HypoNatremia Flashcards
Normal Na level
135 to 145
Kidney Regulation Dependent?
Pituitary secretion of Vasopressin (ADH)
Kidney response to Vasopressin (variant urine concentration)
Intact thirst
Tonicity or effective osmolality ?
Capacity of particles i solution to affect water movement across semi permeable membrane —> which is cell membrane
Urine Osmolality <100 Plasma Osmolality approximately 285
Baroreceptor
Function
Mediated ADH
Hyponatremia
Clinical Manifestations (W Hypotonicity)?
Cellular Edema brain
Increased IP
Hyponatremia
Types ?
- Isotonic
- Hypertonic
- Hypotonic
*** Look on Osmolarity to check Type **
Isotonic Hyponatremia (another name ) Aka ?
Aka Pseudohyponatremia
Isotonic Osmolarity WNL (approximately 285)
can result from:
Lab Artifact?
Hypertriglyceridemia ?
Paraproteinemia? (abnormal Protein that destroys Kidneys due to CA
like melanoma
Check Serum Electro pherisys
Hypertonic Hyponatremia ?
Presence of Excess ECF Osmotically Effective Solutes (i.e glucose)
Exertion of Osmotic Pressure
H2O redistribution from intracellular to Exrecellular compartment
Resulting Dehydration and Hyponatremia
It’s HYponatremia DUE TO Hypertonicity due to decrease cellular Volume
Hypotonic Hyponatremia
Inability of Kidney to Exrete Electrolyte-Free H2O to match water intake
Two different Mechanisms
1. Normal diluting capacity of kidney is overwhelmed by excessive
H2O intake
2. Diluting Capacity of kidney is impaired
3 types of Hypotonic Hyponatremia
Euvolemic
Hypovolemic
Hypervolemic