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KMID : 0438219720090010325
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Korea University Medical Journal
1972 Volume.9 No. 1 p.325 ~ p.369
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Study on the Renal Function of Sodium Excretion
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Abstract
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Since the disturbance of electrolytes is important aspect in the clinical medicine, the function of renal sodium excretion has been studied by many investigators. However the investigation of renal sodium excretion necessitates a sodium balance study for 3 to 5 days. Auther´s preliminary experiment showed that the major effect of sodium intake on urinary excretion of sodium terminats within 24 hours, particularly in about 12 hours. And also a constant content of water and sodium in the body is necessary throughout the study. Author designed the following new simple method to study the function of renal sodium excretion, which avoids the effect of sodium intake on urinary sodium excretion and keeps the body in constant condition of water and sodium. The new method of renal sodium excretion studies are as follows;
1. Basal sodium excretion test; After light supper, no water and sodium intake is allowed. On next early morning (about 12 hours fasting) after urine is voided, 100ml of water and 0. 15gm of salt are taken at the beginning of every hour. Collect urine each hour for 3 hours. The Na, Cl, K are measured in each hour.
2. Na-loading test; Following the basal sodium excretion test, 3gm of salt is loaded orally and also the procedure of basal sodium excretion test is continued for 4 hours. The Na, Cl, K in each urine are measured.
3. Na-deprivation test; After the light supper, no intake is allowed and on next early morning, after urine is voided, 100 ml of water alone is taken hourly for 7 hours. The Na, Cl, K in urine which is collected hourly are measured. During this study one or two eggs are alloweded for hunger. When a drug effect study is intended, after the procedure of basal sodium excretion (control) a drug is given in stead of salt loading. The data of these tests are read by absolute values of sodium excretion and the pattern of variation of Na amount in urine. Applying the author´s method, the renal sodium excretion is studied in 50 normal cases, 70 patients (21 cases of cerebral diseases, 16 cases of heart disease, 9 cases of chronic nephritis, 6 cases of liver cirrhcsis and 18 cases of hypertension) and also the effects of furosemide (7 cases), aminophylline (7 cases), digoxin (5 cases), mannitol (6 cases), reserpine (5 cases) and ismelin (2 cases) are studied and the results are as follows.
1. In normal basal sodium excretion, the amount of sodium excreted each hour varied 5-15mEq and the urinary sodium is high in the first hour, and decreases in the order of the 3rd and 2nd hour urine. By oral loading of 3gm salt, the urinary sodium increases in the 1st and 2nd hour urine after the loading. In deprivation test, the urinary sodium decreases since 17 hours after fasting.
2. The total exchangeable sodium measured in 5 cases shows the amount of urinary sodium excretion is well corelated with the amount of total exchangeable sodium in case of normal kidney function.
3. The basal sodium excretion is decreased in cerebral disease, hypertension, chronic glomerulonephritis and liver cirrhosis. It is normal in compensated heart disease.
4. The effect of urinary sodium excretion which starts in one hour lasting for few hours is most remarkable when furosemide is taken.
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