Hepatic cirrhosis: Effects of sodium chloride administration and restriction and of abdominal paracentesis on electrolyte and water

The formation of ascites and edema by patients with chronic liver disease can be controlled by rigid dietary sodium restriction (1-5). When sodium is administered, ascites formation re-com-mences while sodium excretion usually remains minimal. These facts have not yet been integrated with the factors usually considered contributory to the formation of ascites and edema, viz.: ele-vated portal pressure (6, 7), reduced serum albu-min concentration and colloid osmotic pressure (8-12), increased anti-diuretic activity (13), al-tered membrane permeability (4, 14), or altered renal tubular function (15). However, whatever the pathogenetic factors operating, fluid retention is readily conditioned by the sodium content of the diet. The observations reported here concern patients with cirrhosis of the liver with ascites and edema in whom the alterations in electrolyte and water balance attributable to abdominal paracenteses and to sodium chloride administration and restric-tion were studied under controlled conditions of food, water, and sodium chloride intake. iThis investigation was sponsored by the Commissio