Plasma Renin Activity and Urinary Sodium Excretion as Prognostic Indicators in Nonazotemic Cirrhosis with Ascites

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Abstract
Azotemia is an ominous prognostic sign in cirrhosis with ascites. To investigate whether other renal disturbances are prognostically significant, the renin-aldosterone system and Na excretion (UNaV) were studied in 75 patients who had nonazotemic cirrhosis with ascites; these were related to survival. On the basis of plasma renin activity patients were classified in 2 groups. Group I included 34 patients with normal renin activity (1.13 .+-. 0.69 ng/ml per h) and group II, 41 patients with high renin activity (7.46 .+-. 3.86 ng/ml per h). The 2 groups differed significantly (P < 0.001) in plasma aldosterone, UNaV and wedged hepatic venous pressure but not in clinical features, liver functions, glomerular filtration and renal plasma flow. Patients of group I lived significantly longer than those of Group II (the 50% survival rates were 28 mo. and 6 mo., respectively). Survival curves obtained after grouping the patients according to UNaV (higher and lower than 10 meq/day) were almost identical to those obtained according to renin activity. Plasma renin activity and UNaV apparently are of prognostic value in nonazotemic cirrhosis with ascites.