Renal Failure Associated With Low Extracellular Sodium Chloride

In an earlier report1attention was called to a condition seen in 2 patients with congestive circulatory failure2and diminished renal function. When the intake of fluids was rapidly increased, urinary volume did not increase proportionately and dilution of electrolytes in extracellular fluids occurred. Besides gain in weight there was oliguria and retention of nitrogen in the blood; patients complained of weakness, drowsiness and muscular cramps and became prostrated. It was believed that this sequence of events represented "water intoxication" resulting from a high intake of water and a low intake of salt. Further experience with this condition has since accumulated. It developed in over one third of a series of 40 cardiac patients being studied. It was precipitated not only by excessive intake of fluids but more commonly by the overenthusiastic use of mercurial diuretics in conjunction with diets low in sodium chloride. It has developed spontaneously