Sensed by
osmoreceptors
Water excretion
A V P=ADH
1-Plasma osmolality
2-Urine osmolality
3-Urine Na
4-Urine K
Treatment
1-Raise plasma Na by restricting water
intake and promoting water loss
2-Correct the underlying disorder
2 protocols
CDI
NDI
Clinical features:
• Contracted ICF volume
• Decreased brain cell volume
increasing risk of subarachnoid or
intracerebal hemorrhage .
• Neurologic manifestations:
1-altered mental status
2-weakness
3-seizures and coma
Treatment
• Stop the ongoing water loss
• And correct the water deficit
• Correction:
water deficit=[(Plasma Na concentration-140)/140]X TBW
• TBW is 40% in women and 50%in men
If High:
If LOW
Secondary
Hypoparathyroidism
Renal failure
Clinical manifestaions
• Paresthesias:finger,toes,circumoral
regions
• Carpopedal spasm
• Chvostek sign
• Trousseau sign
• QT prolongation