Effects of water immersion on renal hemodynamics in normal man

Abstract

Although previous studies have demonstrated that water immersion to the neck (NI) results in a significant natriuresis and diuresis, the mechanisms are incompletely delineated. Since recent studies have demonstrated that NI induces a marked increase in cardiac index, it is possible that, as a consequence, renal hemodynamics may be augmented markedly during NI thereby mediating the encountered renal changes. The present study was undertaken to delineate the effects of NI on renal plasma flow and glomerular filtration rate as assessed by the clearance of PAH (CPAH) and inulin (CIn), respectively. Nine normal male subjects were studied on two occasions, control and NI. The conditions of seated posture and time of day were identical. Immersion did not alter CIn or CPAH at a time when sodium excretion was increasing markedly. The constancy of CPAH during NI suggests that renal blood flow is unaltered and that the natriuresis of NI is mediated independently of alterations in overall renal perfusion. The sluggish decline of a naturiuresis during recovery is consistent with the presence of a humoral factor contributing to the encountered natriuresis.