The Antidiuretic Activity of Plasma of Patients with Hepatic Cirrhosis, Congestive Heart Failure, Hypertension and Other Clinical Disorders1

The retention of water which occurs in hepatic cirrhosis and in congestive heart failure has been attributed by some investigators to an increase in the concentration of circulating antidiuretic hor-mone of the neurohypophysis. In support of this hypothesis are the reports of a diminished diuretic response to the ingestion of water (1, 2) and of an increased antidiuretic activity of the blood or urine of patients with ascites and edema. Critical exami-nation of such reports, however, reveals that the assay methods employed usually were neither sen-sitive nor precise (3) or that the number of sub-jects studied was too small for statistical evaluation (Table I). The availability of a relatively simple, sensitive and precise bioassay in the rat for the measure-ment of antidiuretic activity (4) prompted the ex-amination of the activity of the blood of patients with the aforementioned as well as with other clini-cal disorders. METHOD AND RESULTS Only men were selected for this study in order to ob-viate any possible influence of the menstrual cycle. The subjects selected to comprise the "healthy " group showed no apparent physiological or psychological disturbances. All patients with cirrhosis of the liver had ascites and edema. The patients with congestive heart failure had from ++ to ++++ edema. The blood pressures of the patients with hypertension were all beyond a systolic of 180 mm. mercury and a diastolic of 100 mm. mercury. After a preliminary period of ten hours during which the subjects were not permitted to ingest food or water, 1Reviewed in the Veteran's Administration and pub-lished with the approval of the Chief Medical Director. The statements and conclusions published by the authors are a result of their own study and do not necessarily re-flect the opinion or policy of the Veteran's Administration.