Skeletal muscle water and electrolytes in chronic renal failure. Effects of long-term regular dialysis treatment.

Abstract

Skeletal muscle water, Cl, Na and K were studied in 24 patients with predialysis chronic renal failure (CRF) and in 16 patients under regular dialysis treatment (RDT) for 8-16 years; 35 healthy controls were also examined. Total Cl, Na and water (Clm, Nam, TW) were high in both CRF and RDT groups (p less than 0.001); high TW in CRF was due to both extra (ECW) and intracellular (ICW) fractions, which were calculated from Cl space; in RDT only ECW was increased and ICW was normal. Muscle K was diminished in CRF, in reference to both muscle fat free dry solids and ICW, and it was slightly but significantly higher than normal in RDT. The findings demonstrate that high cell volume and low intracellular K observed in CRF are fully corrected by long-term hemodialysis, probably because these abnormalities are mainly related to cell function disturbances due to uremic state. On the contrary, the persistence of high total Cl, Na and muscle ECW seems to be an expression of expanded extracellular fluid volume.