Abstract
Abstract In order to define the alterations in body composition in cardiac patients with hyponatraemic hypochloraemia, the chloride space, total exchangeable chloride, sodium space, total exchangeable sodium and total exchangeable potassium were measured in 12 subjects with hyponatraemic hypochloraemia and in 12 patients with normonatraemia. The groups were selected to be comparable with regard to average body weight, mean age and sex distribution.Statistical analysis defined the pattern of body composition in the hyponatraemic hypochloraemic group in the light of the findings in the normonatraemic group as follows: 1. A significant and parallel decrement of serum chloride and serum sodium concentrations; 2. An unchanged chloride space and sodium space; 3. A parallel decrement of total exchangeable chloride and total exchangeable sodium, although not statistically significant; 4. A normal or increased total exchangeable chloride and sodium in relation to predicted normal values; 5. A normal distribution of sodium in relation to chloride space; and 6. A significant rise in serum potassium concentration and a tendency to decrease of total exchangeable potassium.While the interrelations between chloride space and sodium space and between total exchangeable chloride and total exchangeable sodium were the same in the two groups, the ratios of Cle/Na and Nae/Cl space were significantly lowered in the hyponatraemic hypochloraemic group.It is concluded that, although it is likely that a deficit of total exchangeable chloride in relation to total exchangeable sodium, associated with metabolic alkalosis and decreased total exchangeable potassium, may account in part for the hypochloraemia seen in both groups, the major cause of the marked hypochloraemia in the hyponatraemic group is apparently a dilution of chloride in an expanded extracellular phase caused by the water retention responsible for the hyponatraemia.
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