Erich Koiw

Further Studies on Urinary Aldosterone in Human Arterial Hypertension.

Conclusion Our results indicate 1) increased aldosterone excretion in about 55% of patients, 2) a very significant difference between mean aldosterone excretion of patients with essential, renal or malignant hypertension as compared with normal subjects, 3) a much greater degree of fluctuation in serial daily aldosterone determinations in 2 early asymptomatic hypertensive patients as compared to a normal subject. These observations bring additional and direct evidence for an adrenal cortical disturbance in hypertensive cardio-vascular disease. Although the evidence is suggestive, it cannot be established at the present time if these findings play an etiological role in pathogenesis of arterial hypertension. They may provide the explanation for the successful use of salt depletion by chlorothiazide and mercurials as essential adjunct to the “effectiveness” of the present anti-hypertensive therapy.

Adrenocortical Hormones in Human Hypertension and Their Relation to Angiotensin

In summary, we have demonstrated that: (a) Infusions of epinephrine, norepinephrine, and phenylephrine in 5 per cent glucose for 7 to 10 hours have little effect on, or decrease, urinary aldosterone excretion. (b) Angiotensin II infusions markedly decrease sodium excretion and the Na/K ratio and increase the excretion of aldosterone; of its ring-A reduced metabolite, pregnane-3-α,18,21-triol,11,20-dione; and, to a much lesser degree, of cortisol and tetrahydrocortisone in all normal subjects studied. (c) In patients with benign essential hypertension, infusions of angiotensin also stimulate urinary aldosterone excretion hut have a completely opposite effect on electrolytes-that of increasing sodium output and the Na/K ratio. This basic difference in response to angiotensin points to a fundamental problem to be solved for a better understanding of the disease. It is felt that the relative or absolute excess of aldosterone over progesterone secretion may be the important adrenal disturbance among the basic factors involved in the pathogenesis of arterial hypertension. This disturbance is definitely linked with angiotensin and sodium regulation.

Newer Advances in the Pathogenesis of Human Hypertension: The Adrenal Cortex and Renal Pressor Mechanism.

Excerpt Recent studies from this laboratory have shown (1) an excessive fluctuation of daily urinary aldosterone in hypertensive patients, (2) a significant decrease (p < 0.001) in mean urinary pre...

Isolation of a steroid-like substance from urine and citrous fruits.

The isolation and the partial chemical and physicochemical characterization of a chloroform-soluble substance obtained from human urine and citrous fruit juices are presented. The urinary compound, designated as compound III, is present mostly as a conjugate hydrolyzed by animal β-glucuronidase whereas it is in free form in fruit juices. It is present in the urine of normal males and females and in a number of pathological conditions. Its urinary excretion is significantly increased as a result of diets rich in potassium (250 meq./day). In various paper chromatographic systems, the compound has a mobility similar to that of aldosterone. Detailed study of its chemical and physicochemical characteristics, including oxidative degradation and infrared and elementary analysis, suggests a steroidal or sesquiterpinoidal structure. However, at the present time, the data obtained do not permit the final elucidation of the chemical formula of compound III.