The Clinical Biology of Sodium

The Clinical Biology of Sodium

The Physiology and Pathophysiology of Sodium in Mammals

1st Edition - January 1, 1995

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  • Author: A. R. Michell
  • eBook ISBN: 9781483100821

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Description

The Clinical Biology of Sodium: The Physiology and Pathophysiology of Sodium in Mammals presents a comparative view of mammalian sodium regulation and its clinical disturbances. This book covers a wide range of topics, including the physiological basis of fluid therapy, oral rehydration for diarrhea, the pathogenesis of edema, hypovolemia, endocrine regulation and disturbances, and nutritional requirement. Organized into 12 chapters, this book begins with an overview of the distribution and physiological functions of sodium. This text then explores the two processes that provide the basis of most of the non-endocrine functions of the kidneys, namely, glomerular filtration and tubular reabsorption of sodium. Other chapters consider the avoidable human and material costs of hypertension. This book discusses as well the molecular biology of sodium transport. The final chapter deals with the three mechanisms capable of detecting changes in cardiovascular filling. This book is a valuable resource for doctors, nurses, and veterinarians.

Table of Contents


  • Preface

    Introduction

    1. Body Sodium in Context: Distribution, Functions and Regulation

    Introduction: Some Problems in Context

    Distribution and Concentration of Sodium

    Basic Principles

    Simple Disturbances

    Oedema

    Bone Sodium

    Sodium in Brain and Cerebrospinal Fluid

    Functions of Sodium

    Sodium Transport: Na-K ATPase

    Isoforms

    Factors Affecting Activity

    Na+-H+ Exchange

    Conclusion

    2. Renal Sodium Regulation

    Introduction

    Segmental Distribution of Sodium Reabsorption

    Effects of Hypovolaemia

    Endocrine Aspects of Renal Sodium Regulation

    Glomerular Filtration

    Ultrafiltration

    Proximal Reabsorption

    Loop of Henlé

    Ascending Thick Limb

    Regulation of ADH Release

    Distal Nephron

    Immaturity of Renal Function

    Conclusion

    3. Enteric Sodium Uptake

    Introduction

    Enteric Sodium Transport

    Enteric Sodium Regulation

    Enteric Responses to Changes in Sodium Balance

    Diarrhoea

    Oral Rehydration

    Principles and Criteria of Efficacy

    Amino Acids

    Bicarbonate Precursors

    Sodium

    Sequestration: Third Space'

    Iatrogenic Disturbances

    Conclusion

    4. Behavioural Regulation of Sodium Intake

    General Issues

    An Assumed Need, or a Real One?

    Experimental Approaches

    Early Studies of Salt Appetite

    Studies in Sodium-Depleted Sheep

    1. Neural Aspects

    Taste

    Hepatic Chemoreceptors

    Other Brain Mechanisms

    2. Humoral Aspects

    Adrenal Hormones and Angiotensin

    Reproductive Hormones

    Other Hormones

    3. Salt Appetite and Hypertension

    4. Biological Role of Salt Appetite

    Na, K and the Sodium Transport Hypothesis of Salt Appetite

    Conclusion

    5. Physiological Basis of Nutritional Requirement for Sodium

    Introduction

    Subjectivity, Science and Sodium Intake

    Sodium Requirement and Normality, an Elusive Relationship

    Attitudes, Beliefs and Prejudice

    Definition of Requirement; Factorial, Empirical—and Pitfalls

    Unmeasured Losses

    Comparative Aspects of Sodium Requirement

    Rats

    Cats

    Dogs

    Ruminants, Horses and Pigs

    Conclusion

    6. Comparative Aspects of Salt and Hypertension

    Introduction

    What Matters about Hypertension?

    Nutrition and Blood Pressure; Influences other than Sodium

    Lipids and Fibre

    Magnesium and Potassium

    Calcium

    Sodium and Possible Mechanisms of Hypertension

    The Natriuretic Hormone (ASTI) Hypothesis

    Effects of Hypertension on Fluids and Electrolytes

    Pregnancy Hypertension

    Salt and Human Hypertension

    Comparative Aspects of Hypertension

    Conclusion: Salt and Hypertension—Whose Decision?

    7. Endocrine Effects on Normal and Abnormal Sodium Excretion

    Introduction

    Adrenal Steroids

    Aldosterone: Regulation and Effects

    Renin-Angiotensin System (RAS)

    ANP

    MSH

    Kallikrein-Kinin System

    Pregnancy

    Haemodynamic Changes

    Water Balance

    Hormonal Changes

    8. Clinical Aspects of Extracellular Volume and Sodium Concentration

    Introduction

    Sodium Depletion, Dehydration and Plasma Sodium

    Sodium Excess: Hypertension and Oedema

    Other Aspects of Abnormal Sodium Balance

    Hypertonic, Hypotonic and Isotonic Dehydration

    Isotonic Dehydration

    Hypertonic Dehydration

    Hypotonic Dehydration

    1. Volume Excess

    Oedema

    Nephrotic Oedema

    Hepatic Oedema

    Cardiac Oedema

    Chronic Obstructive Pulmonary Disease

    2. Sodium Concentration: Hypernatraemia and Hyponatraemia

    Hypernatraemia

    Hyponatraemia

    3. Volume Depletion

    Anaesthesia and Surgery

    Hypovolaemia and Shock

    Adrenal Insufficiency (Addison's disease)

    Heat and Exertion

    4. Renal Dysfunction

    Chronic Renal Failure

    Acute Renal Failure (ARF)

    9. Interactions Between Sodium, Potassium, Calcium and Magnesium

    Introduction

    Cellular Interactions

    Renal Interactions

    Physiological and Clinical Implications

    Conclusion

    10. Clinical Disturbances of Sodium Transport

    Introduction

    Cystic Fibrosis

    Disorders of Muscle Excitation

    Down's Syndrome: Alzheimer's Disease

    Papillary Necrosis

    Polycystic Kidney Disease

    Gastric Cancer

    Renal Tubular Acidosis (and Fanconi Syndrome)

    Haemolytic Anaemia

    Bartter's Syndrome

    11. Drugs Affecting Sodium Transport and Sodium Balance

    Diuretics

    Osmotic Diuretics

    Thiazides

    Potassium-Sparing Diuretics

    Loop Diuretics

    Other Side Effects

    Other Diuretics

    Cardiac Glycosides

    NSAIs

    Other Drugs

    12. Concluding Synthesis

    References

    Abbreviations

    Index

Product details

  • No. of pages: 388
  • Language: English
  • Copyright: © Pergamon 1995
  • Published: January 1, 1995
  • Imprint: Pergamon
  • eBook ISBN: 9781483100821

About the Author

A. R. Michell

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