Sodium excretion in advanced cirrhosis: effect of expansion of central blood volume and suppression of plasma aldosterone.

Abstract

Sodium excretion in 13 patients with decompensated cirrhosis was measured under baseline conditions of water loading (n = 13) and during conditions designed to improve effective blood volume including: head-out water immersion alone (n = 13); norepinephrine infusion alone (n = 6), and combined norepinephrine and head-out water immersion (n = 6). All 13 patients were in positive sodium balance under baseline conditions, with a mean plasma aldosterone concentration of 78.7 +/- 15.6 ng per dl. In only four patients was plasma aldosterone less than 50 ng per dl. During head-out water immersion alone, 5 patients achieved negative sodium balance and, in all 5, plasma aldosterone was less than 50 n..