Salt Retention in Cirrhosis of the Liver 1

Goodyer, Allan V. N.; Relman, Arnold S.; Lawrason, F. Douglas; Epstein, Franklin H.

doi:10.1172/jci102344

Cited by 67 publications

(12 citation statements)

References 14 publications

(17 reference statements)

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“…Two out of five patients showed an impairment in ERPF and an abnormal elevation of filtration fraction. These findings agree with those reported in the literature (22)(23)(24)(25). It was difficult to cor-relate any impairment of renal function with the severity of the cirrhosis, degree of ascites or with any past history of cardiovascular renal disease.…”

Section: Discussionsupporting

confidence: 89%

“…They observed higher rates of glomerular filtration and effective renal plasma flow in patients without ascites or during active diuresis than in the presence of actively reaccumulating ascites. Patek and associates (23), and more recently Goodyer, Relman, Lawrason, and Epstein (24) observed that mean glomerular filtration rates and effective renal plasma flows were within normal limits in this disease. Farnsworth and Krakusin (25) showed that the electrolyte excretion in patients with hepatic cirrhosis and ascites resembled that seen in cardiac failure.…”

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confidence: 68%

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Reversal of Diurnal Variation in Renal Function in Cases of Cirrhosis With Ascites 12

Jones¹,

McDonald²,

Last³

1952

J. Clin. Invest.

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The mechanism for control of diurnal rhythm of water and electrolyte excretion remains obscure, though the fact that such a cycle occurs was reported by Quincke (1) in 1877 who pointed out that urinary output was appreciably higher during the day in contrast to night. Campbell and Webster (2,3) observed that the excretion of chlorides and urea was also higher during the day, though creatinine excretion remained more or less at the same level. Subsequent studies (Table I) by Kleitman (4), Simpson (5, 6), Norn (7), Manchester (8), Gerritzen (9), Brod (10), and Sirota, Baldwin, and Villarreal (11) confirmed the observations that urine flow and excretion of certain electrolytes decreased during the hours of deepest sleep in normal individuals.This rhythm was not reversed when normal subjects slept in the daytime and took food and worked at night as reported by Campbell and Webster (2, 3), and confirmed in studies of a night watchman by Jores (12). Gerritzen (13) studied the effect of exposure of four subjects to artificial daylight during the night, and darkness during the day. In three subjects duplication of the rhythm in water and chloride excretion resulted, with two maxima occurring at noon and at midnight. In the fourth subject the rhythm was completely reversed. Borst and de Vries (14) have pointed out the difficulty in evaluating the effect of daylight and of waking on diurnal rhythm, though in some of their subjects the response to the stimulus of daylight was prompt. Jores (12) reported the relative difficulty in reversing a rhythm by a reversal of routine, and this was further supported by Joslings' (15) observation that a subject on a boat going from east to west showed a peak urinary excretion one hour earlier every day, the peak remaining at the same hour on local time. Addis and associates (16) reported nocturnal depression of endogenous creatinine clearances.On the basis of U/P inulin ratios and creatinine clearance data, Sirota, Baldwin, and Villarreal (11) attributed the decrease in urine flow during sleep almost wholly to water reabsorption. The mechanisms of increased tubular reabsorption of water at night were not elucidated and significant diurnal variations in effective renal plasma flow were not noted (11).Reports of a reversal of renal function (Table II) began with Wilson's (17) observation that the day and night rates of excretion of water and solids were approximately the same in the presence of debility, and especially so in cardiac or renal disease. Quincke (18) confirmed these observations several years later, noting that patients with heart or kidney disease often had a peak of ditiresis during the night. Fishberg (19) attributed the nocturnal increase in urine flow in patients with nephritis and congestive heart failure to decreased renal venous pressure and increased cardiac output in the prone position. Subsequent work by Brod and Fejfar (20) and by Baldwin, Sirota, and Villarreal (21), employing clearance techniques, revealed an increased glomerular filtration rate and decrea...

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Section: Discussionsupporting

confidence: 89%

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confidence: 68%

Reversal of Diurnal Variation in Renal Function in Cases of Cirrhosis With Ascites 12

Jones¹,

McDonald²,

Last³

1952

J. Clin. Invest.

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“…The great veins (42), the right heart and pulmonary artery (43), the cranial cavity (44), the "cephalad portion of the body" (45), and the arterial pressoreceptors (46) (50,51), and hemorrhage (52,53) are associated with a diminution in total blood volume. In quiet standing (6), venous congestion of the limbs (54,55), partial occlusion of the superior or inferior vena cava (56), and portal hypertension (57), filtration from the capillaries is increased and in addition blood is pooled in the peripheral veins, away from the general circulation. Acute (58) and chronic (59,60) constrictive pericarditis, constriction of the pulmonary artery (61,62) and congestive heart failure are characterized by distention of the central veins with blood which the heart is unable to pump efficiently into the aorta.…”

Section: Excretion Of Electrolytes and Watermentioning

confidence: 99%

The Effect of an Arteriovenous Fistula on Renal Hemodynamics and Electrolyte Excretion 1

Epstein¹,

Post²,

McDowell³

1953

J. Clin. Invest.

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122

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“…When infusions of hypertonic saline are given to thirsted subjects, the rate of sodium excretion rises, but drops sharply when the serum sodium is suddenly restored to normal by the ingestion of a large quantity of water (49). Some workers have concluded that when an infusion of hypertonic saline is given, "changes in sodium excretion are invoked by differences between extracellular and intracellular osmotic pressures" (50).…”

Section: )mentioning

confidence: 99%

Studies of the Antidiuresis of Quiet Standing: The Importance of Changes in Plasma Volume and Glomerular Filtration Rate 1

Epstein¹,

Goodyer²,

Lawrason³

et al. 1951

J. Clin. Invest.

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Salt Retention in Cirrhosis of the Liver 1

Cited by 67 publications

References 14 publications

Reversal of Diurnal Variation in Renal Function in Cases of Cirrhosis With Ascites 12

Reversal of Diurnal Variation in Renal Function in Cases of Cirrhosis With Ascites 12

The Effect of an Arteriovenous Fistula on Renal Hemodynamics and Electrolyte Excretion 1

Studies of the Antidiuresis of Quiet Standing: The Importance of Changes in Plasma Volume and Glomerular Filtration Rate 1

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