RELATIONSHIP OF THE AMINOPYRINE BREATH TEST AND THE CHILD-PUGH SCORE TO URINARY SODIUM RETENTION IN PATIENTS WITH LIVER-CIRRHOSIS

This study investigated the relationship between urinary sodium excret ion and liver function, as assessed by the aminopyrine breath test (AB T) and conventional parameters, in 62 patients with cirrhosis kept on a constant salt diet. Urinary sodium excretion was related non-linearl y to the ABT (r = 0.76). Less significant correlations were observed t o the Child-Pugh score (r = -0.65), cholinesterase (r = 0.58), bilirub in (r = -0.56), albumin (r = 0.51) and prothrombin time (r = 0.49). Wh en patients were arbitrarily divided into 6 groups according to the AB T, sodium excretion balanced the sodium intake up to a 50% reduction i n ABT. In groups with more than a 50% reduction sodium retention occur ed. When patients were grouped according to the Child-Pugh score, urin ary salt output was balanced in patients with scores of 5 and 6 and de creased in patients with scores greater six. However, the change in so dium output from normal salt excretion to sodium retention was less pr onounced in patients grouped according to the Child-Pugh score than in patients grouped according to the ABT. The results suggest a non-line ar relationship between the impairment in hepatic and renal function i n cirrhosis. They are compatible with the concept of a threshold of he patic function necessary to maintain normal renal function.