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.

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 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.

scholarly journals Total body water and extracellular water measurements throughin vivodilution of D2O and bromide as tracers

2003 ◽  
Vol 17 (2-3) ◽  
pp. 603-611 ◽  
Author(s):  
Giuseppe Sergi ◽  
Roberta Bertani ◽  
Irene Calliari ◽  
Lucia Lupoli ◽  
Adriano Berton ◽  
...  
Keyword(s):  
Total Body Water ◽  
Body Fluids ◽  
Body Water ◽  
Energy Dispersive ◽  
Extracellular Water ◽  
X Ray ◽  
Pathological Conditions ◽  
Ft Ir ◽  
Total Body

Large interest is into the determination of body fluids because of changes in body water in a wide variety of physiological and pathological conditions. Here methods based on dilution of tracers, are reported, for the extracellular water (ECW) and total body water (TBW) determinations on the same sample. As for ECW, bromide is used as tracer and its concentration is determined by energy dispersive X-ray spectrometry; while as for TBW, D2O is used as tracer and HOD is determined by FT IR. Both methods represent significant improvements with respect the procedures described in the literature in terms of availability, reproducibility and accuracy.

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.

scholarly journals The Available Clinical Approaches to the Management of Patients with Acute and Chronic Hypernatremia

2020 ◽  
Vol 8 (F) ◽  
pp. 1-10
Author(s):  
Asaad Moradi ◽  
Foroogh Sabzghabaei ◽  
Mohammadshahab Kalantar
Keyword(s):  
Cerebral Edema ◽  
Serum Sodium ◽  
Total Body Water ◽  
Sodium Concentration ◽  
Clinical Treatment ◽  
The Other ◽  
Present Review ◽  
Serum Sodium Concentration ◽  
A Value ◽  
Total Body

Hypernatremia has been known as a conventional electrolyte problem and is defined as a serum sodium concentration growth up to a value above 145 mmol/l. This disease is also known as a hyperosmolar condition, which is resulted from a reduction in total body water compared to the electrolyte content. Since two types of hypernatremia, including acute and chronic, exist, in the present study, we will review the available clinical approaches for the management of patients with acute and chronic hypernatremia. To this end, 68 studies having the criteria of the present review and published from 2000 were chosen and their data were extracted. The inclusion criterion was to be mainly focused on hypernatremia clinical treatment and those having side topics were excluded from the study. Acute symptomatic hypernatremia is a disease that occurs in <24 h and needs to be treated immediately. On the other hand, there is a chronic hypernatremia that occurs in a duration of more than 48 h and is required to be treated at a lower speed due to cerebral edema risks during treatment. Finally, for providing beneficial outcomes to patients, both chronic and acute hypernatremia need to be compared thoroughly and also more investigation needs to be done.

Acute subtraction alkalosis from gastric juice loss in dogs

1964 ◽  
Vol 207 (3) ◽  
pp. 619-626 ◽  
Author(s):  
Jared J. Grantham ◽  
Paul R. Schloerb
Keyword(s):  
Gastric Juice ◽  
Chloride Concentration ◽  
Plasma Potassium ◽  
Sodium Concentration ◽  
Clinical Syndrome ◽  
Body Water ◽  
Plasma Sodium ◽  
Body Sodium ◽  
Plasma Chloride ◽  
Total Body

The clinical syndrome of acute metabolic alkalosis secondary to pyloric obstruction and vomiting was simulated in 50 dogs by draining gastric juice through a cannula gastrostomy. This study was designed to quantify changes in body electrolyte and water utilizing radioisotope-dilution methods. Total body chloride decreased 43% with good correlation between the decrease in plasma chloride concentration and the decrease in total body chloride. Body sodium decreased 21% with no change in plasma sodium concentration. Body potassium decreased 20% but was not significantly related to the decrease in plasma potassium concentration. A highly significant correlation was obtained between plasma potassium and the product of blood hydrogen and intracellular potassium content. Intracellular pH (DMO) did not change significantly. Body water decreased 16% with isotonic loss of 169 mEq Na + K per liter body water. Sodium chloride solution alone corrected the alkalosis and acidified the urine. Potassium administration was necessary to prevent hypokalemia and aggravation of the cellular potassium deficit during rehydration. This study helps clarify the differences in body composition between the acute alkalosis of gastric juice loss and the alkalosis resulting from prolonged potassium depletion, sodium loading, and excess adrenocorticosteroid administration.

Risk factors for hepatic encephalopathy in patients with cirrhosis and refractory ascites: relevance of serum sodium concentration

2010 ◽  
Vol 30 (8) ◽  
pp. 1137-1142 ◽  
Author(s):  
Mónica Guevara ◽  
María E. Baccaro ◽  
Jose Ríos ◽  
Marta Martín-Llahí ◽  
Juan Uriz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatic Encephalopathy ◽  
Serum Sodium ◽  
Sodium Concentration ◽  
Serum Sodium Concentration ◽  
Refractory Ascites
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