Abstract
It has been demonstrated that part of the normal human response to standing includes a fall in renal plasma flow (RPF), diminished glomerular filtration rate (GFR), a decrease in the urinary rate of excretion of sodium (N NaV), and antidiuresis. Seventeen patients with chronic congestive heart failure of various degrees of clinical severity were investigated, using a tilt table and alternating between the supine and 45-degree position, measuring changes in renal hemodynamics and electrolyte excretion in response to the postural variations. It was found that patients with a mild degree of congestive failure showed a response similar to normal, with an orthostatic fall in RPF, GFR, U NaV, U KV, and U ClV, and antidiuresis. As congestive failure became more marked, the orthostatic response was reduced, and in certain patients with severe failure there was essentially no response to the tilt position.
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