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- Title
Factors determining renal response to water immersion in non-excretor cirrhotic patients.
- Authors
Nicholls, K M; Shapiro, M D; Groves, B S; Schrier, R W
- Abstract
Non-excretor cirrhotic patients, defined by their inability to normally excrete a standard water load, display variable responses to head-out water immersion. The hemodynamic, hormonal, and renal functional status of fifteen such patients were analyzed relative to water excretion during head-out water immersion. Group 1 patients (N = 7) all excreted less than 40% of the water load during immersion, whereas excretion was greater than 40% in all eight patients in Group 2. Group 1 patients, when compared with Group 2, had more ascites, more diuretic resistance, lower serum sodium concentration (125 +/- 2 vs. 130 +/- 1 mEq/liter, P less than 0.05), and more impaired baseline water excretion (12.9 +/- 1.2 vs. 35.9 +/- 5.9% of water load in 5 hr, P less than 0.005). Systemic hemodynamic responses to water immersion were similar in both groups. Glomerular filtration rate and renal plasma flow were significantly more impaired in Group 1 patients (inulin clearance 28 +/- 6 vs. 62 +/- 9 ml/min/1.73 m2, P less than 0.05; para-aminohippurate clearance 212 +/- 35 vs. 357 +/- 37 ml/min, P less than 0.05). Concentrations of plasma vasopressin (1.7 +/- 0.5 vs. 0.8 +/- 0.1 pg/ml, P less than 0.05), renin (8.6 +/- 1.7 vs. 3.8 +/- 0.9 ng/ml/hr, P less than 0.05), aldosterone (82 +/- 14 vs. 39 +/- 10 ng/dl, P less than 0.05) and norepinephrine (1155 +/- 183 vs. 603 +/- 126 pg/ml, P less than 0.05) were all significantly higher in Group 1 than Group 2 patients during water immersion.(ABSTRACT TRUNCATED AT 250 WORDS)
- Publication
Kidney international, 1986, Vol 30, Issue 3, p417
- ISSN
0085-2538
- Publication type
Journal Article
- DOI
10.1038/ki.1986.200