[The role of exchangeable sodium content of the body in cases of hypertension of various etiology]. / A szervezet kicserélhetö nátrium-tartalmának szerepe különbözö aetiológiájú hypertoniákban.

Measurement of exchangeable sodium by isotope dilution is a relatively simple, reliable method for the determination of body sodium contents, which can be used in the clinical practice without significant health hazard to the patient. When computed to body surface area, the values for exchangeable sodium can be compared in patients of different body build. Exchangeable sodium may be variably increased in different clinical conditions associated with hypertension, thus increased sodium contents of the body is of major importance in the pathogenesis of hypertension caused by all forms of mineralocorticoid excess, and in the majority of patients with chronic renal insufficiency. In several endocrine disorders, e. g., acromegaly, hypothyroidism, increased sodium space does not play any significant part in the pathogenesis of hypertension. In diabetes mellitus, exchangeable sodium may be increased already prior to the development of hypertension, however it is still a matter of debate whether this abnormality is involved in the pathogenesis of hypertension in these patients. It seems now beyond any doubt that body sodium is normal in patients with essential hypertension, including those with the low renin form of the disease; nevertheless, some data indicate that blood pressure may be volume dependent in elderly patients with essential hypertension.

Exchangeable body sodium in normal man: analysis of various frames of reference.

Exchangeable sodium is a reliable measure of body sodium contents. Since fat tissue contains significantly less sodium per unit of weight than other tissues, leanness of an individual may considerably affect exchangeable body sodium. Thus, subjects of different body size can be compared only when body build is considered. To evaluate various frames of reference, we analysed the relationship between exchangeable sodium as determined by isotope dilution and various parameters of body size. Body weight, body height, body surface area, and leanness index correlated significantly with exchangeable sodium, the closest relationship having been obtained with body surface area (r = 0.790; p less than 0.001). When analysing males and females separately (n = 18 and 36, resp.), best parallelism of regression lines was also obtained with body surface area. It is concluded that exchangeable sodium should be referred to unit of body surface area, expressing each individual's value as percent of the normal predicted value calculated from the regression equations y = 1388x + 370 and y = 1554x - 196 for males and females, respectively.