The Effect of Diuretics on Transplanted Kidneys

Abstract

The authors attempt to ascertain whether any type of diuretic stimulates a transplanted kidney to increased activity. Both autogenous and homogenous transplants were used. Experiments were usually started 30-48 hours after transplantation and continued at intervals until interruption of function in the transplant. NaCl, Na2SO4, diuretin, caffein, sodium benzoate, and urea were administered intravenously, and water given by stomach tube. Experiments on autogenous transplants demonstrated that active diuresis is produced by any of the diuretics. The effect is similar to that produced in a normal kidney by the same diuretic. Although a homogenous transplant secretes abnormally (albumen, pus, red blood cells), all types of diuretics affect it as they would an autogenous transplant. A diuretic increases output from a homogenous transplant which is functioning actively or fairly so. The fluid follows the general rule as to urine produced by diuretics, becoming more abundant, lighter in color, and of lower specific gravity. Generally diuresis is less marked than in an autogenous transplant or normal kidney. The amount of fluid secreted is apparently governed largely by pathologic changes in the transplant. Diuretics apparently are harmful to homogenous transplants, transient diuresis frequently reducing secretion to less than that previous to the injection; and they shorten the period of viability of the transplant. This is analogous to the effect observed clinically and experimentally in acute nephritis, when a diuretic often hastens death. The reason for this is not established, but a diuretic may cause damage by increasing blood pressure and volume of fluid circulating through the transplant, or induce edema of the cells.