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Vol. 289, Issue 1, 443-447, April 1999
Institute for Basic Psychiatric Research, Department of Biological
Psychiatry, Aarhus University Hospital, Denmark (K.T., M.B.); and
Department of Physiology and Centre for Nephrology, Royal Free and
University College Medical School, London, United Kingdom (D.G.S.)
Chronic treatment of rats with lithium leads to Na+ loss
and a reduced antinatriuretic response to aldosterone, suggesting that
lithium reduces conductive Na+ transport in the distal
nephron. This was investigated in the present study by measuring the
renal response to aldosterone infusion followed by amiloride in
chronically instrumented conscious rats given lithium for 3 to 4 weeks
to achieve plasma Li+ concentrations of approximately 0.5 mM. A servo-controlled infusion system was used to maintain sodium and
water homeostasis, thereby preventing misinterpretation of the findings
as a consequence of drug-induced changes in Na+ balance. In
a control group of rats, Na+ excretion decreased in
response to aldosterone (p < .01) and subsequent
amiloride administration led to a marked increase in Na+
excretion (p < .001). In contrast, in the
lithium-treated group, there was no significant response to either
aldosterone or amiloride. It is concluded that long-term treatment with
lithium, even when plasma Li+ concentrations are below 1 mM, reduces aldosterone-stimulated Na+ transport through
the amiloride-sensitive Na+ channels in the principal cells
of the distal nephron.
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