The effects of venous congestion of the limbs and phlebotomy upon renal clearances and the excretion of water and salt. II. Studies in patients with congestive failure.

A previous report from this laboratory (1) has shown that venous congestion of the limbs in normal subjects and in hypertensive patients before and after splanchnicectomy causes a decrease in urine flow and sodium excretion. In the present study these observations were extended to include also the renal functional effects of phlebotomy (as well as of venous congestion) in patients with congestive heart failure. In addition, cardiohemodynamic measurements were made simultaneously in a majority of patients in order to determine whether changes of cardiac output, or blood pressure in the pulmonary artery, or right ventricle are consistently related to the renal excretory responses. The details of the cardiohemodynamic studies have been presented in a separate communication (2).