ANIMAL EXPERIMENTS RELATING TO WATER DIURESIS TESTS FOR ADRENAL INSUFFICIENCY1

Abstract

ROBINSON, Power and Kepler (25) have proposed a relatively simple two part procedure as an aid in the diagnosis of Addison's disease. This was based on their own and certain older observations of tlowntree and Snell (26) and of Maranón et al. (20). The first part of their test (subsequently referred to as the R-P-K test) was simply a determination of whether or not the excretion of ingested water was at a normal rate. If this response was normal, adrenal insufficiency was considered to be eliminated; if it was sub-normal, further exclusive measures based on chloride and urea clearance were suggested to establish adrenal insufficiency with certainty. The present discussion is concerned with some animal experiments which bear on the first part of this diagnostic procedure or the “water test.” At the time this was proposed for clinical use we had been using tests based on the same principle to detect deficient adrenal function in experimental animals—a method which developed from the earlier experimental work of Rigler (24), Swingle, Parkins, Taylor and Hays (35), and Gaunt, Remington and Schweizer (13). Subsequent work has resulted in the accumulation of considerable information concerning the deficiencies in handling water in adrenal insufficiency, and some of this relates potentially to the uses and limitations of water diuresis tests in clinical conditions. Part of this work is summarized here with a consideration of three questions primarily in mind, viz.: