Diminished sodium excretion is one of the factors underlying edema formation in congestive heart failure. The clinical improvement and disappearance of the edema in some cardiac patients treated with bed rest alone suggests the importance of exercise as a potentiating factor in the sodium retention. Exercise studies carried out in normal and cardiac patients in the upright position by other investigators are open to question since the upright position itself is a factor in diminished sodium excretion. In order to exclude postural effects completely, it became necessary to study renal hemodynamics and electrolyte and water excretion in supine exercising subjects.The present study reports the effect of exercise in the supine subject on renal plasma flow, glomerular filtration rate, sodium and water excretion. Fifteen control subjects and eleven cardiac patients were studied. The control series consisted of convalescent patients who presented no evidence of cardiovascular or renal disease. All of the cardiac subjects were receiving digitalis preparations. All had received mercurial diuretics, varying from one day to two weeks prior to the study. The cardiac subjects were divided into two groups depending on their clinical appraisal at the time of the study. In the "compensated" group were placed those patients who were ambulatory, able to lie flat and were free of edema. In the "severe" group were placed those patients who were confined to bed because of limited exercise tolerance. This group required more frequent mercurial diuretics and were orthopneic. With one exception, they were edematous at time of the study.
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