Hyperchluria

HYPERCHLURIA, HYPOCHLURIA, increased or decreased content of sodium chloride in the urine, respectively. A healthy person excretes on average from 12 to 15 g of sodium chloride in the urine per day, i.e., 0.2 g per kg of body weight. This amount is subject to strong fluctuations, mainly depending on the NaCl content in the food. Individual requirements for NaCl vary considerably. According to Straus, Widal, and others, the organism can get by on 1.5–2 g of NaCl per day. However, NaCl is introduced in quantities far exceeding the organism's requirements for it. According to Bunge, plant food promotes an increased excretion of Na and Cl ions with the urine and increases the need for NaCl. During starvation, the content of the latter in the urine drops to minimal figures (0.6–0.8 g). Salt metabolism is closely connected with water metabolism: strong diuresis is accompanied under normal conditions by enhanced excretion of NaCl; during sweating and fluid loss through the intestines (diarrhea), the excretion of NaCl with the urine decreases. NaCl takes an active part in regulating osmotic processes: water retention in the body, e.g., the development of exudates, ascites, edema, is accompanied by NaCl retention; in the period of reduction of edema and ascites, on the contrary, hyperchluria is observed (up to 50 g per day). The excretion of NaCl with the urine is drastically altered in febrile diseases: at high temperatures, NaCl accumulates in the body, its amount in the urine drops sharply, sometimes to traces (especially in croupous pneumonia). The temperature crisis (in croupous pneumonia, typhus, etc.) is accompanied by a "chloride crisis," i.e., an increased excretion of NaCl. Sodium chloride is apparently excreted by the tubular apparatus of the kidneys (the epithelium of the convoluted tubules). When it is damaged (nephrosis), the ability of the kidneys to excrete NaCl seems to decrease, and the latter, together with water, accumulates in the tissues, which leads to the formation of edema. However, it is very difficult to decide how far the retention of NaCl by the kidneys is truly a primary phenomenon, since the excretion of water simultaneously decreases, and moreover, NaCl and water can be retained by tissues during pathological processes as well. In nephrosis, for example, there is reason to assume physical and chemical changes in all tissues and tissue fluids that contribute to the retention of water and NaCl in them (see Diuresis, Edema, Nephrosis).

N. Pavlov.