ON THE RENAL SITE AND MODE OF ACTION OF GLUCOCORTICOID IN CIRRHOSIS*

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Abstract
The effects of methyl prednisolone on sodium excretion (UNaV) potassium excretion (UkV), glomerular filtration rate (G. F. R.), andthe renal concentrating operation were studied in hydropenic cirrhotic patients on a low salt diet. Drug administration to 3 patients for 8 days was associated with an increase in both maximal concentrating ability and negative free water clearance (TCH2O). Acute drug administration to patients during both steady and changing states of osmotic diuresis with mannitol was associated with decreased UNaV and increased TCH2O. No consistent change in UkV or G.F.R. was found. The data suggest that glucocorticoids increase sodium reabsorption in the ascending limb of Hente''s loop and by enhancing delivery of sodium to the medullary interstitium contribute to the extraction of more solute-free water from the collecting duct in hydropenic subjects.