STUDIES IN EDEMA. III. THE EFFECT OF PITRESSIN ON THE RENAL EXCRETION OF WATER AND ELECTROLYTES IN PATIENTS WITH AND WITHOUT LIVER DISEASE 12

Abstract

A method for studying pitressin antidiuresis was presented. The responses of 4 patients with disease and 7 control subjects without liver dysfunction to single intraven. doses of Pitressin were studied. The patients with liver disease included 3 with liver cirrhosis and ascites and 1 with active infectious hepatitis. None of the 11 patients had any detectable renal disease. Fasting subjects were given a continuous intraven. injn. of 5% glucose and water at an avg. rate of 10 cc./min. When the rate of urinary flow reached a plateau, 0.57 milli-units per kg. of Pitressin was injected rapidly into the infusion tubing near the needle. The urinary bladder was washed out with dist. water and aired at the end of each collection period through an indwelling 6-holed catheter. There was no significant difference in the Pitressin effect expressed as "per cent inhibition of diuresis" between the control subjects and the patients with liver disease. This similarity of Pitressin effect indicated that there is no defect in the mechanism of inactivation of Pitressin injected in physiol. dosage in this series of patients with liver disease. The possibility of over-production of antidiuretic hormone in these patients is discussed and evaluated. Under the exptl. conditions 0.57 milliunits per kg. of Pitressin, injected intraven., did not affect significantly the urinary excretion of Na, chloride, or K, but tended to cause a decrease in the concn. of serum Na only in the patients with liver disease. A table summarizes the literature dealing with the effect of posterior pituitary extracts on the urinary excretion of electrolytes.