Total body electrolyte composition and distribution of body water in uremia

Abstract

Total body sodium and chloride were measured by neutron activation analysis, and total body potassium was measured by whole body counting in ten male patients with endstage renal disease requiring chronic maintenance hemodialysis. The extracellular fluid volume was estimated from the simultaneously measured volume of distribution of bromine 77 and sodium 24. Total body water was estimated from the volume of distribution of triated water. Total body sodium and chloride were significantly increased above normal measured values, but total body potassium was not significantly different from normal. The increase in total body sodium could be attributed to an increase in exchangeable sodium because no significant change in the nonexchangeable portion of total body sodium could be detected. Extracellular fluid volume, estimated fro three different techniques (total body chloride, sodium 24, and bromine 77), and total body water were increased significantly above normal values. Extracellular fluid volume was correlated with exchangeable sodium, and total body water was closely correlated with total cation content (exchangeable sodium and total body potassium). The calculated intracellular fluid volume was decreased and was closely correlated with total body potassium. Despite adequate control of uremia by chronic maintenance hemodijalysis, body electrolyte composition and the distribution of body water remain significantly different from normal.

The Effects of Chronic Renal Failure in Infancy on Growth, Nutritional Status and Body Composition

“…In uraemic subjects, however, it is pertinent to consider critically the accuracy of ICW estimated as TBW minus corrected sodium bromide space. Although the latter is the preferred method of ECV estimation in normal subjects (1 l), its measurement is relatively imprecise, and abnormal cell membrane permeability to small molecules in uraemia (28) might lead to an overestimate of ECV by bromide and a corresponding underestimate of ICW; however, studies of electrolyte distribution in uraemic adults by Brennan et al (6) suggest that the increased bromide space reflects a genuine increase in ECV. These investigators have also shown a close correlation in uraemic subjects between ICW calculated from TBW minus corrected sodium bromide space and TBK similar to that previously described in normals (36).…”

“…Intracellular water includes reduction in alkaline soluble protein on muscle biopsy (ICW), an index of body cell mass, was reduced compared to (17), decreased whole body protein and albumin turnover (4, 16), values predicted for height in 14 children studied under years of decreased plasma and intracellular concentrations of certain esage lGroup I, mean ICW observed:predicted ratio (O/P) 0.67, sential amino acids (7,27), decreased levels of short half-life serum range 0.50-0.931, but was normal in seven prepubertal children proteins (27,47), an increased protein catabolic response to fasting studied between 5-1 1.9 years of age ( G~~~~ 11, mean ICW O/P (221, reduced total body nitrogen (341, and reduced body cell mass 1.01, range 0.88-1.23, P < 0.01 compared to Group I). Both ICW as estimated by measurement of ICW (6,14,15,19) and total O/P and weight for height index increased significantly with age body potassium (TBK) (39, 43). In infancy, when calorie and throughout childhood ( r = 0.79, P < 0.001 and r = 0.62, P < 0.05, protein requirements per kg and rates of growth and nitrogen respectively).…”

“…Both ICW as estimated by measurement of ICW (6,14,15,19) and total O/P and weight for height index increased significantly with age body potassium (TBK) (39,43). In infancy, when calorie and throughout childhood ( r = 0.79, P < 0.001 and r = 0.62, P < 0.05, protein requirements per kg and rates of growth and nitrogen respectively).…”

Assessment of Body Fluid Alteration Using Bioelectrical Impedance in Stroke Patients with Hemiplegia Caused by Cerebral Hemorrhage and Cerebral Infarction

“…Because of the well-known age-related decline in FFM, TBW and ICW reduced in elderly persons [19]. In addition, ICW has been observed to reduce in clinical situations in which TBW is increased, such as uremia, post-trauma, or cirrhosis [20].…”

Análise do desempenho da bioimpedância elétrica e somatória de pregas cutâneas na avaliação da composição corporal em pacientes renais dialíticos

“…Entretanto, a avaliação da CC de pacientes com IRC é dificultada por alterações hidroeletrolíticas e perda de massa óssea por osteodistrofia renal, frequentes nessa população 33,34 .…”