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Pathophysiology and management of disorders in water metabolism  

Kim, Dong Un (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Publication Information
Clinical and Experimental Pediatrics / v.50, no.5, 2007 , pp. 430-435 More about this Journal
Abstract
Even though we drink and excrete water without recognition, the amount and the composition of body fluid remain constant everyday. Maintenance of a normal osmolality is under the control of water balance which is regulated by vasopressin despite sodium concentration is the dominant determinant of plasma osmolality. The increased plasma osmolality (hypernatremia) can be normalized by the concentration of urine, which is the other way of gaining free water than drinking water, while the low plasma osmolality (hyponatremia) can be normalized by the dilution of urine which is the only regulated way of free water excretion. On the other hand, volume status depends on the control of sodium balance which is regulated mainly by renin-angiotensin-aldosterone system, through which volume depletion can be restored by enhancing sodium retention and concomitant water reabsorption. This review focuses on the urine concentration and dilution mechanism mediated by vasopressin and the associated disorders; diabetes insipidus and syndrome of inappropriate antidiuretic hormone secretion.
Keywords
Osmolality; Volume; Urine concentration and dilution; Diabetes insipidus; Syndrome of inappropriate antidiuretic hormone secretion;
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1 Kuhn W, Ryffel K. Herstellung konzentrierter Losungen aus verdunnten durch blose Membranwirkung. Ein Modellversuch zur Funktion der Niere. Hoppe-Seylers Z Physiol Chem 1942;276:145-78   DOI
2 Stephenson JL. Concentration of urine in a central core model of the renal counterflow system. Kidney Int 1972;2: 85-94   DOI
3 Sands JM. Molecular approaches to urea transporters. J Am Soc Nephrol 2002;13:2795-806   DOI
4 Woo SK, Dahl SC, Handler JS, Kwon HM. Bidirectional regulation of tonicity-responsive enhancer binding protein in response to changes in tonicity. Am J Physiol Renal Physiol 2000;278:F1006-12   DOI
5 Knoers NVAM, Deen PM. Molecular and cellular defects in nephrogenic diabetes insipidus. Pediatr Nehrol 2001;16:1146-52   DOI
6 Sampson HA. Comparative study of commercial food antigen extracts for the diagnosis of food hypersensitivity. J Allergy Clin Immunol 1988;82:718-26   DOI
7 Zelenina M, Christensen BM, Palmér J, Nairn AC, Nielsen S, Aperia A. Prostaglandin E2 interaction with AVP: effects on AQP2 phosphorylation and distribution. Am J Physiol Renal Physiol 2000;278:F388-94   DOI
8 Matsumura Y, Uchida S, Kondo Y, Miyazaki H, Ko SB, Hayama A, et al. Overt Nephrogenic diabetes insipidus in mice lacking the CLC-K1 chloride channel. Nature Genet 1999;21:95-8   DOI   ScienceOn
9 Hagy G, Settipane G. Prognosis of positive allergy skin tests in an asymptomatic population. A three tear followup of college students. J Allergy 1971;48:200-5
10 Robertson GL, Aycinena P, Zerbe RL. Neurogenic disorders of osmoregulation. Am J Med 1982;72:339-53   DOI   ScienceOn
11 Grammer LC, Schafer M, Bernstein D. Prevention of chymopapain anaphylaxis by screening chemonucleolysis candidates with cutaneous chymopapain testing. Clin Orthop 1988;234: 12-5
12 Verbalis JG. Pathogenesis of hyponatremia in an experimental model of the syndrome of inappropriate antidiuresis. Am J Physiol 1994;267:R1617-25
13 Brown D, Katsura T, Gustafson CE. Cellular mechanisms of aquaporin trafficking. Am J Physiol Renal Physiol 1998; 275:F328-31   DOI
14 Nishmura H, Koseki C, Imai M, Braun EJ. Sodium chloride and water transport in the thin descending limb of Henle of the quail. Am J Physiol Renal Physiol 1989;257:F994-1002   DOI
15 Kaneko K, Shimojima T, Kaneko K. Risk of exacerbation of hyponatremia with standard maintenance fluid regimens. Pediatr Nephrol 2004;19:1185-6
16 Kokko JP, Rector FC Jr. Countercurrent multiplication system without active transport in inner medulla. Kidney Int 1972;2:214-23   DOI
17 Berendes E, Walter M, Cullen P, Prien T, Van Aken H, Horsthemke J, et al. Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage. Lancet 1997;349:245-9   DOI   ScienceOn
18 Knoers N, Monnens LAH. Amiloride-hydrochlorothiazide versus indomethacin-hydrochlorothiaxide in the treatment of nephrogenic diabetes insipidus. J Pediatr 1990;117:499- 502   DOI
19 Nielsen S, Frokiaer J, Marples D, Kwon TH, Agre P, Knepper MA. Aquaporins in the kidney: from molecules to medicine. Physiol Rev 2002;82:205-44   DOI
20 Georgitis JW, Reisman RE. Venom skin tests in insectallergic and insect-nonallegic populations. J Allergy Clin Immunol 1985;76:803-7   DOI
21 Vervloet D, Arnaud A, Vellieux P. Anaphylactic reactions to muscle relaxants under general anesthesia. J Allergy Clin Immunol 1979;63;348-53   DOI
22 Moritz ML, Ayus JC. Prevention of hospital-acquired hyponatremia: a case for using isotonic saline. Pediatrics 2003; 111:227-30   DOI   ScienceOn
23 Sands JM, Timmer RT, Gunn RB. Urea transporters in kidney and erythrocytes. Am J Physiol Renal Physiol 1997; 273:F321-39   DOI
24 Devuyst O, Guggino WB. Chloride channels in the kidney: lessons learned from knockout animals. Am J Physiol Renal Physiol 2002;283:F1176-91   DOI
25 Dahl SC, Handler JS, Kwon HM. Hypertonicity-induced phosphrylation and nuclear localization of the transcription factor TonEBP. Am J Physiol Cell Physiol 2001;280:C248- 53   DOI
26 Albanese A, Hindmarsh P, Stanhope R. Management of hyponatremia in patients with acute cerebral insults. Arch Dis Child 2001;85:246-51   DOI
27 Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, Zecca S, et al. Central diabetes insipidus in children and young adults. N Eng J Med 2000;343:998-1007   DOI   ScienceOn
28 Gadde J, Spence M, Wheeler B. Clinical experience with penicillin skin testing in a large inner-city STD clinic. JAMA 1993;270:2456-63   DOI
29 Moser M, Crameri R, Brust E. Diagnosis value of recombinant Aspergillus fumigatus allergen 1/a for skin testing and serology. J Allergy Clin Immunol 1994;93:1-11   DOI   ScienceOn