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Tubular sodium handling in cirrhotic patients with ascites as analysed by the renal lithium clearance method
Author(s) -
DIEZ J.,
SIMON M. A.,
ANTON F.,
INDART F. J.,
PRIETO J.
Publication year - 1990
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1990.tb01854.x
Subject(s) - sodium , reabsorption , medicine , natriuresis , endocrinology , renal sodium reabsorption , ascites , lithium (medication) , chemistry , renal function , kidney , organic chemistry
. The proximal and distal sodium reabsorption were calculated from lithium clearance in 21 healthy controls and 24 cirrhotic patients with ascites after 4 days under a sodium‐restricted diet. The values of fractional lithium clearance were lower in patients than in controls (7.37±0.87 vs. 18.13±1.76%, P < 0.001). Fractional proximal sodium reabsorption was increased in patients compared with controls (92.8±1.1 vs. 81.8± 1.7%, P <0.001). No differences were found in fractional distal sodium reabsorption between controls and patients (96.9 ± 0.8 vs. 98.6 ±0.1%). When patients were separated into two subgroups according to their sodium balance, it was found that fractional distal sodium reabsorption was increased in patients whose balance remained positive, compared with patients on a negative sodium balance (98.99 ±0.26 vs. 94.11 ± 1.50%, P <0.05). In addition, the natriuretic response to a specific dose of spirono‐lactone was higher in patients on positive sodium balance compared with patients on negative sodium balance (per cent increase in natriuresis after spirono‐lactone 300 mg day ‐1 : 355.24 ± 73.98 vs. 84.21 ± 15.8%, P <0.01). We conclude that proximal sodium reabsorption is increased in cirrhotics with ascites. In addition, distal sodium reabsorption is enhanced only in those patients which exhibit avid sodium retention.