Abstract
We have described 1 , 2 the metabolism of sodium-d-lactate in normal individuals and in patients with acute diffuse parenchymal disease of the liver. The results obtained suggested the possibility of the use of this substance as a test for liver function. It should be emphasized that the metabolism of sodium-d-lactate is quite different from that of the racemic or the 1-salt with which all previous work has been done.
The test is performed before breakfast, and consists of the intravenous injection of 75 mg. per kilo of body weight of a 10 to 14%
solution of sodium-d-lactate. A control sample of blood, collected in fluoride, is obtained just before the injection of the salt, and again 30 minutes after the injection, and blood lactic acid determinations are made. 3 All determinations are done in duplicate.
In normal individuals the blood lactic acid either falls below or remains very slightly above the control level at the end of 30 minutes, whereas in patients with hepatitis there occurs a distinct delay in the utilization of the injected d-lactate. We consider an elevation of 5 mg. % or more above the control blood lactic acid level at the end of ½ hour as evidence of liver damage.
The advantage of this test lies in the fact that it may be used in the presence of jaundice and thus serve in the differentiation between extrahepatic obstructive and non-obstructive icterus.
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