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July 9, 1938

CONCENTRATIONS OF CHLORIDE, SODIUM AND POTASSIUM IN URINE AND BLOOD: THEIR DIAGNOSTIC SIGNIFICANCE IN ADRENAL INSUFFICIENCY

Author Affiliations

Fellow in Medicine, the Mayo Foundation; ROCHESTER, MINN.

From the Division of Biochemistry (Dr. Power) and the Division of Medicine (Dr. Wilder), the Mayo Clinic.

JAMA. 1938;111(2):117-122. doi:10.1001/jama.1938.02790280007002
Abstract

It was shown by Loeb and his associates1 that adrenalectomized dogs excreted excessive amounts of sodium and chloride and suggested2 that the so-called crisis of Addison's disease might result from a similar loss of these electrolytes. It later was demonstrated by one of us (Wilder) with Kendall and others3 that administering potassium to patients with Addison's disease would provoke excretion of sodium and chloride and precipitate crisis. From this the supposition arose that examination of the urine for sodium and chloride, under standard conditions of administration of potassium, might provide more reliable information about adrenocortical function than frequently is obtained by examination of the blood.

Preliminary studies revealed that the supposition probably was justified. Under conditions imposed, the excretions of chloride and sodium in urine of eight subjects with classic Addison's disease were much greater than those found in a group of eight subjects without evident disease

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