DANIEL BICHET, M.D.; VICTORIA SZATALOWICZ, M.D.; CIDIO CHAIMOVITZ, M.D.; ROBERT W. SCHRIER, M.D.
Twelve stable cirrhotic patients with ascites received a 20 mL/kg water load. Seven patients had abnormal water excretion (27.3% ± 5.4% of the water load in 5 hours) and a minimal urine osmolality of 262 mosmol/kg water. Five patients excreted 82.6% in 5 hours and had a minimal urine osmolality of 65 mosmol/kg water. Mean plasma arginine vasopressin values after water load were significantly higher in Group 1 (1.34 ± 0.36 pg/mL) than in Group 2 (undetectable). An effective blood volume lower in Group 1 than Group 2 patients was suggested by a lower plasma albumin (2.5 versus 3.3 g/dL, p< 0.02), a higher pulse rate (96 versus 72, p < 0.001), a higher plasma renin activity (7.8 versus 1.5 ng/mL h, p < 0.005), a higher plasma aldosterone (66 versus 21 ng/dL, p < 0.05), and a lower urinary sodium excretion (2.7 versus 14.2 meq Na/5 h, p < 0.005). The results suggest that nonosmotic stimulation of vasopressin secondary to a decrease in effective blood volume is an important factor in the abnormal water excretion of cirrhosis.
BICHET D, SZATALOWICZ V, CHAIMOVITZ C, SCHRIER RW. Role of Vasopressin in Abnormal Water Excretion in Cirrhotic Patients. Ann Intern Med. 1982;96:413–417. doi: 10.7326/0003-4819-96-4-413
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Published: Ann Intern Med. 1982;96(4):413-417.
Gastroenterology/Hepatology, Liver Disease, Nephrology.
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