Summary
Since the reabsorption of lithium occurs almost exclusively in the proximal tubule and is associated with that of sodium, the fractional excretion of lithium (FELit) ws examined in 18 patients with cirrhosis in order to examine the reabsorption rate of sodium at the proximal tubule. As expected, the fractional excretion of sodium (FENa) was significantly lower in cirrhotic patients with ascites (0.43±0.10%, mean±SEM) than in cirrhotic patients without ascites (0.75±0.14%, P<0.05) and healthy controls (0.82±0.17%, P<0.05). By contrast, there was no significant difference in FELit among cirrhotic patients with ascites (16.7±2.0%), cirrhotic patients without ascites (15.4±2.0%) and controls (17.4±1.5%). It is unlikely, therefore, that in cirrhotic patients with ascites, the impaired sodium excretion is solely caused by the abnormal sodium reabsorption capacity of the proximal tubule.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Lieberman FL, Denison EK, Reynolds TB: The relationship of plasma volume, portal hypertension, ascites, and renal sodium retention in cirrhosis: The overflow theory of ascites formation. Ann NY Acad Sci 1970;170:202–212
Epstein M: Renal sodium handling in cirrhosis: A reappraisal. Nephron 1979;23:211–217
Epstein M: Deranged sodium homeostasis in cirrhosis. Gastroenterology 1979;76:622–635
Eptein M: Pathogenesis of renal sodium handling in cirrhosis. Am J Nephrol 1983;3:297–309
Unikowsky B, Wexler MJ, Levy M: Dogs with experimental cirrhosis of the liver but without intrahepatic hypertension do not retain sodium or form ascites. J Clin Invest 1983;72: 1594–1604
Schedl HP, Bartter FC: An explanation for and experimental correction of the abnormal water diuresis in cirrhosis. J Clin Invest 1960;39:248–261
Chiandussi L,Bartoli E, Arras S: Reabsorption of sodium in the proximal renal tubule in cirrhosis of the liver. Gut 1978;19:497–503
Chaimovitz C, Szylman P, Alroy G, et al: Mechanism of increased renal tubular sodium reabsorption in cirrhosis. Am J Med 1972;52:198–202
Thomsen K, Schou M: Renal lithium excretion in man. Am J Physiol 1968;215:823–827
Hayslett JP, Kashgarian M: A micropuncture study of the renal handling of lithium. Pflugers Arch 1979;380:159–163
Thomsen K, Holstein -Rathlou N-H, Leyssac PP: Comparison of three measures of proximal tubular reabsorption: lithium clearacne, occlusion time, and micropuncture. Am J Physiol 1981;241:F348-F355
Thomsen K, Schou M, Steiness I, et al: Lithium as an indicator of proximal sodium reabsorption. Pflugers Arch 1969;308: 180–184
Steele TH, Manuel MA, Newton M, et al: Renal lithium reabsorption in man: Physiologic and pharmacologic determinants. Am J Med Sci 1975;269:349–363
Thomsen K: Lithium clearance: A new method for determining proximal and distal tubular reabsorption of sodium and water. Nephron 1984;37:217–223
Onen KH: Renal hemodynamics in hepatic cirrhosis. Lancet 1960;1:203–204
Klingler EL, Vaamonde CA, Vaamonde LS, et al: Renal function changes in cirrhosis of the liver. Arch Intern Med 1970;125:1010–1015
Clapp JR, Robinson RR: Distal sites of action of diuretic drugs in the dog nephron. Am J Physiol 1968;215:228–235
Clapp JR, Nottebohm GA, Robinson RR: Proximal site of action of ethacrynic acid: Importance of filtration rate. Am J Physiol 1971;220:1355–1360
Rosin JM, Katz MA, Rector FC, et al: Acetazolamide in studying sodium reabsorption in diluting segment. Am J Physiol 1970;219:1731–1738
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hattori, K., Yauchi, T., Minato, Y. et al. A lithium clearance study of sodium reabsorption at the proximal tubule in liver cirrhosis with ascites. Gastroenterol Jpn 24, 535–539 (1989). https://doi.org/10.1007/BF02773881
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02773881