However, we observed no difference in free water clearance.
limiting CLP-induced drop of urine output with limitation of free water clearance.
Sodium-free water clearance was estimated from an established equation using urine volume and urine and serum sodium [34].
Endotoxemia also can increase urine output and water clearance despite decrease in GFR due to tubular aquaporin-2 dysfunction [54].
In addition, no changes in free water clearance, urinary flow rate, or 24-hour Na excretion were demonstrated.
Likewise, in patients with septic shock, corticosteroids improved permeability of the glomerular endothelium [33] and normalized free water clearance and renal sodium excretion (Djillali Annane, personal communication).
In our study high respiratory rate reduced lung water clearance, which resulted in an increase of lung water content, indicating that increasing respiratory rate could augment VILI.
Mechanisms of renal IRI-induced lung injury are assumed to include a dysregulation of water clearance, inflammation, an innate immune response, proinflammatory cytokines, oxidative stress, and apoptosis [29].
Fig 2 shows the changes in urine output and sodium-free water clearance observed before and 24 h after administration of Tolvaptan, as well as the change in serum and urine osmolality.
In fact, clinical investigations have pointed out subtle defects in the maximum urinary dilution and free water clearance in patients with polydipsia and hyponatremia, perhaps in relationship with an enhanced sensitivity to arginine vasopressin [147, 148].
The ability to not only replace solute and water clearance but also active reabsorptive transport and metabolic activity will add additional benefit to the therapy of patients suffering from renal failure.
