Abstract
Edematous patients, irrespective of the concurrent disease, either maintain their weight from day to day and excrete sodium in the urine or gain weight and do not excrete sodium. Two simple tests to identify the patient with edema refractory to conventional therapy are to determine the rate of daily weight gain referable to intake of salt and to analyze the urinary sodium. Procedures advocated to overcome refractoriness to mercurial diuresis are designed to increase the sodium delivered to the distal portion of the nephron or to create a proper electrolytic milieu for mercurial action. Use of steroids appears empirical.
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