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Therapy of Renal Diseases and Related Disorders pp 1–22Cite as

Treatment of Hypoosmolar and Hyperosmolar States

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Abstract

Sodium and its attendant anions are the major solutes which determine extracellular fluid (ECF) osmolality. In fact, serum osmolality can be closely estimated by the formula: Posm = 2 Na (mEq/l)+BUN (mg%)/2.8+glucose (mg%)/18 It is not surprising, therefore, that hypotonicity almost always comes to the attention of the clinician when the serum sodium concentration is low. As will be discussed later, the therapy of the hyponatremic patient is dictated by the clinical setting and the underlying etiology of the disorder. While in most patients with hyponatremia hypoosmolality will also be present, before diagnostic or therapeutic maneuvers are undertaken it is necessary to establish that a hypoosmolar state truly exists. This is so because hyponatremia associated with normal osmolality, ‘pseudo or spurious hyponatremia’, requires no therapeutic or diagnostic intervention (1).

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Authors
  1. Moshe Levi
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  2. Daniel G. Bichet
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  3. Tomas Berl
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Editors and Affiliations

  1. The Bernard J. Hanley, Los Angeles, CA, 90033, USA

    Wadi N. Suki M.D. (Professor of Medicine Professor of Physiology and Biophysics Chief) (Professor of Medicine Professor of Physiology and Biophysics Chief)

  2. Division of Nephrology, University of Southern California School of Medicine, Los Angeles, CA, 90033, USA

    Wadi N. Suki M.D. (Professor of Medicine Professor of Physiology and Biophysics Chief) (Professor of Medicine Professor of Physiology and Biophysics Chief)

  3. Renal Section Baylor College of Medicine, The Methodist Hospital, Houston, TX, 77030, USA

    Shaul G. Massry M.D. (Professor of Medicine and Physiology Chief) (Professor of Medicine and Physiology Chief)

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© 1984 Martinus Nijhoff Publishing, Boston/ The Hague/ Dordrecht/ Lancaster

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Levi, M., Bichet, D.G., Berl, T. (1984). Treatment of Hypoosmolar and Hyperosmolar States. In: Suki, W.N., Massry, S.G. (eds) Therapy of Renal Diseases and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3807-9_1

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