ON MAINTENANCE OF PROPER OSMOLALITY AND VOLUME OF BODY FLUIDS .3. DIURETIC EFFECT OF INTRAVENOUS AND INTRAGASTRIC SALINE INFUSIONS IN HUMAN

In 10 healthy subjects, in 5 patients with cirrhosis of the liver (with evidence of portal hypertension) and in 2 patients with chronic hepatitis the diuretic effects of 0.9% and of 0.45% saline given either by gastric tube or intravenously were studied. Urine volume, urinary sodium excretion and osmotic clearance were determined. In healthy subjects the diuretic response following 0.45% saline infused into the stomach is earlier and stronger, than the response following 0.45% saline infused intravenously. This difference was not observed with normal (0.9%) saline. Intravenous and intragastric infusions of 0.45% saline did not show a differing response in patients with severe liver disease. Our results can be interpreted as positive evidence of an osmoregulatory mechanism between the intestine and the hepatic veins in the human. The efferent limb of this mechanism is either humoral or nerval. The absence or inefficiency of this mechanism might be contributory to fluid retention in severe liver disease. © 1969 Springer-Verlag.