Excessive water retention, spoken of as dropsy or edema, may be noticeable only as swollen ankles or puffiness around the eyes yet be so extensive that an emaciated person appears overweight. Such a condition usually indicates adrenal exhaustion.

Giving large amounts of pantothenic acid to young men under stress increased the excretion of sodium, which holds water in the body. A diet high in calcium and adequate in vitamin D likewise increases the excretion of salt, thus reducing edema, whereas one high in carbohydrate holds both salt and water in the tissues. The stress of nephritis may also cause the adrenals to produce excessive amounts of aldosterone, which holds so much salt and water in the body that edema and elevated blood pressure result. Animals given diets deficient in nutrients that limit cortisone production, such as pantothenic acid and vitamins B2 and B12 develop edema, which is corrected when the missing vitamins are supplied or cortisone is given.

Another cause of dropsy is that, when the kidneys are damaged, blood albumin is lost in the urine. Frequently as much protein as is supplied by a quart of milk is excreted daily over a period of years, so all of it coming from body tissues unless supplied in foods. Much additional albumin passes into the intestines and is lost in the feces particularly in persons who are anemic, a common abnormality during nephrosis, when iron, copper, and numerous blood-building nutrients are so easily lost through the damaged kidneys.' Because blood albumin is vitally important in collecting urine, when it drops abnormally low, fluids and wastes remain in the' tissues. Edema occurs readily when the diet is too low in protein or supplies so few calories that protein must be used for energy, but the rate of albumin production can be doubled by an adequate diet extremely high in protein.

Because cholesterol deposition of long standing damages the kidneys and heart alike, severe nephrosis is often associated with a tired, slow-pumping heart which can force relatively little blood through the diseased kidneys, thus resulting in still greater fluid, salt, and urea retention and still higher blood pressure. This condition, often treated only by restricting salt and liquid, calls for maximum dietary improvement.

Increasing Urine

Years ago it was shown that vitamin C markedly increased urine production, and that only 300 to 500 milligrams daily were as effective as many medicinal diuretics. Vitamin C is less effective when the salt intake is high, and if given by injection, is lost so rapidly ,through the injured kidneys that it has little value. Vitamin E at times also acts as a diuretic; and urine production has been increased by giving 75,000 units of vitamin A daily.

A potassium deficiency, which can further harm the kidneys, can be produced by eating too much salt, by cortisone therapy, or by diuretics used in treating kidney diseases. In animals, this deficiency causes the blood pressure to soar, the kidneys to swell to twice their normal size, and the cells of the tubules to become so engorged with water that they burst. When the kidney arteries of animals are tied to simulate those plugged with cholesterol and such animals are given salt, severe nephrosis develops, but similarly treated animals kept on a low-salt diet have no kidney damage.

Provided nephrotic patients are given tablets supplying several grams of potassium chloride daily, such kidney damage is prevented; and the amount of salt and water held in the body decrease, especially when cortisone is administered. Many physicians believe that tablets of potassium chloride should be taken whenever salt is restricted; and salt substitutes containing potassium chloride should I be used liberally as a source of this nutrient.

Unfortunately, taking diuretics, given to increase urine flow, imposes serious nutritional problems. Large amounts of every nutrient soluble in water appear to be lost in the urine, and the more liquid taken, the greater become these losses. The tragedy is that such losses occur when cholin, pantothenic acid, vitamin C, magnesium, and many other nutrients are vitally needed. The same problem arises when patients with nephritis without edema are asked to drink 3 to 5 quarts of fluids daily. In this case, even dangerous salt (sodium) deficiencies have been produced.