Professional Documents
Culture Documents
net/publication/24235778
CITATIONS READS
35 998
4 authors, including:
Shashank Joshi
Lilavati Hospital and Research Centre
217 PUBLICATIONS 3,951 CITATIONS
SEE PROFILE
Some of the authors of this publication are also working on these related projects:
All content following this page was uploaded by Shashank Joshi on 29 May 2014.
Abstract
Total body water and tonicity is tightly regulated by renal action of antidiuretic hormone (ADH), renin-angiotensin-
aldosterone system, norepinephrine and by the thirst mechanism. Abnormalities in water balance are manifested as
sodium disturbances – hyponatremia and hypernatremia. Hyponatremia ([Na+<136meq/l]) is a common abnormality
in hospitalized patients and is associated with increased morbidity and mortality. A common cause of hyponatremia
is impaired renal water excretion either due to low extracellular fluid volume or inappropriate secretion of ADH.
Clinical assessment of total body water and urine studies help in determining cause and guiding treatment of
hyponatremia. Acute and severe hyponatremia cause neurological symptoms necessitating rapid correction with
hypertonic saline. Careful administration and monitoring of serum [Na+] is required to avoid overcorrection and
complication of osmotic demyelination. Vasopressin receptor antagonists are being evaluated in management of
euvolemic and hypervolemic hyponatremia. Hypernatremia ([Na+]>145meq/l) is caused by primary water deficit
(with or without Na+ loss) and commonly occurs from inadequate access to water or impaired thirst mechanism.
Assessment of the clinical circumstances and urine studies help determine the etiology, while management of
hypernatremia involves fluid resuscitation and avoiding neurological complications from hypernatremia or its
correction. Frequent monitoring of [Na+] is of paramount importance in the treatment of sodium disorders that
overcomes the limitations of prediction equations. ©
Announcement
18th All India Post Graduate Training Programme For Internal Medicine & Dip. N.B. Students conducted by API
Chennai Chapter.
Dates: 19th , 20th & 21st December – 2008 (Friday to Sunday)
Venue : Panagal Hall, Kilpauk Medical College, Chennai – 600 010
Registration: Rs. 500/- (Rupees Five Hundred only) cash / D/D
Further Details: Dr. E Prabhu, Course Director, Advanced Nuclear Medicine Research Institute, No. 12, Vellallar
Street, Purasawalkkam, Chennai – 600 084.
E.-Mail – dreprabhu@hotmail.com, www.apichennai.com
Phone – 04426612794, 26612860, 09382730296
Travel & Accomodation: Shri. S Sreekumar, Hoteline, AL 20, 110/B, Shanthi Colony, 4th Avenue, Anna Nagar West,
Chennai – 600 040.
Phone – 04426280802, 26280803, Fax: 91-44-26214064
Cell: 09841144805; 09444017270, E-Mail: hoteline@vsnl.com; hoteline@eth.net