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Core Concepts in the Disorders of Fluid, Electrolytes and Acid-Base Balance pp 29–48Cite as

Disorders of Water Metabolism

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Abstract

Disorders of serum sodium are very frequently encountered particularly in hospitalized elderly patients. Most often these reflect disorders in water balance. This chapter reviews normal water regulation, and how dysregulation culminates in hyponatremic and hypernatremic states. The complications of these electrolyte disorders, particularly as they relate to neurological adaptations and sequelae, are discussed. An approach to the diagnosis, evaluation, and treatment of these disorders is presented with emphasis on assessment of extracellular fluid volume status, interpretation of urinary osmolality and urinary sodium, and calculation of water excess and deficits. The central role of the presence or absence of vasopressin in the pathogenesis and treatment of dysnatremias permeates the entire chapter.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Denver School of Medicine, 1775 Aurora Ct., M20-3103, Aurora, CO, 80111, USA

    Joshua M. Thurman M.D.

  2. Department of Medicine, University of Colorado, 12700 E. 19th Ave., C281, Aurora, CO, 80045, USA

    Tomas Berl M.D.

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  1. Joshua M. Thurman M.D.
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Correspondence to Joshua M. Thurman M.D. .

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Editors and Affiliations

  1. Brigham and Women's Hospital, Harvard Medical School, VA Boston Healthcare System, Blackfan Circle 4, Boston, 02115, Massachusetts, USA

    David B. Mount

  2. Harvard Medical School, Renal Division, Brigham and Women's Hospital, Francis Street 75, Boston, 02115, Massachusetts, USA

    Mohamed H. Sayegh

  3. Harvard Medical School, Renal Division, Brigham and Women's Hospital, Francis Street 75, Boston, 02115, Massachusetts, USA

    Ajay K. Singh

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Thurman, J.M., Berl, T. (2013). Disorders of Water Metabolism. In: Mount, D., Sayegh, M., Singh, A. (eds) Core Concepts in the Disorders of Fluid, Electrolytes and Acid-Base Balance. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-3770-3_2

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  • DOI: https://doi.org/10.1007/978-1-4614-3770-3_2

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