Changes in blood volume during absolute fasting with and without sodium chloride administration

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      Abstract

      In this study, investigations were made of the blood volume of 13 obese patients during 10 days of absolute fasting. In 7 of the patients, we found a decrease in blood volume between 200 and 1200 ml., corresponding to 14 per cent on the average. On the assumption that the changes occurred secondarily to a loss of sodium, the other 6 patients received 90 mEq. Na+ daily as sodium chloride during the fast. Under these conditions, the decrease in blood volume was significantly reduced, but the hypernatriuresis still occurred and weight loss continuously exceeded what could be expected on a caloric basis. Absolute fasting with sodium supply was found to eliminate the otherwise observed increase in blood volume under refeeding. However, the regimen could only diminish to some extent the weight gain in this situation. The possible mechanisms involved are discussed. It appears probable that changes in the production of aldosterone, as well as the hypernatriuresis produced, plays a great part in the problem.
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