The Clinical Biology of Sodium

The Clinical Biology of Sodium: The Physiology and Pathophysiology of Sodium in Mammals presents a comparative view of mammalian sodium regulation and its clinical disturbances. This book covers a wide range of topics, including the physiological basis of fluid therapy, oral rehydration for diarrhea, the pathogenesis of edema, hypovolemia, endocrine regulation and disturbances, and nutritional requirement.

Organized into 12 chapters, this book begins with an overview of the distribution and physiological functions of sodium. This text then explores the two processes that provide the basis of most of the non-endocrine functions of the kidneys, namely, glomerular filtration and tubular reabsorption of sodium. Other chapters consider the avoidable human and material costs of hypertension. This book discusses as well the molecular biology of sodium transport. The final chapter deals with the three mechanisms capable of detecting changes in cardiovascular filling.

This book is a valuable resource for doctors, nurses, and veterinarians.

Contenu

Preface
Introduction

1. Body Sodium in Context: Distribution, Functions and Regulation
   Introduction: Some Problems in Context
   Distribution and Concentration of Sodium
   Basic Principles
   Simple Disturbances
   Oedema
   Bone Sodium
   Sodium in Brain and Cerebrospinal Fluid
   Functions of Sodium
   Sodium Transport: Na-K ATPase
   Isoforms
   Factors Affecting Activity
   Na+-H+ Exchange
   Conclusion
2. Renal Sodium Regulation
   Introduction
   Segmental Distribution of Sodium Reabsorption
   Effects of Hypovolaemia
   Endocrine Aspects of Renal Sodium Regulation
   Glomerular Filtration
   Ultrafiltration
   Proximal Reabsorption
   Loop of Henlé
   Ascending Thick Limb
   Regulation of ADH Release
   Distal Nephron
   Immaturity of Renal Function
   Conclusion
3. Enteric Sodium Uptake
   Introduction
   Enteric Sodium Transport
   Enteric Sodium Regulation
   Enteric Responses to Changes in Sodium Balance
   Diarrhoea
   Oral Rehydration
   Principles and Criteria of Efficacy
   Amino Acids
   Bicarbonate Precursors
   Sodium
   Sequestration: Third Space'
   Iatrogenic Disturbances
   Conclusion
4. Behavioural Regulation of Sodium Intake
   General Issues
   An Assumed Need, or a Real One?
   Experimental Approaches
   Early Studies of Salt Appetite
   Studies in Sodium-Depleted Sheep
   
   1. Neural Aspects
      Taste
      Hepatic Chemoreceptors
      Other Brain Mechanisms
   2. Humoral Aspects
      Adrenal Hormones and Angiotensin
      Reproductive Hormones
      Other Hormones
   3. Salt Appetite and Hypertension
   4. Biological Role of Salt Appetite
      Na, K and the Sodium Transport Hypothesis of Salt Appetite
      Conclusion
5. Physiological Basis of Nutritional Requirement for Sodium
   Introduction
   Subjectivity, Science and Sodium Intake
   Sodium Requirement and Normality, an Elusive Relationship
   Attitudes, Beliefs and Prejudice
   Definition of Requirement; Factorial, Empirical-and Pitfalls
   Unmeasured Losses
   Comparative Aspects of Sodium Requirement
   Rats
   Cats
   Dogs
   Ruminants, Horses and Pigs
   Conclusion
6. Comparative Aspects of Salt and Hypertension
   Introduction
   What Matters about Hypertension?
   Nutrition and Blood Pressure; Influences other than Sodium
   Lipids and Fibre
   Magnesium and Potassium
   Calcium
   Sodium and Possible Mechanisms of Hypertension
   The Natriuretic Hormone (ASTI) Hypothesis
   Effects of Hypertension on Fluids and Electrolytes
   Pregnancy Hypertension
   Salt and Human Hypertension
   Comparative Aspects of Hypertension
   Conclusion: Salt and Hypertension-Whose Decision?
7. Endocrine Effects on Normal and Abnormal Sodium Excretion
   Introduction
   Adrenal Steroids
   Aldosterone: Regulation and Effects
   Renin-Angiotensin System (RAS)
   ANP
   MSH
   Kallikrein-Kinin System
   Pregnancy
   Haemodynamic Changes
   Water Balance
   Hormonal Changes
8. Clinical Aspects of Extracellular Volume and Sodium Concentration
   Introduction
   Sodium Depletion, Dehydration and Plasma Sodium
   Sodium Excess: Hypertension and Oedema
   Other Aspects of Abnormal Sodium Balance
   Hypertonic, Hypotonic and Isotonic Dehydration
   Isotonic Dehydration
   Hypertonic Dehydration
   Hypotonic Dehydration
   
   1. Volume Excess
      Oedema
      Nephrotic Oedema
      Hepatic Oedema
      Cardiac Oedema
      Chronic Obstructive Pulmonary Disease
   2. Sodium Concentration: Hypernatraemia and Hyponatraemia
      Hypernatraemia
      Hyponatraemia
   3. Volume Depletion
      Anaesthesia and Surgery
      Hypovolaemia and Shock
      Adrenal Insufficiency (Addison's disease)
      Heat and Exertion
   4. Renal Dysfunction
      Chronic Renal Failure
      Acute Renal Failure (ARF)
9. Interactions Between Sodium, Potassium, Calcium and Magnesium
   Introduction
   Cellular Interactions
   Renal Interactions
   Physiological and Clinical Implications
   Conclusion
10. Clinical Disturbances of Sodium Transport
    Introduction
    Cystic Fibrosis
    Disorders of Muscle Excitation
    Down's Syndrome: Alzheimer's Disease
    Papillary Necrosis
    Polycystic Kidney Disease
    Gastric Cancer
    Renal Tubular Acidosis (and Fanconi Syndrome)
    Haemolytic Anaemia
    Bartter's Syndrome
11. Drugs Affecting Sodium Transport and Sodium Balance
    Diuretics
    Osmotic Diuretics
    Thiazides
    Potassium-Sparing Diuretics
    Loop Diuretics
    Other Side Effects
    Other Diuretics
    Cardiac Glycosides
    NSAIs
    Other Drugs
12. Concluding Synthesis
    References
    Abbreviations
    Index