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Betydningen af kroppens stilling for det diuretiske respons ved behandling af dekompenseret cirrose og morbus cordis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • C Wilken-Jensen
  • H Ring-Larsen
  • Jens Henrik Sahl Henriksen
  • J Clausen
  • H Pals
  • N J Christensen
The diuretic effect of the supine position was evaluated in six patients with cirrhosis and ascites and six with congestive cardiac failure. All patients received 1 mg bumethanide intravenously and were randomly assigned to either bed rest in the supine position or normal daily activity in the upright position for the next six hours. The diuretic response was similar in patients with heart failure and cirrhosis, and was significantly greater in the supine than in the upright position: mean 1,133 v 626 ml/6 h (p less than 0.01). The natriuresis was similarly greater during recumbency: mean sodium 96 v 45 mmol (mEq)/6 h (p less than 0.01), and the excreted potassium in six hours was similar in both postures. The glomerular filtration rate was 100 and 66 ml/min (p less than 0.01) and the heart rate 76 and 83 beats/min (p less than 0.05) in the supine and upright positions, respectively. Plasma concentrations of noradrenaline, renin, and aldosterone rose significantly during the upright position. The results suggest that the attenuated response to intravenous bumethanide in the upright position and during normal daily activity may be due to the activation of several, homoeostatic mechanisms which may reduce the excretion of water and salt.
Udgivelsesdato: 1989-Jan-2
OriginalsprogDansk
TidsskriftUgeskrift for læger
Vol/bind151
Udgave nummer1
Sider (fra-til)13-5
Antal sider2
ISSN0041-5782
StatusUdgivet - 1989

ID: 18697636