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.
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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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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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