Water and Sodium Balance, Hypernatremia and Hyponatremia, Animation
(USMLE topics) Body fluid regulation and sodium disorders, pathology, causes and treatment.
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Voice by Ashley Fleming
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Water moves from the more diluted solution to the more concentrated solution - from lower to higher osmolality.
Sodium, being the major extracellular solute, is the principal determinant of plasma osmolality and the most important regulator of fluid balance. A normal blood sodium level is kept between 135 and 145 mmol/L. Hyponatremia occurs when blood sodium falls below 135, while hypernatremia is when it exceeds 145. Clinical manifestations of sodium disorders reflect disturbances in water movement in the brain. In hypernatremia, high blood sodium levels draw water out of the brain cells, causing dehydration and shrinkage. Whereas in hyponatremia, low concentrations of plasma sodium drive water into brain cells, making them swell, causing edema. Both situations produce neurologic symptoms, which can range from headache, confusion, to seizures, coma or even death.
Hypernatremia most often occurs because of inadequate water intake, or excessive water loss or excretion. Water intake is regulated by thirst. When a decreased body fluid volume or an increased plasma osmolality is detected, the brain perceives it as thirst and produces water-seeking behavior. Impaired thirst mechanism is a common cause of hypernatremia in the elderly.
The body loses water primarily by excreting it in urine. Water excretion by the kidneys is mainly regulated by vasopressin, a hypothalamic hormone that causes the kidneys to retain water in response to low blood volume or high plasma osmolality. Impaired vasopressin release, renal dysfunction, and use of certain diuretics, are common causes of excessive water loss through the kidneys.
Fluid loss through the digestive tract is normally negligible, but can be substantial in vomiting or diarrhea. Sweat loss though skin can be significant in extreme heat or during excessive exercise.
Chronic hypernatremia is treated with oral hypotonic fluids, while acute or severe hypernatremia may require intravenous administration along with constant monitoring to avoid overcorrection.
For hyponatremia, treatment depends on the body fluid volume:
- In low volume, or hypovolemic hyponatremia, both sodium and water levels decrease, but sodium loss is relatively greater. This commonly occurs due to loss of sodium-containing fluids, as in vomiting and diarrhea, especially when loses are replaced with plain water. This type is managed by rehydration with isotonic fluids.
- In high volume, or hypervolemic hyponatremia, both sodium and water levels increase, with a relatively greater increase in body water. This often results from fluid retention in conditions such as heart failure, liver cirrhosis, or kidney failure; and is usually treated with diuresis.
- In normal volume, or euvolemic hyponatremia, sodium level is normal, but there is an increase in total body water. This can be caused by excessive water intake combined with renal insufficiency, or syndrome of inappropriate ADH secretion, which causes the kidneys to retain more water. This type is managed by restricting free water intake and addressing the underlying cause.
Premenopausal women are more susceptible to acute hyponatremia with severe brain edema, perhaps because female hormones increase vasopressin level, and inhibit the brain sodium-potassium pump, which pumps sodium out of the cell and helps maintain normal brain volume.
Пікірлер: 107
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Good video but you forgot to mention that hypervolemic hyponatremia iso HF/ESRD/cirrhosis is also treated with low dietary sodium intake to prevent fluid retention. This is important to remember because some providers will incorrectly recommend increasing sodium intake d/t low sodium level
This video was very helpful! Thank you so much!!
it helped me a lot during my medical university exms😍😍..Thank you for this easy animated video.Concept clear video.awesome👍
@laraibali4880
Жыл бұрын
Could you please tell me if have the symptoms of hypernatremia which doctor should I see?
Excellent.explanation.
Why can’t medical school professors give simple explanations like these
@jeanyoute3928
2 жыл бұрын
They would lose money lol 😂
@zelifdemirci
2 жыл бұрын
oh i guess this is a global problem 🙄😅
@isaissac2441
Жыл бұрын
Totally , i mean they like to complicate things
@r.y776
Жыл бұрын
Reallyyyyy! WHY?
@randomboiiii69420
Жыл бұрын
Because most of them are stupid Only the g’s that are capable of simplifying and summarizing any subject without fucking the scientific approach
This is VERY HELPFUL, many many many thx. It took me days to understand thiss!
@Alilamedicalmedia
Жыл бұрын
Great to hear!
Nice video... Thank you❤
After many searches i found your video and its really helpful for me.. its total clear my idea and peception.. thank you very much🙏👏
@Alilamedicalmedia
3 жыл бұрын
You are most welcome!
@ff-ti7nj
2 жыл бұрын
@@Alilamedicalmedia Hey my mom has high blood pressure, and also hyponatremia. she needs to loose weight, what can we do that these contradictions don't mess up?
Amazingly informative easy
Thank you so much
that was a great video - thank you
Understood... thank you very much.👍👍🥰
Very beautiful
Thank's you for help
THANKYOU SOOO MUCH
Thanks a lot ❤
Good information
Excellent mam thank u🙂🙂
I drank a lot of water within short period of time.now my head is feeling heavy.this video let me know im suffering from hyponatremia 'evolemic condition'.Straight to the points and well arranged informations.thank you very much
@Joshua-gu5nj
4 жыл бұрын
That's just what happens when you drink a lot of water in a short period of time. So maybe don't do that.
@toylo9567
3 жыл бұрын
only drink when you feel brainfog, or thirst. sometimes you will feel brainfog before feeling thirst
@hassan4576
Жыл бұрын
How do you feel now? What did you end up doing about it?
Thank.you.very.much.sir.
This easily replaces 2 hours worth of convoluted lectures on the topic, which i was presented with at med school. For free. In 5 minutes.
Thanks
Thank you very much Can you please upload a video on the Nephritic syndrome?
I LOVE YOU GUYS
Best video
Respect ❤❤❤
Nice vedio
I have brain damage caused by a common blood pressure medication which damaged the salt/water pump area of my brain. This is also the area of the brain that controls ones ability to lose weight/sleep cycles/and the ability to hang on to water during sleep. (as as opposed to waking up all night for the restroom) Anyway there is research in Medical Journals according to my Dr. that show this particular blood pressure med causes this brain damage! Yet the med is FDA approved! Been in treatment and have improved dramatically.
@ElectedOfficial1
2 жыл бұрын
I now call the FDA the federal death administration. They approve medicines for their own corporation and profit and could care less about us! I just found out my sodium level is dangerously well when I could have a heart attack! Now I’m drinking Redmond salt in water daily! I couldn’t understand why my heart rate and blood pressure were high and that’s why.
@e.maldonado4540
2 жыл бұрын
Which medication?
@Sara-world
2 жыл бұрын
What area of the brain is the salt /water pump? I was born with a kidney abnormality and what started with twitches have turned out to be full on convolsions with aura migraines. I recently realized that electrolytes help within seconds. I know I have a problem regulating sodium I'm just not sure where to look and Dr's have told me it's all in my head and not really happening. It's definitely not in my head.
@mb-us3oz
2 жыл бұрын
@@Sara-world I have something simmilar
@nooch190
Жыл бұрын
hydralazine maybe?
Good
Best video! Thank you.
Structure of contractile proteins and mechanism of muscle contraction please
excellent!
@Alilamedicalmedia
Жыл бұрын
Thanks!
Thanks ..
Hey guys, make a video about kidney insufficiency!
Can you please upload a video on Diarrhoea???
Can i have use this in my project? Thank you.
Hello , is hypernatremia responsible for paralysis ?
I forgot I left volume on 100 when I plugged in my earphones... press f to pay respects..
@cerealsop
3 жыл бұрын
F
@danielcalma2138
3 жыл бұрын
F
@samromario9332
3 жыл бұрын
E
@loganmarshall7380
Жыл бұрын
U must have understood HYPERVOLUMIC hyponatremia clearly then
8 by Cree dew
I am pleased to hear However Dil mange more Hence for this purpose whom Should I consul locally The specialist in sangli city To guide me more
First comment ❤
In hypervolumic hyponatremia...due to retention of water sudium goes down. In Euvolemic hyponatremia again excees water intake lead to soudium decrease....both have same meachnism then how placed in different classification.. either on causes or something else???
@Alilamedicalmedia
14 күн бұрын
It's the difference in volume: higher than usual volume (hyper) vs. normal volume (eu). The volume is an important factor in determining treatment.
If,Sodium low in body so. Edema desease come.
I try to drink a lot of water but i pee a lot. BUN level is high. Had brain tumor taken out earlier this year. Wonder if it’s linked at all.
@consciousriverfilms
3 ай бұрын
You pee a lot because you drink enough water to dilute sodium levels (hyponatremia), and without getting enough sodium in your water and/or diet (esp. on a low carb diet) to replace losses in the urine and sweat, the water you drink will keep flowing right through you. It simply won't be retained well ... in other words, you won't stay hydrated. Salt (and other electrolytes) and carbs with water hydrate, water alone does not.
Interesting... can we use this teknic to prevent wrinkles 🤔
@iradesign4796
3 жыл бұрын
For example if we put more Na+ in skin cells more water go in.... i think
So if i drink a lot of water with a little bit of salt will it counter balance the excess water using the Nacl i consumed ?
@underated17
11 ай бұрын
That's what I am wondering? I am thirsty after eating foods like pizza. It's terrible.
@consciousriverfilms
3 ай бұрын
Thirst is to raise blood volume or lower sodium levels in the blood. In your case, with pizza, thirst is mostly to lower/dilute sodium levels in your blood.
Can someone to help to understand I have high blood pressure , and always eat salty food ( cant eat without salt ) , in some way craving for salt , on other hand i drinking too much water like 6-8 l ( 1.5-2 gallons ) , too many times go to pee. Does too much water cause my low sodium that crave for salt or my high intake sodium cause drinking too much water and remove my soidum and electrolytes ?, what overwhelmeing my kidneys ? Solution ? Thank you
@kikiamballz3288
Жыл бұрын
our body only needs 6mmol or 106mg sodium per day, water is like an eraser for sodium so yes, due to too much water you would crave sodium. So for my solution go on a balance diet where you aim to get 6mmol, you can lose and gain them everyday but if you can maintain it for a day you can check for results by taking a lab results for sodium, it would be great to know if you have high or low sodium so you can know what to do for your diet everyday
@actionrick9345
Жыл бұрын
Also if you eat sodium you will crave water
@consciousriverfilms
3 ай бұрын
Your excessive water intake (assuming you aren't also exercising and sweating excessively) would be the reason you crave salt, because you're likely not replenishing the sodium losses from peeing all the time (like every hour or less). The Human body already knows how to balance fluids in the body ... resist forcing yourself to drink any amount of water you've heard you're "suppose to" drink and simply drink to thirst. Problem solved. 🤗
I m senior path tech
Does anyone know if blood non fasting results are accurate? I cannot tolerate a slice of pizza or anything salty without developing an unquenchable thirst. Anyone else have this? My non fasting blood sodium result was 139 once and 140 another time. I am very concerned. My doctor said it's within normal range but this was non fasting! I also have low vitamin D 64.2. Does anyone else have advice? I am a seemingly otherwise healthy 31 year old female.
@bobvance-
10 ай бұрын
Go see another doctor.
Did you really need to watermark the entire video? Very distracting,
im bloated.
if i ate salty foods i have dizzyness if contineous salty foods will make me seizures...the doctors does not know why.
@Genesis817
3 жыл бұрын
How are you now,?
@ElectedOfficial1
2 жыл бұрын
I just found out that I have low sodium levels that could give me a heart attack! We are supposed to eat salt and no one ever told me that! I work out every day and have water retention, not bad but now I know why my blood pressure is up and I have a faster heart rate! Now I’m drinking Redmond salt in filtered water every day to save my life.
@TheManWithoutAName1120
Жыл бұрын
Just checking up on you john, you good bro?
Every universal third just as inerpt. Pho
Hii ha
Ga bisa centangg😬😬😬
To much sodium cause of too little water To little sodium due to having too much water The body is odd like that
@lesliewinchester8225
2 жыл бұрын
The problem for me is anti-depressant citalopram hydrobromide causes hyponatremia for me. I keep yelling at mental health professionals that my rape that my youngest son is from is what has made me crazy. Solve the rape get a better patient, when the fbi refuses to assign a detective I feel more raped by those who are suppose to help. My rape was on federal property so no other agency can do it. I’ve been fighting over getting it investigated for four months because I learned there were no time limits in my Nov 1998 rape.
@joshuegv-4492
Жыл бұрын
There sould always be 2x of potassium for each sodium.
Proceeds to drink slice which contains 9mg sodium
Hypernatremia cause Edema not hyponatremia 🚫
@Alilamedicalmedia
Жыл бұрын
www.ncbi.nlm.nih.gov/pmc/articles/PMC4470176/ www.ncbi.nlm.nih.gov/pmc/articles/PMC6500936/#:~:text=Acute%20hyponatremia%20or%20hypernatremia%20can,causes%20osmotic%20demyelination%20(1). www.mayoclinic.org/diseases-conditions/hyponatremia/symptoms-causes/syc-20373711#:~:text=In%20acute%20hyponatremia%2C%20sodium%20levels,of%20hyponatremia%2Drelated%20brain%20damage.
I’m just eating more salt, the good salt, sea salt.
@GouramiNatural
2 жыл бұрын
Isn't salt just salt?? 😂
@consciousriverfilms
3 ай бұрын
Celtic salt has more trace minerals (specifically more magnesium) than sea salt.