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Renal System O1

Case Opening- Polyuria, Ratliff, 1/4/2013

Multiple voids of small amount, Daily urine volume is within normal Urinary Frequency
Polyuria Increased urine volume (>2.5-4 L/day or >2ml/min)
Units of Osmolality Osm/Kg
Units of Osmolarity Osm/L
Measure of osmotic pressure gradient between two solutions Tonicity
Intracellular fluid volume 25 L
Extracellular fluid volume 15 L
Interstitial fluid volume 12 L
Plasma Volume 3 L
Urine Osmolality range 50mOsm/Kg-1400mOsm/Kg
Normal Serum Osmolality 285-295 mOsm/Kg
Hypernatremia does NOT occur if Thirst is intact and there is access to free water
Hyposmolality leads to a net Water retention in excess of solute
Osmolality is regulated by Sensors, Mediators, and Thirst
Thirst is triggered at serum Osm of 290 mOsm/Kg
Water permeable sites in the nephron Proximal tubule, descending loop, Collecting ducts(with ADH)
Water impermeable sites in the nephron Ascending loop, DCT
Urine Osm > Serum Osm Osmotic diuresis
Serum Osm > Urine Osm Water diuresis
If patient with water diuresis is given DDAVP and produces hypertonic urine, what is the diagnosis? Hypothalamic diabetes insipidus aka they werent producing ADH
An adult that does not respond to DDAVP could be diagnosed with 2 things Lithium toxicity or Hypercalcemia
Created by: mcasto