RÔLE OF SODIUM IN THE FORMATION AND CONTROL OF ASCITES IN PATIENTS WITH CIRRHOSIS

Abstract

The factors which might produce ascites in patients with cirrhosis are; 1) an increased production of adrenal salt-active hormones, 2) increased production of pituitary antidiuretic hormone by osmoreceptor stimulation, blood volume reduction which may cause 3) a decreased glomerular filtration rate and 4) activation of "volume receptors" to increase the production of antidiuretic hormone. A diet restricted in Na aggravates all of these ascites-forming mechanisms with the exception of the osmoreceptor stimulation which is reduced. Despite this, the control of ascites by salt restriction is usually effective and well tolerated. Dietary treatment of ascites in 25 patients with advanced cirrhosis resulted in 11 becoming clinically well.