[Sodium balance in Laennec's cirrhosis]

Area of Science:

• Hepatology
• Nephrology
• Endocrinology

Background:

• Decompensated alcoholic hepatic cirrhosis often presents with sodium and water retention.
• Pathogenetic factors for fluid retention can vary even within homogeneous patient groups.

Purpose of the Study:

• To investigate sodium and water balance in patients with decompensated alcoholic hepatic cirrhosis.
• To compare balance with biochemical and hemodynamic parameters.
• To evaluate the impact of rest, alcohol withdrawal, and dietary sodium on fluid balance.

Main Methods:

• Studied seven patients with decompensated alcoholic hepatic cirrhosis.
• Monitored sodium and water balance.
• Assessed biochemical and hemodynamic parameters.
• Observed patients with and without complications and those requiring specific medications.

Main Results:

• A significant frequency of spontaneous natriuresis, weight loss, and clinical improvement was observed with bed rest, alcohol withdrawal, and moderate sodium restriction.
• Spontaneous natriuresis was absent in patients with complications (renal failure, bleeding) and those requiring anti-aldosteronic drugs.
• Inappropriate use of diuretic drugs was noted.

Conclusions:

• Spontaneous natriuresis and improvement are possible in decompensated alcoholic cirrhosis under specific conditions.
• Complications and specific medical interventions impact fluid balance.
• A therapeutic strategy for hospitalized cirrhotic patients with fluid retention is suggested.
• Systematic assessment of water and sodium balance is recommended for all hospitalized patients.