title: Bed-rest-induced hypernatriuresis in cirrhotic patients without ascites: does it contribute to maintain 'compensation'?
abstract: Renal function, plasma renin activity, plasma aldosterone concentration and urine excretion of free norepinephrine were evaluated in 13 cirrhotics without previous or ongoing ascites and in 13 healthy subjects, after 6 days of controlled electrolyte intake (40 mmol of Na and 70 mmol of K per day) and during 24 h of recumbency. Plasma concentrations of the atrial natriuretic peptide (ANP) were also measured in 8 patients and 8 controls. Despite a low-normal filtered load of sodium (14.6 +/- 1.2 vs. 17.1 +/- 1.2 mmol/min), cirrhotic patients showed supernormal natriuresis (141.5 +/- 14.1 vs. 78.8 +/- 8.6 mmol/day; p < 0.001). Whereas the fractional excretion of sodium in these patients was twice that of controls (0.70 +/- 0.05 vs. 0.36 +/- 0.04%; p < 0.001), potassium excretion (42.5 +/- 2.7 vs. 43.1 +/- 2.7 mmol/day) and urine volume (1270 +/- 98 vs. 1452 +/- 148 ml/day) did not differ. In cirrhotics, plasma renin activity was reduced (0.50 +/- 0.12 vs. 1.39 +/- 0.33 ng/ml/h; p < 0.02), and plasma aldosterone concentration tended to be lower (66 +/- 10 vs. 86 +/- 9 pg/ml; p = 0.09), while urine norepinephrine excretion did not significantly differ from controls (961 +/- 120 vs. 782 +/- 43 ng/h). ANP was higher in patients than in controls (92 +/- 17 vs. 48 +/- 9 pg/ml; p < 0.05). Natriuresis was directly correlated with ANP (r = 0.69, p < 0.005) and ANP/plasma aldosterone ratio (r = 0.63; p < 0.01) in patients and healthy subjects taken together.(ABSTRACT TRUNCATED AT 250 WORDS)
authors: Istituto di Patologia Speciale Medica e Metodologia Clinica, University of Bologna, Italy.
authors: F
authors: F
authors: Trevisani
authors: M
authors: M
authors: Bernardi
authors: A
authors: A
authors: Gasbarrini
authors: M R
authors: MR
authors: Tamè
authors: S
authors: S
authors: Giancane
authors: P
authors: P
authors: Andreone
authors: M
authors: M
authors: Baraldini
authors: C
authors: C
authors: Cursaro
authors: A
authors: A
authors: Ligabue
authors: G
authors: G
authors: Gasbarrini
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood; D001510:Bed Rest; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D005919:Glomerular Filtration Rate; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007677:Kidney Function Tests; D008103:Liver Cirrhosis / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009318:Natriuresis / Q000502:physiology*; D009638:Norepinephrine / Q000652:urine; D012044:Regression Analysis; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology
chemical_list: D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D012083:Renin; D009638:Norepinephrine