WATER STORAGE AND THE MOVEMENTS OF BODY FLUIDS AND CHLORIDES DURING ACUTE LIVER DISEASE

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Abstract
Periodic observations of the thiocyanate space, total blood, and plasma vols. were undertaken during the hospital course of 14 patients with acute infectious hepatitis under conditions of rigid water balance and correlated with measur-ments of plasma and urine chlorides, the tendency to retain ingested water as measured by a water tolerance test, and tests of liver function. During the acute phase of hepatitis, the thiocyanate compartment and blood and plasma vols. were found to be expanded. Depressed plasma and urinary chlorides as well as an increased tendency to retain ingested water accompanied these changes. With convalescence and improving liver function, shrinkage of the thiocyanate compartment and a decrease in the total blood and plasma vols. occurred. A diuresis and decreased tendency to retain ingested water was noted at this time and a rise in plasma and urinary chloride levels followed. The slight alterations in total circulating protein were thought to be attributable to nutritional factors and to decreased protein synthesis during hepatitis and were not considered to be of major importance in determining these fluid shifts. It is suggested that these movements in body fluids during acute infectious hepatitis may be directed by endocrine factors and related to incomplete inactivation of the antidiuretic principle by a damaged liver.