Toward an Integrative Concept of Control of Total Body Sodium

Physiology ◽  
2000 ◽  
Vol 15 (6) ◽  
pp. 319-325 ◽  
Author(s):  
H. Wolfgang Reinhardt ◽  
Erdmann Seeliger
Keyword(s):  
Arterial Pressure ◽  
Regulatory Elements ◽  
Body Water ◽  
Major Determinant ◽  
Pressure Balance ◽  
Renin Angiotensin Aldosterone System ◽  
Body Sodium ◽  
Total Body ◽  
Integrative Concept ◽  
Atrial Receptors

Total body sodium (TBSodium) is a major determinant of body water and arterial pressure. Several observations, in particular that of a “sodium memory,” indicate that TBSodium is a controlled variable. Various regulatory elements are involved, e.g., the renin-angiotensin-aldosterone system, atrial receptors, and renal arterial pressure. Balance studies in dogs provide new insights into their contributions to TBSodium control.

scholarly journals Relationships Among Intravascular Volume, Total Body Sodium, Arterial Pressure, and Vasomotor Tone

1961 ◽  
Vol 9 (6) ◽  
pp. 1233-1239 ◽  
Author(s):  
HIDEO TAKAGI ◽  
HARRIET P. DUSTAN ◽  
IRVINE H. PAGE
Keyword(s):  
Arterial Pressure ◽  
Intravascular Volume ◽  
Vasomotor Tone ◽  
Body Sodium ◽  
Total Body

scholarly journals Regulation of Water and Some Ions in Gammarids (Amphipoda)

1971 ◽  
Vol 55 (2) ◽  
pp. 357-369
Author(s):  
D. W. SUTCLIFFE
Keyword(s):  
Sodium Chloride ◽  
Sea Water ◽  
Chloride Concentration ◽  
Sodium Concentration ◽  
Body Water ◽  
The Body ◽  
Salinity Range ◽  
Sodium Potassium ◽  
Body Sodium ◽  
Total Body

1. A comparison was made of the body water contents and the concentrations of sodium, potassium and chloride in the blood and body water of Gammarus zaddachi, G. locusta and Marinogammarus finmarchicus. 2. G. zaddachi had a slightly higher body water content than G. locusta and M. finmarchicus. 3. In all three species the blood chloride concentration was lower than the external chloride concentration in 80-113 % sea water, but the blood sodium concentration was equal to or slightly above the sodium concentration in the external medium. 4. The total body sodium concentration was always greater than the total body chloride concentration. In M.finmarchicus the ratio of body sodium/chloride increased from 1.2 to 1.3 over the salinity range 100-20% sea water. In G. zaddachi the ratio of body sodium/chloride increased from 1.08 at 100% sea water to 1.87 in 0.25 mM/l NaCl. 5. The total body potassium concentration remained constant. The potassium loss rate and the balance concentration were relatively high in G. zaddachi. 6. The porportion of body water in the blood space was calculated from the assumption that a Donnan equilibrium exists between chloride and potassium ions in the extracellular blood space and the intracellular space. In G. zaddachi the blood space was equivalent to 60% body H2O at 100% sea water, and equivalent to 50% body H2O at 40% sea water down to 0.5 mM/l NaCl. In M.finmarchicus the blood space was equivalent to 38-44% body H2O at salinities of 20-100% sea water. 7. The mean intracellular concentrations of sodium, potassium and chloride were also calculated. It was concluded that for each ion its intracellular concentration is much the same in the four euryhaline gammarids. The intracellular chloride concentration is roughly proportional to the blood chloride concentration. The intracellular sodium concentration is regulated in the face of large changes in the blood sodium concentration.

Regulation of Water and Some Ions in Gammarids (Amphipoda)

1971 ◽  
Vol 55 (2) ◽  
pp. 345-355
Author(s):  
D. W. SUTCLIFFE
Keyword(s):  
Water Content ◽  
Sea Water ◽  
Potassium Concentration ◽  
Body Water ◽  
The Body ◽  
Sodium Potassium ◽  
Intracellular Space ◽  
Body Sodium ◽  
The Mean ◽  
Total Body

1. The water content, and the concentrations of sodium potassium and chloride in the blood and body water were determined in Gammarus pulex acclimatized to external salinities ranging from 0.06 mM/l NaCl up to 50 % sea water. 2. The mean body water content remained constant at 79.0-80.3 % body wet weight. The total body sodium and chloride concentrations were lowered in 0.06 mM/l NaCl and increased markedly at salinities above 10% sea water. The normal ratio of body sodium/chloride was 1.45-1.70, decreasing to 1.0 at 50% sea water. 3. The total body potassium concentration remained constant at 47.5-55.2 mM/kg body H2O. The rate of potassium loss across the body surface was relatively fast. Potassium balance was maintained at an external potassium concentration of 0.005 mM/l by starved animals, and at 0.005 mM/l by fed animals. 4. The proportion of body water in the blood space was calculated from the concentrations of potassium and chloride in the blood and in the body water. The blood space contained 38-42% body H2O in animals from fresh water. The blood space decreased to 31 % body H2O in animals from 0.06 mM/l NaCl. The sodium space was equivalent to about 70 % body H2O. 5. The mean intracellular concentrations of sodium, potassium and chloride were estimated and the results were compared with previous analyses made on the tissues of G. pulex and other crustaceans. It was concluded that in G. pulex from fresh water the distribution of potassium and chloride ions between the extracellular blood space and the intracellular space approximately conforms to a Donnan equilibrium. 30-40% of the body sodium is apparently located in the intracellular space.

Relation of Arterial Pressure with Body Sodium, Body Potassium and Plasma Potassium in Essential Hypertension

1982 ◽  
Vol 63 (3) ◽  
pp. 257-270 ◽  
Author(s):  
C. Beretta-Piccoli ◽  
D. L. Davies ◽  
K. Boddy ◽  
J. J. Brown ◽  
A. M. M. Cumming ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Arterial Pressure ◽  
Potassium Concentration ◽  
Plasma Potassium ◽  
Normal Subjects ◽  
Total Body Potassium ◽  
Hypertensive Patients ◽  
Body Sodium ◽  
Low Renin Hypertension ◽  
Total Body

1. Exchangeable sodium (NaE), plasma electrolytes and arterial pressure were measured in 121 normal subjects and 91 patients with untreated essential hypertension (diastolic >100 mmHg), 21 of whom had low-renin hypertension. Plasma concentrations of renin, angiotensin II and aldosterone were measured in all hypertensive patients, total body sodium, total body potassium and exchangeable potassium (KE) in some patients. 2. Mean NaE was not different in normal and hypertensive subjects provided the two groups were matched for leanness index. In the subgroup of young hypertensive patients aged 35 years or less mean NaE was below normal. NaE was not related to arterial pressure in normal subjects but in hypertensive patients there were positive and significant correlations of arterial pressure with NaE and with total body sodium. 3. NaE and total body sodium increased with age in hypertensive but not in normal subjects. Partial regression analysis suggested that the correlation of NaE with arterial pressure was not explained by an influence of age. 4. Mean NaE was not increased and mean KE was not decreased in patients with low-renin hypertension. 5. Plasma potassium concentration, KE and total body potassium correlated inversely and significantly with blood pressure in hypertensive patients. These correlations were more marked in young than in old patients. 6. Multiple regression analysis showed that the combination of NaE and plasma potassium concentration ‘explained’ more of the variation of systolic blood pressure in hypertensive patients than it did in normal subjects. Plasma potassium concentration ‘explained’ more of the variation in young hypertensives and NaE ‘explained’ more in older patients. 7. Our findings suggest that changes of plasma and body potassium are important in the earlier stages of essential hypertension and that changes of body sodium become important later.

scholarly journals Body Sodium, Potassium and Water in Peritoneal Dialysis-Associated Hyponatremia

2014 ◽  
Vol 34 (3) ◽  
pp. 253-259 ◽  
Author(s):  
Yijuan Sun ◽  
David Mills ◽  
Todd S. Ing ◽  
Joseph I. Shapiro ◽  
Antonios H. Tzamaloukas
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Evaluation ◽  
Serum Sodium ◽  
Total Body Water ◽  
Sodium Concentration ◽  
Body Water ◽  
Serum Sodium Concentration ◽  
Monovalent Cations ◽  
Body Sodium ◽  
Total Body

Objective This report presents a method quantitatively analyzing abnormalities of body water and monovalent cations (sodium plus potassium) in patients on peritoneal dialysis (PD) with true hyponatremia. Methods It is well known that in the face of euglycemia serum sodium concentration is determined by the ratio between the sum of total body sodium plus total body potassium on the one hand and total body water on the other. We developed balance equations that enabled us to calculate excesses or deficits, relative to the state of eunatremia and dry weight, in terms of volumes of water and volumes of isotonic solutions of sodium plus potassium when patients presented with hyponatremia. We applied this method retrospectively to 5 episodes of PD-associated hyponatremia (serum sodium concentration 121–130 mEq/L) and compared the findings of the method with those of the clinical evaluation of these episodes. Results Estimates of the new method and findings of the clinical evaluation were in agreement in 4 of the 5 episodes, representing euvolemic hyponatremia (normal total body sodium plus potassium along with water excess) in 1 patient, hypovolemic hyponatremia (deficit of total body sodium plus potassium along with deficit of total body water) in 2 patients, and hypervolemic hyponatremia (excess of total body sodium along with larger excess of total body water) in 1 patient. In the 5th patient, in whom the new method suggested the presence of water excess and a relatively small deficit of monovalent cations, the clinical evaluation had failed to detect the cation deficit. Conclusions Evaluation of imbalances in body water and monovalent cations in PD-associated hyponatremia by the method presented in this report agrees with the clinical evaluation in most instances and could be used as a guide to the treatment of hyponatremia. Prospective studies are needed to test the potential clinical applications of this method.

scholarly journals Edelman Revisited: Concepts, Achievements, and Challenges

2022 ◽  
Vol 8 ◽  
Author(s):  
Mark Rohrscheib ◽  
Ramin Sam ◽  
Dominic S. Raj ◽  
Christos P. Argyropoulos ◽  
Mark L. Unruh ◽  
...  
Keyword(s):  
Serum Sodium ◽  
Quantitative Methods ◽  
Sodium Concentration ◽  
Body Fluids ◽  
Body Water ◽  
Serum Sodium Concentration ◽  
Sodium Potassium ◽  
Body Sodium ◽  
Total Body

The key message from the 1958 Edelman study states that combinations of external gains or losses of sodium, potassium and water leading to an increase of the fraction (total body sodium plus total body potassium) over total body water will raise the serum sodium concentration ([Na]S), while external gains or losses leading to a decrease in this fraction will lower [Na]S. A variety of studies have supported this concept and current quantitative methods for correcting dysnatremias, including formulas calculating the volume of saline needed for a change in [Na]S are based on it. Not accounting for external losses of sodium, potassium and water during treatment and faulty values for body water inserted in the formulas predicting the change in [Na]S affect the accuracy of these formulas. Newly described factors potentially affecting the change in [Na]S during treatment of dysnatremias include the following: (a) exchanges during development or correction of dysnatremias between osmotically inactive sodium stored in tissues and osmotically active sodium in solution in body fluids; (b) chemical binding of part of body water to macromolecules which would decrease the amount of body water available for osmotic exchanges; and (c) genetic influences on the determination of sodium concentration in body fluids. The effects of these newer developments on the methods of treatment of dysnatremias are not well-established and will need extensive studying. Currently, monitoring of serum sodium concentration remains a critical step during treatment of dysnatremias.

Regulation of Water and Some Ions in Gammarids (Amphipoda)

1971 ◽  
Vol 55 (2) ◽  
pp. 325-344
Author(s):  
D. W. SUTCLIFFE
Keyword(s):  
Brackish Water ◽  
Sea Water ◽  
Chloride Content ◽  
Chloride Ions ◽  
Body Water ◽  
The Body ◽  
Potassium Balance ◽  
Body Sodium ◽  
External Potassium ◽  
Total Body

1. Gammarus duebeni from brackish water was acclimatized to salinities ranging from 100% sea water down to 0.25 mM/1 NaCl at 9 °C. 2. The body water content increased from 76 to 81% body wet weight. The ratio of total body sodium/chloride increased from 1.04 to 1.52. The sodium space remained constant, equivalent to about 65 % body H2O. The chloride space decreased from about 60% body H2O down to 35% body H2O. 3. Total body potassium remained almost constant and showed only a small decrease in dilute NaCl-media. Potassium balance was maintained for several days at an external potassium concentration of 0.010-0.015 mM/1. 4. The proportion of body water in the extracellular blood space was calculated from the assumption that potassium and chloride ions were distributed in a Donnan equilibrium between the blood and intracellular spaces. The blood space was slightly smaller than the chloride space. 5. The mean intracellular concentrations of sodium, potassium and chloride were calculated. Sodium fell from 120 to 75 mM/kg cell H2O, potassium fell from 125 to 75 mM/kg cell H2O and chloride fell from 55 to 12 mM/kg cell H2O. These concentrations are similar to the concentrations found in the muscles of decapods and in the tissues of other animals. 6. About 10% of the body chloride and 93-97% of the body potassium is situated in the cells. The proportion of intracellular sodium increased from 17-18% body sodium at 100% sea water to 40-50% body sodium at 0.25 mM/l NaCl. 7. G. duebeni from three freshwater populations were acclimatized to 2 % sea water, 0.5 and 0.25 mM/l NaCl. The body surface is three times more permeable to potassium than it is to sodium and chloride. Potassium balance in starved animals was achieved at 0.010-0.015 mM/l K. Fed animals had a higher body sodium and chloride content than starved animals. 8. The regulation of body water and ions in animals from the freshwater populations was essentially the same as in animals from brackish-water populations. The significance of the results is discussed in relation to the process of adaptation to fresh water.

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