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Total body water, extracellular water, plasma volume, and total body potassium in cirrhosis of the liver

Ganzkörperwasser, Extrazellulärwasser, Plasmavolumen und Ganzkörperkalium bei Lebercirrhose

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Zusammenfassung

Untersucht wurden die Flüssigkeitsräume Extrazellulärwasser (82-Bromid; ECW), Ganzkörperwasser (3-THO; TBW), Intrazellulärwasser (ICW=TBW-ECW) und Plasmavolumen (51-Chrom; PV), sowie das Ganzkörperkalium (40-K; TBK) bei Lebercirrhotikern (n=12) im Vergleich zu einer Kontrollgruppe (n=12). Die auf das Körpergewicht bezogenen Größen ECW (39%), TBW (28%), ICW (19%) und PV (24%) fanden wir bei den an Lebercirrhose Erkrankten vergrößert, das Ganzkörperkalium (% des Sollwertes) um 28% erniedrigt. Diese Ergebnisse weisen darauf hin, daß bei der Lebercirrhose weniger die sogenannte fettfreie Substanz (lean body mass; LBM) als vielmehr die intrazelluläre Kaliumkonzentration verringert ist. (Cirrhose: 84±21 mol/l ICW; Kontrolle: 115±23 mmol/l ICW). Als Ursachen werden ein vermindertes Kalium (mmol) pro Zelle und eine vergrößerte intrazelluläre Wasserkonzentration (ml/kg) diskutiert. Die Korrelation zwischen dem TBK (%) und dem Serum-Kalium (mmol/l) beträgtr=0,56 (p<0,002). Die klinisch chemischen Parameter γ-Globuline, Cholinesterase, Serumnatrium und Albumine (g/l PV) korrelieren signifikant mit den charakteristischen Veränderungen der Flüssigkeitsräume und des Ganzkörperkaliums. Hierbei ist das auf das Körpergewicht bezogene Gesamtalbumin trotz der relativen Hypoalbuminämie nicht erniedrigt. Unsere Ergebnisse sprechen für die ‘overflow theory’ der Ascites-Pathogenese (Lieberman et al., 1970).

Summary

Extracellular water (EWC; 82-bromide), total body water (TBW; 3-THO), intracellular water (ICW=TBW-ECW), plasma volume (PV; 51-Cr), and total body potassium (TBK; 40-K) were studied in patients with cirrhosis of the liver (n=12) and in controls (n=12). ECW (39%), TBW (28%), ICW (19%), and PV (24%) increased, TBK (28%) however, decreased in cirrhosis. The results indicate that it is less the lean body mass, but rather the intracellular potassium concentration that is lowered (cirrhosis: 84±21 mmol/l ICW; controls: 115±23 mmol/l ICW). Decreased potassium per cell (mmol) and increased intracellular water are discussed as possible reasons for this. The correlation between TBK (%) and serum potassium (mmol/l) was found to ber=0.56 (p<0.002). Correlations between the biochemical parameters gamma-globulins, cholin esterase, serum sodium and serum albumin (g/l PV) and characteristic fluid disturbances in cirrhosis are highly significant whereas albumin (g/kg bodyweight) was the same in both groups. We can support the ‘overflow theory’ of ascites formation [19].

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Authors and Affiliations

  1. Department of Radiology, Medizinische Hochschule Hannover, Germany

    O. Schober, P. Mariß, F. W. Schmidt & H. Hundeshagen

  2. Department of Internal Medicine, Medizinische Hochschule Hannover, Germany

    F. W. Schmidt

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  1. O. Schober
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  2. P. Mariß
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  3. F. W. Schmidt
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  4. H. Hundeshagen
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This paper is part of a medical doctorate of O. Schober

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Schober, O., Mariß, P., Schmidt, F.W. et al. Total body water, extracellular water, plasma volume, and total body potassium in cirrhosis of the liver. Klin Wochenschr 57, 757–761 (1979). https://doi.org/10.1007/BF01478033

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