Document Detail

Pregnancy: an overfill or underfill state.
MedLine Citation:
PMID:  3554999     Owner:  NLM     Status:  MEDLINE    
With pregnancy, the expansion of plasma and extracellular fluid volume, increased cardiac output, and increased glomerular filtration rate (GFR) and renal blood flow (RBF) are compatible with primary renal sodium and water retention with secondary enlargement of the vascular compartment (overfill hypothesis). Alternatively, a primary enlargement of the vascular compartment (eg, prostaglandin-mediated vasodilation and placental arteriovenous shunting) with secondary renal sodium and water retention (underfill hypothesis) is supported by the activation of the renin-angiotensin-aldosterone (RAA) system, resetting of vasopressin release and thirst to a lower plasma osmolality, and a further stimulation of the RAA system and vasopressin when pregnant rats' water intake is maintained at a level of a virgin rat fluid intake, diminished BP and increased cardiac output in the first trimester, and worsening of hyponatremia with sodium restriction in the pregnant but not the virgin rat. With the underfill hypothesis, normal sodium and water excretion with mineralocorticoid escape could be mediated by hormonally induced increases in GFR and RBF associated with pregnancy. The nature of such a hormone effect of pregnancy to enhance renal hemodynamics remains to be defined.
R W Schrier; J A Dürr
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  9     ISSN:  0272-6386     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  1987 Apr 
Date Detail:
Created Date:  1987-05-26     Completed Date:  1987-05-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  284-9     Citation Subset:  IM    
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MeSH Terms
Extracellular Space / physiology
Kidney / physiology
Osmolar Concentration
Plasma Volume
Pregnancy / physiology*
Renin-Angiotensin System
Water-Electrolyte Balance

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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