scholarly journals The Development of Intensive Care Unit Acquired Hypernatremia Is Not Explained by Sodium Overload or Water Deficit: A Retrospective Cohort Study on Water Balance and Sodium Handling

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
M. C. O. van IJzendoorn ◽  
H. Buter ◽  
W. P. Kingma ◽  
G. J. Navis ◽  
E. C. Boerma
Keyword(s):  
Water Balance ◽  
Water Deficit ◽  
Fluid Balance ◽  
Sodium Intake ◽  
Severity Of Illness ◽  
Sodium Concentration ◽  
Balance Study ◽  
Icu Patients ◽  
Sodium Overload ◽  
Sodium Handling

Background. ICU acquired hypernatremia (IAH, serum sodium concentration (sNa) ≥ 143 mmol/L) is mainly considered iatrogenic, induced by sodium overload and water deficit. Main goal of the current paper was to answer the following questions: Can the development of IAH indeed be explained by sodium intake and water balance? Or can it be explained by renal cation excretion?Methods.Two retrospective studies were conducted: a balance study in 97 ICU patients with and without IAH and a survey on renal cation excretion in 115 patients with IAH.Results.Sodium intake within the first 48 hours of ICU admission was 12.5 [9.3–17.5] g in patients without IAH (n=50) and 15.8 [9–21.9] g in patients with IAH (n=47),p=0.13. Fluid balance was 2.3 [1–3.7] L and 2.5 [0.8–4.2] L, respectively,p=0.77. Urine cation excretion (urine Na + K) was < sNa in 99 out of 115 patients with IAH. Severity of illness was the only independent variable predicting development of IAH and low cation excretion, respectively.Conclusion. IAH is not explained by sodium intake or fluid balance. Patients with IAH are characterized by low urine cation excretion, despite positive fluid balances. The current paradigm does not seem to explain IAH to the full extent and warrants further studies on sodium handling in ICU patients.

scholarly journals What Is the Optimal Dialysate Sodium Concentration?

2021 ◽  
Vol 1 (2) ◽  
pp. 157-160
Author(s):  
Elizabeth Lindley ◽  
James Tattersall
Keyword(s):  
Fluid Balance ◽  
Serum Sodium ◽  
Sodium Intake ◽  
Sodium Concentration ◽  
Sodium Removal ◽  
Lower Fluid ◽  
Dialysate Sodium

In haemodialysis, sodium and fluid balance (where intake matches loss) is achieved by ultrafiltration and by diffusion between the plasma water and dialysate. If a patient’s sodium intake does not change, any reduction in fluid gain obtained by lowering dialysate sodium concentration will result in less sodium removal by ultrafiltration. The corresponding change in diffusion to achieve balance may mean the benefit of lower fluid gain is offset by morbidity caused by a fall in serum sodium during dialysis. The standard dialysate sodium should minimise harm caused by both high ultrafiltration rates and osmotic disequilibrium. For most units, this is likely to be 138 to 140 mmol/L.

scholarly journals Drought resistance of sugar-cane crop for different levels of water availability in the soil

2014 ◽  
Vol 34 (2) ◽  
pp. 203-210 ◽  
Author(s):  
Fernando da S. Barbosa ◽  
Rubens D. Coelho ◽  
Rafael Maschio ◽  
Carlos J. G. de S. Lima ◽  
Everaldo M. da Silva
Keyword(s):  
Water Balance ◽  
Soil Water ◽  
Water Deficit ◽  
Early Development ◽  
Drought Resistance ◽  
Sugar Cane ◽  
Water Availability ◽  
Sandy Loam ◽  
Final Population ◽  
Different Levels

Soil water availability is the main cause of reduced productivity, and the early development period most sensitive to water deficit. This study aimed to evaluate the drought resistance of the varieties of sugar-cane RB867515 and SP81-3250 during the early development using different levels of water deficit on four soil depths. The experiment was conducted at the Department of Biosystems at Escola Superior de Agricultura "Luiz de Queiroz" (ESALQ/USP) in a greenhouse in soil classified as Oxisol, sandy loam texture (Series "Sertãozinho"). Once exhausted the level of available water in the soil, the dry strength of the studied strains are relatively low. Water balance with values less than -13 mm cause a significant decrease in the final population of plants, regardless of the variety, and values below -35 mm, leads to the death of all plants.

Serum Sodium Concentration Changes Are Related to Fluid Balance and Sweat Sodium Loss

2010 ◽  
Vol 42 (9) ◽  
pp. 1669-1674 ◽  
Author(s):  
MATTHEW D. PAHNKE ◽  
JOEL D. TRINITY ◽  
JEFFREY J. ZACHWIEJA ◽  
JOHN R. STOFAN ◽  
W. DOUGLAS HILLER ◽  
...  
Keyword(s):  
Fluid Balance ◽  
Serum Sodium ◽  
Sodium Concentration ◽  
Serum Sodium Concentration ◽  
Concentration Changes ◽  
Sodium Loss ◽  
Sweat Sodium

scholarly journals AVALIAÇÃO DA DISPONIBILIDADE HÍDRICA NA SUB-BACIA DO BOI BRANCO ATRAVÉS DO BALANÇO HÍDRICO CLIMATOLÓGICO E DE CULTIVO

Irriga ◽  
2017 ◽  
Vol 22 (1) ◽  
pp. 1-17
Author(s):  
Mariana Alexandre de Lima Sales ◽  
RODRIGO MÁXIMO SÁNCHEZ ROMÁN ◽  
LEONOR RODRÍGUEZ SINOBAS ◽  
RAIMUNDO NONATO FARIAS MONTEIRO ◽  
JOÃO VICTOR RIBEIRO DA SILVA DE SOUZA
Keyword(s):  
Water Balance ◽  
Water Deficit ◽  
Environmental Planning ◽  
Water Cycle ◽  
Crop Coefficient ◽  
Monthly Precipitation ◽  
Agricultural Planning ◽  
Historical Series ◽  
Average Monthly Precipitation ◽  
E Mail

AVALIAÇÃO DA DISPONIBILIDADE HÍDRICA NA SUB-BACIA DO BOI BRANCO ATRAVÉS DO BALANÇO HÍDRICO CLIMATOLÓGICO E DE CULTIVO  MARIANA ALEXANDRE DE LIMA SALES1; RODRIGO MÁXIMO SÁNCHEZ ROMÁN2; LEONOR RODRÍGUEZ SINOBAS3; RAIMUNDO NONATO FARIAS MONTEIRO4; JOÃO VICTOR RIBEIRO DA SILVA DE SOUZA5. 1 Tecnóloga em Irrigação e Drenagem, Doutoranda em Agronomia (Irrigação e Drenagem) – FCA/UNESP. Rua José Barbosa de Barros, 1780, CEP 18610-307, Botucatu – SP, e-mail: [email protected] Eng. de Irrigação e Drenagem, Prof. Doutor FCA/UNESP. Rua José Barbosa de Barros, 1780, CEP 18610-307, Botucatu, SP. Fone: (14) 3711-7100. E-mail: [email protected] Eng. Agrônoma, Profa. Doutora ETSIA/UPM, Ciudad Universitaria, 28040 Madri, Espanha. e-mail: [email protected] Tecnólogo em Recursos Hídricos/Irrigação, Doutor em Agronomia (Irrigação e Drenagem) – FCA/UNESP. Rua José Barbosa de Barros, 1780, CEP 18610-307, Botucatu – SP, e-mail: [email protected] Eng. Agrônomo, Doutorando em Agronomia (Irrigação e Drenagem) – FCA/UNESP. Rua José Barbosa de Barros, 1780, CEP 18610-307, Botucatu – SP, e-mail: [email protected].  1 RESUMO Uma das formas de contabilizar a quantidade de água de um determinado sistema é por meio do balanço hídrico, o qual é uma importante ferramenta para o processo de avaliação do ciclo da água em uma determinada região. O objetivo deste trabalho foi determinar o balanço hídrico na sub-bacia hidrográfica do Boi Branco-SP, para servir como ferramenta ao planejamento hidroagrícola e ambiental da região. Para o balanço hídrico climatológico, utilizaram-se dados da série histórica da região (1971 a 1995). Os dados de evapotranspiração foram estimados pelo método de Thornthwaite. O balanço hídrico climatológico mostrou déficit hídrico total anual de 10,1 mm, e um excedente de 319,7 mm, tendo no mês de janeiro um excedente de 92,6 mm, para a precipitação média mensal; com a precipitação efetiva mensal com probabilidade de 75%, déficit hídrico no solo é de 238,8 mm e o excedente 56,8 mm. Quando se adiciona a esses dados os das culturas implantadas na área de estudo, como coeficiente de cultivo e fator de depleção da umidade do solo, observa-se que todas as culturas do estudo apresentaram déficit hídrico em todos os meses em que estiveram no campo. Palavras-chave: Planejamento hidroagrícola, capacidade de água disponível no solo, evapotranspiração.  SALES, M. A. L.; SÁNCHEZ-ROMÁN, R. M.; SONOBAS, L. R.; MONTEIRO, R. N. F.; SOUZA, J. V. R. S.ASSESSMENT OF WATER AVAILABILITY AT BOI BRANCO WATERSHED   THROUGH CLIMATIC WATER BALANCE AND GROWING  2 ABSTRACT One way to calculate the amount of water in a determined system is by means of the water balance, an important tool for the assessment of the water cycle in a specific region. The main goal of this work was to establish the water balance in the watershed Boi Branco-SP, so that it can be used as a tool for the hydro-agricultural and environmental planning of the region. For the climatic water balance, data of the historical series of the region (1971 - 1995) were used. Evapotranspiration data were estimated by the Thornthwaite method. The climatic water balance showed  total annual water deficit  of 10.1 mm, and surplus of 319.7 mm, with January presenting surplus  of  92.6 in the average monthly precipitation; given that the effective monthly precipitation presenting probability of 75%,  water deficit  in the soil  is 238.8 mm and surplus is 56.8 mm. When these data are added to the ones of the crop, as a crop coefficient and soil humidity depletion factor, it is observed that all crops studied showed water deficit  in all the months covered. Keyword: Water agricultural planning, water capability available in the soil, evapotranspiration.

Disorders of Water Balance

2017 ◽  
Author(s):  
Richard H Sterns ◽  
Stephen M. Silver ◽  
John K. Hix ◽  
Jonathan W. Bress
Keyword(s):  
Water Balance ◽  
Water Intake ◽  
Serum Sodium ◽  
Water Conservation ◽  
Free Water ◽  
Sodium Concentration ◽  
Serum Sodium Concentration ◽  
Water Losses ◽  
Water Excretion ◽  
Impaired Water

Guided by the hypothalamic antidiuretic hormone vasopressin, the kidney’s ability to conserve electrolyte–free water when it is needed and to excrete large volumes of water when there is too much of it normally prevents the serum sodium concentration from straying outside its normal range. The serum sodium concentration determines plasma tonicity and affects cell volume: a low concentration makes cells swell, and a high concentration makes them shrink. An extremely large water intake, impaired water excretion, or both can cause hyponatremia. A combination of too little water intake with too much salt, impaired water conservation, or excess extrarenal water losses will result in hypernatremia. Because sodium does not readily cross the blood-brain barrier, an abnormal serum sodium concentration alters brain water content and composition and can cause serious neurologic complications. Because bone is a reservoir for much of the body’s sodium, prolonged hyponatremia can also result in severe osteoporosis and fractures. An understanding of the physiologic mechanisms that control water balance will help the clinician determine the cause of impaired water conservation or excretion; it will also guide appropriate therapy that can avoid the life-threatening consequences of hyponatremia and hypernatremia.

Disorders of Water and Sodium Balance: Hypernatremia

2019 ◽  
Author(s):  
Danilea M. Carmona Matos ◽  
Herbert Chen
Keyword(s):  
Water Balance ◽  
Diabetes Insipidus ◽  
Sodium Intake ◽  
Pure Water ◽  
Elevated Serum ◽  
Isotonic Saline ◽  
Sodium Balance ◽  
Lifestyle Modifications ◽  
Volume Depletion ◽  
Electrolyte Disorder

Hypernatremia is an electrolyte disorder most prevalent in the elderly and the critically ill, with over 60% of cases developing over the course of an inpatient stay. Characterized by elevated serum sodium concentrations, this disorder is manifested either by pure-water loss without replacement, or excessive sodium intake without appropriate water balance. Left untreated it may lead to seizures and coma. General treatment in the case of severe hypernatremia is infusion of isotonic saline followed by pure-water after the patient is stabilized. Further treatment of the underlying cause may involve diuretics, thiazides, and a variety of other medications in conjunction with dietary and lifestyle modifications. This review offers an overview of various disorders of water balance: diabetes insipidus, nephrotic syndrome, cirrhosis, idiopathic edema, and volume depletion, as well as their clinical presentations, lab tests, and management. This review contains 1 figure, 1 table, and 25 references. Key words: Hypernatremia, Edematous States , Diabetes insipidus, Volume Depletion, Cirrhosis, Diuretics

Renal sodium handling in normal humans subjected to low, normal, and extremely high sodium supplies

1985 ◽  
Vol 249 (6) ◽  
pp. F941-F947 ◽  
Author(s):  
J. C. Roos ◽  
H. A. Koomans ◽  
E. J. Dorhout Mees ◽  
I. M. Delawi
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Sodium Intake ◽  
Extracellular Fluid ◽  
Plasma Renin ◽  
Renin Activity ◽  
Sodium Reabsorption ◽  
Lithium Clearance ◽  
Renal Sodium Handling ◽  
Sodium Handling

We studied renal sodium handling, extracellular fluid volume (ECFV), plasma renin activity, aldosterone and norepinephrine, and blood pressure in eight healthy volunteers after equilibration on intakes of 20, 200, and 1,128 +/- 141 meq sodium, respectively. Renal sodium handling was assessed by means of clearance studies during maximal water diuresis and lithium clearance. Urinary sodium excretions were 22 +/- 4, 202 +/- 19, and 1,052 +/- 86 meq/day. From the lower to the upper sodium intake level, 24-h creatinine clearance rose from 111 +/- 7 to 136 +/- 11 ml/min and inulin clearance from 103 +/- 9 to 129 +/- 9 ml/min, whereas proximal and distal fractional sodium reabsorption (FSRprox and FSRdist, respectively) fell from 86.8 +/- 1.3 to 79.0 +/- 2.7% and from 96.5 +/- 0.5 to 76.0 +/- 1.9%, respectively. During the normal sodium intake (200 meq), intermediate values were recorded. The changes in fractional lithium clearance were less consistent but correlated with FSRprox (r = 0.78, P less than 0.001) and not with FSRdist. Major changes in plasma renin activity, aldosterone, and, to a lesser extent, norepinephrine accompanied these changes in kidney function, displaying inverse and exponential correlations with daily sodium excretion and ECFV. No consistent rise in blood pressure was detected. These observations indicate that in healthy humans renal adaptation to vast variations in sodium intake includes resetting of glomerular filtration rate, FSRprox, and, in particular, FSRdist. Alterations in neurohumoral factors may play a dominant role in this adaptation.

scholarly journals Heritability and individuality of the plasma sodium concentration: a twin study in the United States veteran population

2019 ◽  
Vol 316 (6) ◽  
pp. F1114-F1123
Author(s):  
Andrew K. Timmons ◽  
Anna M. Korpak ◽  
Jenny Tan ◽  
Kathryn P. Moore ◽  
Cindy H. Liu ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Water Balance ◽  
Plasma Glucose ◽  
Genome Wide Association Study ◽  
Sodium Concentration ◽  
The United States ◽  
European Ancestry ◽  
Plasma Sodium ◽  
Individual Level ◽  
Plasma Sodium Concentration

Little is known about the population genetics of water balance. A recent meta-genome-wide association study on plasma sodium concentration identified novel loci of high biological plausibility, yet heritability of the phenotype has never been convincingly shown in European ancestry. The present study linked the Vietnam Era Twin Registry with the Department of Veterans Affairs VistA patient care clinical database. Participants ( n = 2,370, 59.6% monozygotic twins and 40.4% dizygotic twins) had a median of seven (interquartile range: 3−14) plasma sodium determinations between October 1999 and March 2017. Heritability of the mean plasma sodium concentration among all twins was 0.41 (95% confidence interval: 0.35−0.46) and 0.49 (95% confidence interval: 0.43−0.54) after exclusion of 514 twins with only a single plasma sodium determination. Heritability among Caucasian ( n = 1,958) and African-American ( n = 268) twins was 0.41 (95% confidence interval: 0.34−0.47) and 0.36 (95% confidence interval: 0.17−0.52), respectively. Exclusion of data from twins who had been prescribed medications known to impact systemic water balance had no effect. The ability of the present study to newly detect substantial heritability across multiple racial groups was potentially a function of the cohort size and relatedness, exclusion of sodium determinations confounded by elevated plasma glucose and/or reduced glomerular filtration rate, transformation of plasma sodium for the independent osmotic effect of plasma glucose, and use of multiple laboratory determinations per individual over a period of years. Individual-level plasma sodium concentration exhibited longitudinal stability (i.e., individuality); the degree to which individual-level means differed from the population mean was substantial, irrespective of the number of determinations. In aggregate, these data establish the heritability of plasma sodium concentration in European ancestry and corroborate its individuality.

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