Clinical disorders of water metabolism

Berl, Tomás; Anderson, Robert J.; McDonald, Keith M.; Schrier, Robert W.

doi:10.1038/ki.1976.83

Cited by 122 publications

(70 citation statements)

References 108 publications

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“…7,8 The basic components of the system include: 1) delivery of tubular fluid to the distal nephron, a function of water reabsorption in the proximal tubule and the descending limb of Henle' s loop; 2) separation of solutes from water, which takes place primarily in the water-impermeable ascending limb of Henle' s loop and the distal tubule; 3) urea transport in the inner medullary collecting duct in conjunction with Na-K-2Cl cotransport in the medullary thick ascending limb, which enables the establishment and maintenance of the hypertonic medulla required for water reabsorption; and 4) final control of water excretion, a process entrusted to the collecting tubules and regulated by VP.…”

Section: Factors In the Control Of Water Excretionmentioning

confidence: 99%

“…The major factor known to influence VP secretion in normal circumstances is plasma osmolality. 6,8,48 Neurons, known as ''osmoreceptors,'' are located in the anterior hypothalamus close to the supraoptic nuclei. These osmoreceptors are very sensitive to changes in plasma osmolality, which is sensed through changes in the intracellular water content of the neurons.…”

Section: Factors In the Control Of Water Excretionmentioning

confidence: 99%

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Hyponatremia in cirrhosis: From pathogenesis to treatment†

et al. 1998

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Section: Factors In the Control Of Water Excretionmentioning

confidence: 99%

Section: Factors In the Control Of Water Excretionmentioning

confidence: 99%

Hyponatremia in cirrhosis: From pathogenesis to treatment†

et al. 1998

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“…Proper treatment depends on prompt and appropriate identification, diagnosis, and classification and is based on the patient's serum osmolality and fluid volume. 3,[6][7][8][9][10][11]13, Symptomatic hyponatremia. Severe symptomatic hyponatremia (e.g., altered mental status, seizures) requires prompt correction with free-water restriction and i.v.…”

Section: Sodiummentioning

confidence: 99%

“…The urine is inappropriately concentrated (>100 mosmole/kg) with an increase in urine sodium concentration of greater than 20-30 meq/L. 3,6,8 The continued intake of water (or hypotonic fluids) will ultimately lead to the development of hyponatremia. Numerous conditions and medications may induce SIADH (Figure 1).…”

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Treatment of electrolyte disorders in adult patients in the intensive care unit

Kraft

Btaiche²,

Sacks³

et al. 2005

American Journal of Health-System Pharmacy

241

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Purpose. The treatment of electrolyte disorders in adult patients in the intensive care unit (ICU), including guidelines for correcting specific electrolyte disorders, is reviewed. Summary. Electrolytes are involved in many metabolic and homeostatic functions. Electrolyte disorders are common in adult patients in the ICU and have been associated with increased morbidity and mortality, as has the improper treatment of electrolyte disorders. A limited number of prospective, randomized, controlled studies have been conducted evaluating the optimal treatment of electrolyte disorders. Recommendations for treatment of electrolyte disorders in adult patients in the ICU are provided based on these studies, as well as case reports, expert opinion, and clinical experience. The etiologies of and treatments for hyponatremia hypotonic and hypernatremia (hypovolemic, isovolemic, and hypervolemic), hypokalemia and hyperkalemia, hypophosphatemia and hyperphosphatemia, hypocalcemia and hypercalcemia, and hypomagnesemia and hypermagnesemia are discussed, and equations for determining the proper dosages for adult patients in the ICU are provided. Treatment is often empirical, based on published literature, expert recommendations, and the patient's response to the initial treatment. Actual electrolyte correction requires individual adjustment based on the patient's clinical condition and response to therapy. Clinicians should be knowledgeable about electrolyte homeostasis and the underlying pathophysiology of electrolyte disorders in order to provide the optimal therapy to patients. Conclusion. Treatment of electrolyte disorders is often empirical, based on published literature, expert opinion and recommendations, and patient's response to the initial treatment. Clinicians should be knowledgeable about electrolyte homeostasis and the underlying pathophysiology of electrolyte disorders to provide optimal therapy for patients.

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Vasopressin-Resistant Nephrogenic Diabetes Insipidus

Barbour¹

1979

Arch Intern Med

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Clinical disorders of water metabolism

Cited by 122 publications

References 108 publications

Hyponatremia in cirrhosis: From pathogenesis to treatment†

Hyponatremia in cirrhosis: From pathogenesis to treatment†

Treatment of electrolyte disorders in adult patients in the intensive care unit

Vasopressin-Resistant Nephrogenic Diabetes Insipidus

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