Effects of Na Restriction, K Supplement and Diuresis on Aldosterone Metabolic Clearance in the Normal Korean

한국인의 Aldosterone 대사 제거율에 미치는 Na 섭취제한, K 보충투여 및 이뇨의 영향

In the previous study of the release, excretion, and plasma concentration of aldosterone in normal Koreans, the author found that urinary aldosterone excretion and aldosterone secretion rate of the Korean who usually take high amount of salt are significantly lower, in compared to Americans, although the plasma concentration is only tended to be low. The control of plasma aldosterone level depends on the secretion rate and the metabolic clearance of the hormone. In this experiments, the metabolic clearance rate of aldosterone was determined in normotensive korean and the effects of adrenal stimulations on the rates were also studied in the same subjects. The metabolic clearance rate of the normal Korean was not significantly different from those of the American, and shown a little increase in response to sodium restriction. These results indicate that the decrease in secretion rate rather than the increase in metabolic clearance Tate is the major factor maintaining lower plasma aldosterone level. After furosemide diuresis, on the contrary, the removal of aldosterone showed significant the decrease despite slight increase of secretion rate. This suggest that the reduction in metabolic clearance rate of the hormone during volume depletion found to be major cause of high plasma concentration. Additional potassium supply produced detectable decrease of metabolic clearance rate, but the changes were smaller than that of secretion rate, which suggested that the higher secretion rate could account for elevated plasma concentration of aldosterone rather than metabolic clearance. Above results also support author's previous evidences that the normal Korean who already adapted to a high sodium diet have ability to produce adequate aldosterone activity without producing detectable changes on the metabolic clearance rate under the condition of sodium restriction with approp riate potassium intake.