Sodium homeostasis with chronic sodium loading in preascitic cirrhosis
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Summary
This summary is machine-generated.Patients with preascitic cirrhosis develop a natriuretic escape after three weeks of high sodium intake, leading to weight gain and compensated sodium retention without ascites. This indicates a complex, compensated sodium-retaining abnormality in early cirrhosis.
Area Of Science
- Nephrology
- Gastroenterology
- Cardiology
Background
- Patients with preascitic cirrhosis exhibit positive sodium balance on high sodium intake.
- Renal sodium handling beyond seven days in this population is not well understood.
Purpose Of The Study
- To investigate renal sodium handling in preascitic cirrhosis patients over five weeks of high sodium diet.
- To assess neurohormonal and hemodynamic changes associated with sodium balance.
Main Methods
- Sixteen preascitic cirrhotic patients were monitored weekly for five weeks on a 200 mmol sodium/day diet.
- Daily weight, 24-hour urinary sodium, fasting neurohormone levels, and hemodynamics were assessed.
Main Results
- A three-week high sodium diet induced weight gain, positive sodium balance, suppressed renin-aldosterone, and elevated atrial natriuretic peptide.
- Weight plateaued at week four with complete sodium balance and suppressed noradrenaline.
- Subsequent negative sodium balance and weight loss occurred, followed by complete sodium balance despite weight gain and normal renin-angiotensin-aldosterone levels.
Conclusions
- Preascitic cirrhotics demonstrate a natriuretic escape after three weeks of high sodium intake.
- This is linked to elevated atrial natriuretic peptide and suppressed renin-angiotensin-aldosterone system.
- Compensated sodium retention occurs with weight gain and presumed increased intravascular volume, but without ascites.