Sodium Restriction and Cation Exchange Resin Therapy in Nephrotic Children

Probable Clinical Utility of Cation Exchange Resins

“…This analogy is supported not only by the well-documented changes following ammonium chloride administration but also 6y the invariable occurrence of hyperchloremia as a se-quel to the' use of any of the so-called Acidifying diuretics (11). It is true, as our own findings indicate (4), that frank acidosis and overbreathing may accompany the ingestion of acidifying resins, especially in patients with far-advanced renal failure. Since it is highly dubious that accentuation of a definite acidosis already present as a consequence of renal insufficiency exerts any further stimulus to urinary sodium and water losses, it is well to identify such patients and treat them either with lesser amounts of resin, or with non-acidifying resins in other cycles, or perhaps both.…”

“…The data which have been presented in the previous papers clearly indicate that the carboxylic cation exchange resins in the hydrogen, ammonium, sodium, and potassium forms individually or in combinations increase the stool excretion of sodium and potassium in man and dog (1)(2)(3)(4). In the amounts administered however, 20 to 60 g./ day, there was only a limited absolute increase in the stool content of sodium and potassium.…”

Biochemical Changes Accompanying the Ingestion of a Carboxylic Cation Exchanger in the Hydrogen, Ammonium, Sodium, Potassium, or Calcium Form

“…The fact that in this series no complications developed such as clinical acidosis or potassium intoxication does not mean that these exchangers can be used with impunity in all forms of renal disease. The risks and benefits have been described in greater detail in another paper in this series (5). Insofar as the current studies are concerned it should be emphasized that they were of limited duration and interrupted short of undesirable or dangerous changes when certain trends had become well established, as with the acidosis in GDe, Table I.…”

An Introduction to Experimental and Clinical Studies of Carboxylic Cation Exchange Resins

“…The possible influences of the steroids and of the trophic hormone or hormones of the adrenal on stool composition have been defined elsewhere (48). The fifth unit reports the events which occur in nephrotic children to whom an acidifying exchanger is administered during the course of essentially complete sodium restriction (49). In the sixth and final paper attempts are made to summarize and interconnect the findings of all the studies, to list logical sequellar investigations, and to predict the probable clinical utilities of the resins (50).…”