[Aspects of water-electrolyte metabolism studied with muscle needle-biopsy. Findings in cardiac insufficiency, hepatic cirrhosis, diabetes mellitus and chronic renal insufficiency].

The skeletal muscle composition in water, electrolyte and protein nitrogen was investigated in 4 groups of patients with decompensated liver cirrhosis, cardiac decompensation, diabetes mellitus and chronic renal insufficiency. The results were compared with those obtained in normal subjects. In patients with decompensated liver cirrhosis and cardiac decompensation the following were observed: an increase in both the intracellular and extracellular water of muscle tissue, with a simultaneous rise in sodium and chloride and a fall in the potassium and magnesium concentrations. In patients with diabetes mellitus and chronic renal insufficiency, the decrease in cell protein nitrogen was the most significant finding; moreover, in diabetic patients the cell content of inorganic phosphate was also reduced. These results suggest that the reduction in the effective plasma volume and the secondary aldosteronism are important pathogenetic factors only in cirrhotic and cardiac patients. On the contrary, in patients with diabetes mellitus and chronic renal insufficiency, protein catabolism is by far the most important metabolic disorder and may explain, to some extent, the alterations in water and electrolyte metabolism.