Renin, aldosterone, urinary sodium and weight change in cirrhotic patients with ascites and sodium restriction.

To study the relalionship between Plasma Renin Activity (PRA), Plasma A1dost~one Concentralion (PAn and Urinazy Sodium Excretion iii 24 h voluma (UNaV), and Lo detcnnine Lhe prognosdc value of th~e vaiiables iii rdaticn to the r~ponse to sodium restnction, we studied 25 palients who had liva~ ciniiosis and non complicated ascites. A wi de vanation was found both in basal values and afta sodium restaiction, in PRA (13.7 ± 15.8 and 13.5 ± 14.7 ng/ml/h) and PAC (377.6 ± 437.5 and 441.1 * 439.1 pg/ml); UNa V was v~y low in both o~sions ~27 ± 33.8 and 16.7 ± 14.2 mmd). A positive correlation between PRA and PAC was found when Lhe sodium mIa ke was in Lhe range of 44 ± lOmEq/day, but not with severe sodium restnction. No negalive correlation vias found between PAC and UNa V, suggesting that otlier factors besides Aldosterone, are important in Lhe sodium retention found iii these patient.s. Ali patients with ao initial high tiNa V (> 30 mmol/24 h) have low PRA and PAC and lose w~ght; Lhe opposite is not mie. Tbis study contirins that PAC is n~ the only fac.tor in the renal sodium handling in drrhotic patients with ascites, and iixlicate that UNa V is of prognostic value for Lhe response to dietaiy sodium restrio. tion.