EFFECT OF EPINEPHRINE ON URINARY pH AND ELECTROLYTE EXCRETION IN MAN

Abstract

THE effect of epinephrine and nor-epinephrine on the kidney is a subject which has received considerable attention for many years. Earlier, most interest was focused on the effect of these hormones on the vascular bed. More recently, studies of the electrolyte changes have appeared (1–4).

It has been found that epinephrine and nor-epinephrine will cause a significant increase in the pH of the urine in rabbits (5); however, no such studies have been carried out in man.

Ureteral catheterization in our clinic has revealed that the urine coming from the kidneys almost invariably has a higher pH than that of bladder urine. In cases in which patients have had an adrenergic reaction from instrumentation, this difference in pH has been as much as 2.5 pH units.

The possible effect of epinephrine on urinary pH seems to be of more than academic interest. For instance, it has been shown that rabbits injected with hemoglobin will exhibit a physiologic increase in the pH of urine. This appears to prevent the precipitation of hemoglobin in the renal tubules. A prevention of this increase, which can be brought about by the administration of an antiadrenergic substance, may result in kidney damage (5). Miles and co-workers (6) have described an impressive water, sodium and chloride diuresis in a hypertensive subject in response to emotion.