THE EFFECT OF HUMAN SERUM ALBUMIN, MERCURIAL DIURETICS, AND A LOW SODIUM DIET ON SODIUM EXCRETION IN PATIENTS WITH CIRRHOSIS OF THE LIVER 123

Abstract

11 patients with cirrhosis of the liver with ascites excreted only small quantities of Na in the urine regardless of either the quantity of salt admd. or the route of its admn. (oral and intraven.). The failure to excrete Na in amts. adequate Na equilibrium occurred in spite of the maintenance of a normal serum albumin concn. by repeated injns. of concd. salt-poor human serum albumin. The urinary excretion of sodium was usually increased by the admn. of salt-poor human serum albumin (intraven.) and also during a spontaneous decrease in ascites and edema formation. A low Na but otherwise adequate diet decreased the rate of ascites formation, while larger quantities of admd. Na led to a proportionately increased rate of formation. Although several factors might have led to the failure of these patients to excrete Na, there was no evidence that any one factor was solely implicated. The relative importance of the failure to excrete Na, of hypoalbuminemia, and of portal hypertension in the genesis of ascites could not be precisely defined.