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Research Article Free access | 10.1172/JCI106588
Division of Renal Diseases, Department of Medicine, The Mount Sinai Medical School of the City University of New York, New York 10029
Division of Nephrology, Department of Medicine, and the Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
Find articles by Bercovitch, D. in: JCI | PubMed | Google Scholar
Division of Renal Diseases, Department of Medicine, The Mount Sinai Medical School of the City University of New York, New York 10029
Division of Nephrology, Department of Medicine, and the Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
Find articles by Kasen, L. in: JCI | PubMed | Google Scholar
Division of Renal Diseases, Department of Medicine, The Mount Sinai Medical School of the City University of New York, New York 10029
Division of Nephrology, Department of Medicine, and the Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
Find articles by Blann, L. in: JCI | PubMed | Google Scholar
Division of Renal Diseases, Department of Medicine, The Mount Sinai Medical School of the City University of New York, New York 10029
Division of Nephrology, Department of Medicine, and the Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
Find articles by Levitt, M. in: JCI | PubMed | Google Scholar
Published May 1, 1971 - More info
After the relief of 24 hr of complete unilateral ureteral obstruction in the dog, the experimental kidney is characterized by a decrease in filtration rate and an increase in fractional and often absolute excretion of sodium before and after the administration of mannitol. In the hydrated state, the failure to conserve sodium is associated with increases in fractional free water clearance and fractional sodium supply to water-freeing sites signifying that the augmented sodium excretion is derived from a proximal source. In the hydropenic state there is decreased fractional free water reabsorption, and sometimes free water excretion, in the postobstructive kidney. An early plateau in free water reabsorption is associated with an increased fractional excretion of sodium. These findings are attributed to the early development of distal nephron impermeability to water as a result of enhanced distal tubular supply and transport of sodium. There is a decrease in maximal tubular reabsorptive capacity (Tm) of glucose in the post-obstructive kidney which is, however, less marked than the decrease in filtration rate. The fall in filtration rate is to some extent likely due to a dropping out of nephrons from the circulation while the remaining nephrons are hypoperfused. The magnitude of the sodium reabsorptive defect is markedly exaggerated as the concentration of nonreabsorbable solute (mannitol) in the glomerular perfusate is increased. It is concluded that the postobstructive increase in sodium excretion during mannitol administration is in part due to a limit in the capacity to reabsorb sodium against a concentration gradient in the proximal tubule.