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

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Abstract
Total exchangeable Na, total exchangeable K and total body water (TBW) were determined in nonedematous hospitalized "controls" and in edematous patients with cirrhosis of the liver and chronic congestive heart failure with the use of Na24, K42 and D2O as tracers. Total body water expressed as per cent of body weight is increased in edematous subjects; it averaged 58.6, 62.9 and 54.6% in male subjects with edema and cirrhosis and with edema and heart failure, and in "controls," respectively. Edema formation is associated with an increase in Nae by all criteria (per unit body weight, per unit "dry" body weight, per liter of body water and per meq of Ke). While the Nae/ "dry" body weight was highest in the edematous cardiac group, no difference was found in the ratios of Nae/TBW and Nae/Ke between edematous cirrhotic and edematous cardiac subjects. Selective or disproportionate accumulation of sodium with heart disease beyond that associated with edema formation was not demonstrated. Exchangeable K was decreased below normal standards when referred to either body weight or "dry" body weight in all groups of patients. There was no difference in body potassium between edematous and nonedematous subjects when referred to "dry" body weight. Edematous male cardiacs had the highest Ke/"dry" body weight, probably because total body fat was least in this group. Limitations in interpretation of these data are discussed.