The Relation of Zincuria to Water and Electrolyte Excretion in Patients with Hepatic Cirrhosis

Vallee has emphasized the occurrence of increased urinary zinc, decreascd serum zinc, and low hepatic zinc content in postalcoholic cir­ rhosis. He has suggested that high concen­ trations of blood alcohol inhibit the zinc-containing metalloenzyme, alcohol de­ hydrogenasc, and account, in a manner un­ determined, for the increased zincuria. 4 The increase in urine zinc content and decrease in serum zinc concentration might result however, from a primary abnormality in renal function. The nephrotic syndrome is associated with a severe increase in urinary zinc excretion 5 and demonstrates that excess amounts of zinc may bc excreted in the urine secondary to renal disease. The most prominent changes in renal function observed in cirrhotic patients are the abnormalities in sodium and water excretion. The retention of salt and water and associated loss of potassium is thought to result from the effect of aldosterone on the renal tubules. 6