hard · MCAT bio-biochem

A researcher infuses a healthy volunteer with a large volume of isotonic saline. Over the next hour, plasma renin activity falls, and urinary sodium excretion rises substantially, even though plasma osmolarity and plasma Na^+ concentration remain essentially unchanged.

Which signal most directly triggers the natriuresis observed despite unchanged plasma osmolarity?

  1. Atrial stretch from the expanded plasma volume boosts atrial natriuretic peptide release, promoting renal Na^+ excretion regardless of osmolarity.
  2. Because plasma osmolarity is unchanged, ADH secretion rises to compensate, and the resulting water retention secondarily forces more Na^+ into the urine.
  3. The isotonic saline directly raises plasma Na^+ concentration, which osmoreceptors detect and use to suppress renin release.
  4. Reduced sympathetic tone from baroreceptor unloading directly increases the glomerular filtration rate enough to excrete the extra sodium load by filtration alone.

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