STUDIES IN DIURNAL VARIATION OF WATER AND ELECTROLYTE EXCRETION: NOCTURNAL DIURESIS OF WATER AND SODIUM IN CONGESTIVE CARDIAC FAILURE AND CIRRHOSIS OF THE LIVER 12

Abstract

Urine was collected every 4 hrs. from 8 normal individuals, 8 patients with compensated cardiac failure, and 13 patients with cirrhosis of the liver and ascites. The total vol. and the quantities of Na, K, and creatinine were determined tor each specimen. In the normal individuals a daytime max. excretion was found for each of the components measured which was in agreement with previously reported observations. SK of the 8 patients with compensated cardiac failure were found to have a marked nocturnal max. excretion of water and Na. Excretion of K did not show this marked alteration but tended to show either a flattening of the normal cycle or a slight nocturnal increase. Observations on the patients with cirrhosis of the liver and ascites showed a similar nocturnal excretion of Na and water with less marked changes in excretion of K. In both conditions creatinine excretion tended to be in the same direction as the other components; however, this was not entirely consistent and was not as marked. Possible mechanisms to account for the nocturnal diuresis of water and Na in these 2 classes of patients are discussed.