Salt Loading in Renal Aldosteronism Before and After Nephrectomy

In the primary hyperaldosteronism discovered by Conn, a paradoxical phenomenon has been observed: in response to the rapid intravenous infusion of a hypertonic and isotonic solution of sodium chloride, diuresis increased abnormally and the urine contained a high concentration of sodium.1,2 The phenomenon has been described to occur in Cushing's syndrome,3,4 in essential hypertension,4,5 in the so-called autonomic insufficiency,6 as well as in healthy subjects treated with ganglionic blocking agents.7 In its genesis, significance has been attributed to high blood pressure,1-5 a potassium-depletion state,2 and to a loss of normal circulatory reflexes.2,6,7 It is a fact that in the patient with Conn's syndrome, the phenomenon disappears following surgical removal of the adrenal cortical adenoma.1,2 On the basis of the postoperative cessation of the increased rate of glomerular filtration evoked by the infusion, it has been suggested that in the genesis of