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- Both the deficit of body water (dehydration) and its excess (overhydration) lead to potentially serious clinical problems. The assessment of water and electrolyte balance is an important part of clinical examination.
- Body water balance is closely linked to the balance of dissolved ions (electrolytes), the most important of which are sodium and potassium.
- The movement of water between ECF and ICF is controlled by osmotic gradients.
- The movement of water between the lumen of a blood vessel and the interstitial fluid is controlled by the balance between the osmotic and hydrostatic pressures.
- The main regulators of water and electrolyte balance are vasopressin
 (water excretion and intake) and aldosterone (sodium and potassium excretion). - The renin-angiotensin system is the principal regulator of blood pressure and vascular tone.
- The measurements of natriuretic peptides help to diagnose cardiac failure.
- Kidney is the key organ controlling the water and electrolyte balance. Serum concentrations of urea and creatinine, and creatinine clearance, are the key tests performed to assess the renal function.
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- Comment on the role of Na+K+-ATPase in maintaining the ion gradients across cell membrane.
- Describe the role of counter-current multiplication in the renal water reabsorption.
- Explain the role of renin-angiotensin system in the maintenance of blood pressure.
- Describe water movements between ECF and ICF which take place in water deprivation.
- Why does the low concentration of albumin in plasma lead to edema?
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Rubattu S, Volpe M. The atrial natriuretic peptide: a changing view. J Hypertens 2001;19:1923-1931.
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| Shapiro BP, Chen HH, Burnett JC Jr, Redfield MM. Use of plasma brain natriuretic peptide concentration to aid in the diagnosis of heart failure. Mayo Clinic Proceedings 2003;78:481-486.
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| Kozono, D, Yasui M King L S, Agre P. Aquaporin water channels: atomic structure and molecular dynamics meet clinical medicine. J Clin Invest 2002;109:1395-1399.
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| Adrogue, H J.; Madias NE. Hyponatremia. The N Engl J Med 2000;342:1581-1589.
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| Manohar P, Pina IL. Therapeutic role of angiotensin II receptor blockers in the treatment of heart failure. Mayo Clinic Proceedings 2003;78:334-338.
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| Chobanian A, Bakris GL, Black HR et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. The JNC7 Report. JAMA 2003;289;2560-2572.
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