Hemodynamic Effects of Water Immersion in Humans

Murray Epstein

10.1002/cphy.cp040237

Source: Supplement 14: Handbook of Physiology, Environmental Physiology

Originally published: 1996

Published online: January 2011

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Characterization of the “Afferent” Limb of the Immersion Model
2 Characterization of the “Efferent” Limb of the Immersion Model
2.1 Renal Water Handling
2.2 Mechanisms of the Diuresis
2.3 Renal Sodium Handling
2.4 Dissociation of Natriuresis from Diuresis
2.5 Mechanisms of the Natriuresis
2.6 Renin‐Angiotensin‐Aldosterone System
2.7 Arginine Vasopressin (AVP) or Antidiuretic Hormone
2.8 Renal Prostaglandins
2.9 Atrial Natriuretic Peptides (ANF)
2.10 Humoral Natriuretic Factor
2.11 Catecholamines and Dopa‐Dopamine Systems
3 Considerations for Selecting Water Immersion for Studies of Volume Homeostasis
4 Studies of Disorders Characterized by Deranged Volume Homeostasis
5 Conclusions
Figure 1. Figure 1.

Schematic drawing of possible mechanisms whereby immersion‐induced central hypervolemia induces diuresis. Heavy arrows indicate pathways for which evidence is available; (—) signifies inhibitory action.

From Epstein 11 with permission
Figure 2. Figure 2.

Comparison of effects of immersion on rate of sodium excretion (UNaV) in subjects in balance on low‐sodium (top) and high‐sodium (bottom) diets. Shaded areas represent mean ± SE for control studies. A significant increase in UNaV occurs within the initial hour in sodium‐replete subjects, but is delayed to the 4th hour in subjects ingesting a sodium‐restricted diet.

Data from sodium‐restricted subjects from Epstein and Saruta 32 and for sodium‐replete subjects from Epstein et al. 16; figure from Epstein 11 with permission
Figure 3. Figure 3.

Schematic drawing of possible mechanisms whereby immersion‐induced central hypervolemia induces natriuresis. Heavy arrows indicate pathways for which evidence is available. Diverse hemodynamic, renal, and hormonal effectors act in concert to promote the natriuresis.

From Epstein 11 with permission
Figure 4. Figure 4.

Effect of water immersion on plasma ANP levels in 13 normal subjects. Within 30 min, immersion induced a marked increase in ANP that was sustained throughout immersion. Recovery was associated with a prompt return to the prestudy level. Results are mean ± SE. *P < 0.05 or more compared with the level at the end of the prestudy period.

From Epstein et al. 23 with permission.


Figure 1.

Schematic drawing of possible mechanisms whereby immersion‐induced central hypervolemia induces diuresis. Heavy arrows indicate pathways for which evidence is available; (—) signifies inhibitory action.

From Epstein 11 with permission


Figure 2.

Comparison of effects of immersion on rate of sodium excretion (UNaV) in subjects in balance on low‐sodium (top) and high‐sodium (bottom) diets. Shaded areas represent mean ± SE for control studies. A significant increase in UNaV occurs within the initial hour in sodium‐replete subjects, but is delayed to the 4th hour in subjects ingesting a sodium‐restricted diet.

Data from sodium‐restricted subjects from Epstein and Saruta 32 and for sodium‐replete subjects from Epstein et al. 16; figure from Epstein 11 with permission


Figure 3.

Schematic drawing of possible mechanisms whereby immersion‐induced central hypervolemia induces natriuresis. Heavy arrows indicate pathways for which evidence is available. Diverse hemodynamic, renal, and hormonal effectors act in concert to promote the natriuresis.

From Epstein 11 with permission


Figure 4.

Effect of water immersion on plasma ANP levels in 13 normal subjects. Within 30 min, immersion induced a marked increase in ANP that was sustained throughout immersion. Recovery was associated with a prompt return to the prestudy level. Results are mean ± SE. *P < 0.05 or more compared with the level at the end of the prestudy period.

From Epstein et al. 23 with permission.
References
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Article Title: Renal, Endocrine, and Hemodynamic Effects of Water Immersion in Humans
 

How to Cite

Murray Epstein. Renal, Endocrine, and Hemodynamic Effects of Water Immersion in Humans. Compr Physiol 2011, Supplement 14: Handbook of Physiology, Environmental Physiology: 845-853. First published in print 1996. doi: 10.1002/cphy.cp040237