SALT RETENTION IN CIRRHOSIS OF THE LIVER 1

Abstract

500 cc. of 5% saline was infused into normal adults and into patients with cirrhosis, most of whom had normal glomerular filtration rates (mannitol) and renal plasma flows (p-aminohippurate). All subjects were deprived of food and water for 12 hrs. before the infusion and for 6-8 hrs. thereafter. The concns. of serum Na rose about 10 meq./l. during the infusion in all expts., and remained elevated during the subsequent period of water deprivation, during which time the normal subjects and 2 cirrhotics without ascites or edema excreted 12-54% of the admd. Na. The concns. of Na in their urines increased to as much as 267 meq./l. and their rates of Na excretion increased greatly. In contrast, during the same period, the cirrhotics with edema and/or ascites excreted 0.2-10% of the admd. Na. The concns. of Na in their urines increased to a maximum of 102 meq./l., and their rates of Na excretion increased only minimally. These results are interpreted as evidence of a specific impairment of the renal mechanism for the excretion of admd. Na in cirrhotics with edema and/or ascites. The clearance data indicate the probability that dietary Na is retained by the kidneys of these patients as a result of its increased tubular reabsorption, the stimulus for which remains obscure.