Clinical and experimental nephrology
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Clin. Exp. Nephrol. · Jun 2003
Case ReportsA new quantitative approach to the treatment of the dysnatremias.
Rapid correction of the dysnatremias can result in significant patient morbidity and mortality. To avoid overly rapid correction of the dysnatremias, the sodium deficit equation, water deficit equation, and Adrogue-Madias equation are frequently utilized to predict the change in plasma sodium concentration (Delta[Na+]p) following a therapeutic maneuver. However, there are significant limitations inherent in these equations. ⋯ These equations consider the mass balance of Na+, K+, and H2O, as well as therapy-induced changes in TBW. The first equation is applicable to both hypernatremia and hyponatremia. The second equation is applicable to the management of severe symptomatic SIADH requiring intravenous therapy.
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Clin. Exp. Nephrol. · Jun 2003
Case ReportsA simple quantitative approach to analyzing the generation of the dysnatremias.
Although the dysnatremias are the most common electrolyte disorders in hospitalized patients, the complexity of the parameters normally used to explain their generation mechanistically is often bewildering to medical students and experts alike. A number of methods have been utilized clinically to analyze retrospectively and predict prospectively the pathogenesis of these disorders. These approaches include the measurements of plasma and urine osmolality, free water clearance, electrolyte free water clearance, and tonicity balance. ⋯ The conceptual simplification resulting from the use of this formula should significantly improve the current approaches used in analyzing the generation of the dysnatremias.