TOTAL EXCHANGEABLE SODIUM, TOTAL EXCHANGEABLE POTASSIUM, AND TOTAL BODY WATER IN EDEMATOUS PATIENTS WITH CIRRHOSIS OF THE LIVER AND CONGESTIVE HEART FAILURE1

Abstract

The application of isotope-dilution methods to the study of body composition has provided ac-curate in vivo estimates of the amount of body so-dium, potassium, chloride, water, and fat in nor-mal human subjects of both sexes at many age levels (1-10). Similar studies in a variety of dis-ease states have shown changes in body compo-sition characterized by decreases in body fat, cell mass, and body potassium, and increases in body sodium and water, when these values are expressed on a body weight basis (11-16). While this pat-tern of change in composition is apparent in chron-ically ill or acutely stressed patients who are free of edema, it is particularly pronounced in edema-tous subjects (13, 14, 16-18). These studies, however, have not indicated whether there are changes in the proportions of body sodium, potas-sium, and water which are specific for a disease state. Recently, Farber and Soberman (19) noted that edematous patients with heart disease have less body water and a higher ratio of ex-changeable sodium to body water than edematous patients with hepatic or renal disease. They sug-gested that heart failure invokes an increase in body sodium content out of proportion to the gain of extracellular water. Similar comparative stud-' This work was financed by grant-in-aid support from