[Sodium balance in Laennec's cirrhosis]

Sodium and water balance of seven patients with decompensated alcoholic hepatic cirrhosis was studied and compared with biochemical and hemodynamic parameters. The pathogenetic factors of sodium and water retention are different also in a relatively homogeneous group of patients; in particular attention is drawn to one case with associated syndrome of likely inappropriate secretion of ADH (SIADH). However our data point out an elevated frequency of spontaneous natriuresis, weight loss and clinical improvement, with bed rest, alcohol withdrawal and dietary sodium intake only moderately reduced. Spontaneous natriuresis was not observed in two cases of decompensated cirrhosis with complication (pre-existing renal failure and oesophagogastric bleeding) and in one patient who needed anti-aldosteronic drugs. Evidence was observed of improper, especially domiciliary use of diuretic drugs. Moreover we suggest a therapeutic strategy in hospitalized cirrhotic patients with sodium and water retention. It is emphasized that studies about water and sodium balance should be systematically extended to any patient, when hospitalized, independently from any previous domiciliary treatment.