{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T04:56:30Z","timestamp":1778820990309,"version":"3.51.4"},"reference-count":58,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,1,1]]},"abstract":"<jats:p>Objective.\u2003To assess the physiologic response to salt depletion in subjects with cystic fibrosis (CF) and control male adolescents for sodium balance, sodium space, and stimulation of the renin\u2013angiotensin\u2013aldosterone axis.<\/jats:p><jats:p>Design.\u2003Seven subjects with CF and six controls received a salt-replete (150 or 290 mmol NaCl per day) diet and then a salt-deplete (10 mmol NaCl per day) diet while in a clinical research center.<\/jats:p><jats:p>Results.\u2003Space maintenance: CF subjects responded to salt depletion with a greater weight loss than did controls (1.9 vs 0.8 kg) and a decrease in 24Na+ space, whereas controls maintained 24Na+ space. Paired (Na-deplete\/Na-replete) blood volumes decreased in subjects with CF, but not in controls. Renin\u2013angiotensin\u2013aldosterone axis stimulation: During salt repletion, subjects with CF had significantly higher aldosterone values than did controls in the afternoon, but not at 7:00 AM. During salt depletion, plasma renin activity and aldosterone increased significantly more in subjects with CF than in controls (renin, 35 vs 13 ng\/mL\/hour [9.7 vs 3.6 ng\u00b7L\u22121s\u22121]; aldosterone: 181 vs 101 ng\/dL [5021 vs 2802 pmol\/L]). Furthermore, the angiotensin antagonist saralasin increased renin much more in subjects with CF (154 vs 36 ng\/mL per hour [43 vs 10 ng\u00b7L\u22121 s\u22121]). Vasomotor functions: Mean arterial pressure was decreased in subjects with CF on both diets and decreased significantly more with low salt only in subjects with CF. During salt depletion, subjects with CF showed enhanced orthostatic tolerance (less heart rate increase with standing) compared with controls, thus obscuring their volume loss. The blood pressure response to an acute infusion of saralasin suggested that in salt-replete subjects with CF, but not in controls, angiotensin receptors were functional in maintaining vascular tone. During salt depletion, angiotensin was more important for maintenance of blood pressure in subjects with CF than in controls, because the saralasin-induced drop in blood pressure was 20%, ie, close to shock levels, in subjects with CF, and only 6% in controls.<\/jats:p><jats:p>Conclusion.\u2003The data suggest that patients with CF are so successful in compensating for volume depletion by vigorous activation of the renin\u2013angiotensin system that salt depletion\/dehydration cannot be recognized easily by routine clinical measurements, eg, capillary refill, serum sodium levels, or tachycardia.<\/jats:p>","DOI":"10.1542\/peds.101.1.48","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"48-56","source":"Crossref","is-referenced-by-count":23,"title":["Sodium Space and Intravascular Volume: Dietary Sodium Effects in Cystic Fibrosis and Healthy Adolescent Subjects"],"prefix":"10.1542","volume":"101","author":[{"given":"Gregory J.","family":"Legris","sequence":"first","affiliation":[{"name":"St Joseph's Hospital and Medical Center, Phoenix, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorr","family":"Dearborn","sequence":"additional","affiliation":[{"name":"Leroy W. Matthews Cystic Fibrosis Center, Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Stern","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics,"},{"name":"Leroy W. Matthews Cystic Fibrosis Center, Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia L.","family":"Geiss","sequence":"additional","affiliation":[{"name":"St Joseph's Hospital and Medical Center, Phoenix, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Hopfer","sequence":"additional","affiliation":[{"name":"Physiology and Biophysics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice G.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Leroy W. 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