Rascher W, Tulassay T, Seyberth H W, Himbert U, Lang U, Schärer K
J Pediatr. 1986 Oct;109(4):609-14. doi: 10.1016/s0022-3476(86)80222-0.
The diuretic and natriuretic response to water immersion, which is known to increase effective central blood volume, was studied in eight edematous children with nephrotic syndrome. The rise in central blood volume was indicated by a decrease in hematocrit from preimmersion median of 40.2% to 38.6% during water immersion (P less than 0.05, Friedman test). Similarly, serum protein concentration fell from 36.7 gm/L to 33.5 gm/L (P less than 0.05). Water immersion induced diuresis from a preimmersion median of 0.33 ml/min/1.73 m2 to 1.52 ml/min/1.73 m2 (P less than 0.05). Osmolar clearance rose, as did sodium and potassium excretion. Urine osmolality fell during water immersion (P less than 0.05). Serum sodium concentration and plasma osmolality did not change. Plasma arginine vasopressin values fell from 11.1 pg/ml to 3.0 pg/ml (P less than 0.05), as did renin activity (8.5 ng to 5.2 ng angiotensin l/ml/hr, P less than 0.01), aldosterone (18.0 ng/dl to 10.1 ng/dl), and norepinephrine (344 pg/ml to 213 pg/ml, P less than 0.05). Water immersion produces a potent natriuretic and diuretic response in children with nephrotic syndrome.
对已知可增加有效中心血容量的水浸试验的利尿和利钠反应，在8名患有肾病综合征的水肿儿童中进行了研究。中心血容量的增加表现为水浸期间血细胞比容从浸前中位数40.2%降至38.6%（Friedman检验，P<0.05）。同样，血清蛋白浓度从36.7g/L降至33.5g/L（P<0.05）。水浸诱导利尿，尿量从浸前中位数0.33ml/min/1.73m²增至1.52ml/min/1.73m²（P<0.05）。渗透清除率升高，钠和钾排泄量也增加。水浸期间尿渗透压降低（P<0.05）。血清钠浓度和血浆渗透压未改变。血浆精氨酸加压素值从11.1pg/ml降至3.0pg/ml（P<0.05），肾素活性（从8.5ng/ml/hr降至5.2ng/ml/hr，P<0.01）、醛固酮（从18.0ng/dl降至10.1ng/dl）和去甲肾上腺素（从344pg/ml降至213pg/ml，P<0.05）也降低。水浸在患有肾病综合征的儿童中产生显著的利钠和利尿反应。
