Abstract
Metabolic balance studies were carried out in four patients with refractory edema with the use of the guanidine diuretic, amipramizide (MK 870), and ethacrynic acid. MK 870 caused limited natriuresis and little or no weight loss. In all patients ethacrynic acid induced natriuresis and weight loss. With ethacrynic acid and MK 870, potassium balance in the cardiac patient remained at control values. One cirrhotic patient was maintained in normal potassium balance with normal serum electrolytes. In the other cirrhotic patients there was negative potassium balance but it was of lesser magnitude with milder degrees of hypokalemic alkalosis. In all patients the natriuresis and weight loss were greater than after ethacrynic acid alone.
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