scholarly journals Novel Algorithm for the Differential Diagnosis of Hyponatraemia in Anuric Patients Undergoing Maintenance Haemodialysis

2021 ◽  
pp. 1-6
Author(s):  
Lenka Vitova ◽  
Monika Tothova ◽  
Otto Schuck ◽  
Miroslava Horackova
Keyword(s):  
Differential Diagnosis ◽  
Total Body Water ◽  
Body Weight Gain ◽  
Extracellular Fluid ◽  
Sodium Concentration ◽  
Body Water ◽  
Maintenance Haemodialysis ◽  
Significant Difference ◽  
Calculated Volume ◽  
Total Body

<b><i>Introduction:</i></b> Hyponatraemia is associated with increased mortality in patients undergoing maintenance haemodialysis. In anuric patients, hyponatraemia development depends on the water-sodium ratio in retained fluid within the interdialysis interval (IDI). <b><i>Objective:</i></b> This study aimed to calculate the retained sodium-retained water ratio in patients on maintenance haemodialysis and make a differential diagnosis of hyponatraemia according to these data. <b><i>Methods:</i></b> The amount of retained water was determined as body weight gain (ΔBW) within the IDI. Sodium retention was calculated using our formula: eRNa<sup>+</sup> = ΔBW × (SNa<sup>+</sup>)<sub>t2</sub> − total body water (TBW)<sub>t1</sub> × ([SNa<sup>+</sup>]<sub>t1</sub> − [SNa<sup>+</sup>]<sub>t2</sub>), where TBW represents the calculated volume of the total body water and (SNa<sup>+</sup>)<sub>t1</sub> and (SNa<sup>+</sup>)<sub>t2</sub> represent the sodium concentration at the beginning and at the end of the IDI, respectively. We performed 89 measurements in 32 anuric patients on maintenance haemodialysis. <b><i>Results:</i></b> Hyponatraemia was detected in 13 measurements at the end of the IDI. The ΔBW had no statistically significant difference between normonatraemic and hyponatraemic patients. Hyponatraemic patients had significantly lower levels of retained sodium. The retained water-­retained sodium ratio facilitated in differentiating dilution hyponatraemia, nutritional hyponatraemia, depletion hyponatraemia, and dilution hyponatraemia associated with sodium wasting or malnutrition. <b><i>Conclusion:</i></b> The composition of retained fluid during the IDI may be hypotonic, hypertonic, or isotonic in relation to the extracellular fluid. Most of the hyponatraemic patients had hypotonic fluid retained during the IDI because of dilution as well as gastrointestinal sodium loss and/or malnutrition.

scholarly journals Hipernatremia dan Penatalaksanaanya

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Yuswanto Setyawan
Keyword(s):  
Total Body Water ◽  
Geriatric Patients ◽  
Clinical Signs ◽  
Extracellular Fluid ◽  
Sodium Concentration ◽  
Body Water ◽  
Brain Vessels ◽  
Concentrate Urine ◽  
Total Body ◽  
The Brain

Abstract: Hypernatremia could be caused by loss of water (increased loss or decreased intake), and although rarely, due to over intake of natrium. Patients who are at risk of hypernatremia are those with disturbance of thirst or limited access of water. Several factors that could cause hypernatremia especially among geriatric patients are, as follows: change of thirst stimuli, decreased ability to concentrate urine, and decreased total body water. Clinical signs of hypernatremia are usually not specific, however, patients tend to become symptomatic if hypernatemia occurs acutely. Hypernatremia clinical signs are mostly neurological related to the severity and the change of serum sodium concentration. Complications of hypernatremia are inter alia shrinkage of brain tissue due to the movement of water from intracellular to extracellular fluid which results in injury of brain vessels, bleeding in the brain, and a variety of neurological signs due to brain involovement which could lead to death. Management of hypernatremia has to be carried out accurately and thoroughly because inaccurate or too-rapid correction could risk the occurrence of cerebral edema.Keywords: hypernatremia, total body water  Abstrak: Hipernatremia dapat disebabkan oleh kehilangan air (peningkatan kehilangan atau penurunan asupan) dan, walaupun jarang, karena kelebihan asupan natrium. Yang berisiko tinggi untuk hipernatremia ialah mereka dengan gangguan mekanisme rasa haus atau keterbatasan akses terhadap air. Berbagai faktor dapat menyebabkan hipernatremia terutama pada geriatri seperti perubahan rangsangan haus, berkurangnya kemampuan pemekatan urin, dan berkurangnya total body water. Gejala klinis hipernatremia biasanya tidak spesifik namun pasien cenderung menjadi simtomatik saat hipernatremia terjadi secara akut. Gejala hipernatremia terutama bersifat neurologik terkait dengan tingkat keparahan dan kecepatan perubahan konsentrasi natrium serum. Komplikasi hipernatremia ialah antara lain penyusutan otak akibat perpindahan cairan intrasel ke ekstrasel yang dapat merobek pembuluh darah otak, pendarahan otak, dan berbagai gejala neurologik akibat keterlibatan otak, yang dapat berakhir fatal. Penatalaksanaan hipernatremia perlu dilakukan dengan cermat karena penanganan yang tidak tepat atau koreksi yang terlalu cepat dapat berisiko terjadinya edema serebri.Kata kunci: hipernatremia, total body water

BODY WATER COMPARTMENTS IN THE PREMATURE INFANT, WITH SPECIAL REFERENCE TO THE EFFECTS OF THE RESPIRATORY DISTRESS SYNDROME AND OF MATERNAL DIABETES AND TOXEMIA

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 883-889
Author(s):  
Wesley M. Clapp ◽  
L. Joseph Butterfield ◽  
Donough O'Brien
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Total Body Water ◽  
Distress Syndrome ◽  
Body Water ◽  
Control Group ◽  
Extracellular Water ◽  
Water Compartments ◽  
Significant Difference ◽  
Total Body

Normal values for both total body water and extracellular water have been determined in 86 premature infants aged 1 to 90 days and weighing 940 to 2,435 gm, with use of the techniques of deuterium oxide and bromide dilution. Nine full-term infants aged 1 to 6 days and weighing 2,590 to 4,985 gm were similarly studied. Nine infants with the respiratory distress syndrome and eight infants of toxemic mothers studied in the first 24 hours of life showed no significant difference in their body water compartments in comparison to a control group of normal infants matched for age and weight. Seven infants of diabetic mothers studied in the first 24 hours of life showed a significant decrease in total body water, expressed as percentage of body weight, with a normal intracellular to extracellular water ratio. These data indirectly support other evidence that there is an increase in body fat in these infants at birth. See Table in the PDF file

scholarly journals The Use of Infrared Spectrophotometry for Measuring Body Water Spaces

1999 ◽  
Vol 45 (7) ◽  
pp. 1077-1081 ◽  
Author(s):  
Graham Jennings ◽  
Leslie Bluck ◽  
Antony Wright ◽  
Marinos Elia
Keyword(s):  
Sample Preparation ◽  
Total Body Water ◽  
Biological Fluids ◽  
Deuterium Oxide ◽  
Body Water ◽  
The Body ◽  
Infrared Spectrophotometry ◽  
Significant Difference ◽  
Total Body ◽  
Novel Algorithm

Abstract Background: The conventional method of measuring total body water by the deuterium isotope dilution method uses gas isotope ratio mass spectrometry (IRMS), which is both expensive and time-consuming. We investigated an alternative method, using Fourier transform infrared spectrophotometry (FTIR), which uses less expensive instrumentation and requires little sample preparation. Method: Total body water measurements in human subjects were made by obtaining plasma, saliva, and urine samples before and after oral dosing with 1.5 mol of deuterium oxide. The enrichments of the body fluids were determined from the FTIR spectra in the range 1800–2800 cm−1, using a novel algorithm for estimation of instrumental response, and by IRMS for comparison. Results: The CV (n = 5) for repeat determinations of deuterium oxide in biological fluids and calibrator solutions (400–1000 μmol/mol) was found to be in the range 0.1–0.9%. The use of the novel algorithm instead of the integration routines supplied with the instrument gave at least a threefold increase in precision, and there was no significant difference between the results obtained with FTIR and those obtained with IRMS. Conclusion: This improved infrared method for measuring deuterium enrichment in plasma and saliva requires no sample preparation, is rapid, and has potential value to the clinician.

Time course and magnitude of changes in total body water, extracellular fluid volume, intracellular fluid volume and plasma volume during submaximal exercise and recovery in horses

2004 ◽  
Vol 1 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Michael I Lindinger ◽  
Gloria McKeen ◽  
Gayle L Ecker
Keyword(s):  
Plasma Volume ◽  
Total Body Water ◽  
Time Course ◽  
Extracellular Fluid ◽  
Submaximal Exercise ◽  
Body Water ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Intracellular Fluid ◽  
Total Body

AbstractThe purpose of the present study was to determine the time course and magnitude of changes in extracellular and intracellular fluid volumes in relation to changes in total body water during prolonged submaximal exercise and recovery in horses. Seven horses were physically conditioned over a 2-month period and trained to trot on a treadmill. Total body water (TBW), extracellular fluid volume (ECFV) and plasma volume (PV) were measured at rest using indicator dilution techniques (D2O, thiocyanate and Evans Blue, respectively). Changes in TBW were assessed from measures of body mass, and changes in PV and ECFV were calculated from changes in plasma protein concentration. Horses exercised by trotting on a treadmill for 75–120 min incurred a 4.2% decrease in TBW. During exercise, the entire decrease in TBW (mean±standard error: 12.8±2.0 l at end of exercise) could be attributed to the decrease in ECFV (12.0±2.4 l at end of exercise), such that there was no change in intracellular fluid volume (ICFV; 0.9±2.4 l at end of exercise). PV decreased from 22.0±0.5 l at rest to 19.8±0.3 l at end of exercise and remained depressed (18–19 l) during the first 2 h of recovery. Recovery of fluid volumes after exercise was slow, and characterized by a further transient loss of ECFV (first 30 min of recovery) and a sustained increase in ICFV (between 0.5 and 3.5 h of recovery). Recovery of fluid volumes was complete by 13 h post exercise. It is concluded that prolonged submaximal exercise in horses favours net loss of fluid from the extracellular fluid compartment.

scholarly journals Extracellular fluid and total body water changes in neonates undergoing extracorporeal membrane oxygenation

1992 ◽  
Vol 27 (8) ◽  
pp. 1003-1008 ◽  
Author(s):  
Harry L. Anderson ◽  
Arnold G. Coran ◽  
Robert A. Drongowski ◽  
Hyun J. Ha ◽  
Robert H. Bartlett
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Total Body Water ◽  
Extracellular Fluid ◽  
Body Water ◽  
Membrane Oxygenation ◽  
Total Body

The Ratio of Extracellular Fluid to Total Body Water and Technique Survival in Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Colin H. Jones ◽  
Charles G. Newstead
Keyword(s):  
Peritoneal Dialysis ◽  
Total Body Water ◽  
Extracellular Fluid ◽  
Residual Renal Function ◽  
Body Water ◽  
C Reactive Protein ◽  
Dialysis Patients ◽  
Technique Survival ◽  
Reactive Protein ◽  
Total Body

Background Patients receiving peritoneal dialysis experience a high technique failure rate and are often overhydrated. We examined whether an increased extracellular fluid volume (VECF) as a proportion of the total body water (VTBW) predicted technique survival (TS) in a prevalent patient cohort. Methods The VECF and VTBW were estimated by multiple-frequency bioelectric impedance in 59 prevalent peritoneal dialysis patients (median time on dialysis 14 months). Demographic, biochemical (albumin, C-reactive protein, and ferritin), and anthropometric data, forearm muscle strength, nutritional score by three-point Subjective Global Assessment, residual renal function, dialysate-to-plasma (D/P) creatinine ratio, total weekly Kt/V urea, total creatinine clearance, normalized protein equivalent of nitrogen appearance, and midarm muscle circumference were also assessed. Technique survival was determined at 3 years, and significant predictors of TS were sought. Results In patient groups defined by falling above or below the median value for each parameter, only residual renal function ( p = 0.002), 24-hour ultrafiltrate volume ( p = 0.02), and VECF / VTBW ratio ( p = 0.05) were significant predictors of TS. Subjects with a higher than median VECF / VTBW ratio had a 3-year TS of 46%, compared to 78% in subjects with a lower than median value. In multivariate analysis, systolic blood pressure and VECF / VTBW ratio (both p < 0.05) were significant predictors of TS. C-reactive protein approached significance. Conclusion Increased ratio of extracellular fluid volume to total body water is associated with decreased TS in peritoneal dialysis.

Some biochemical and physiological features of normal monkeys (Macaca radiata)

1963 ◽  
Vol 18 (6) ◽  
pp. 1231-1233 ◽  
Author(s):  
S. G. Srikantia ◽  
C. Gopalan
Keyword(s):  
Total Body Water ◽  
Body Fluid ◽  
Extracellular Fluid ◽  
Body Water ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Sodium Thiocyanate ◽  
Macaca Radiata ◽  
Hematological Indices ◽  
Total Body

Determinations of body-fluid spaces with antipyrine for total-body water and sodium thiocyanate for extracellular fluid volume, hematological indices, and several serum constituents in about 500 Macaca radiata monkeys revealed that most of the values obtained were very similar to values obtained in man. body fluid spaces; hematology Submitted on April 22, 1963

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