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1. 1
RENAL PHYSIOLOGY
(V)
m
BODY FLUID COMPARTEMENTS
(CLINICAL CORRELATION)
Mohammed Abdel Gawad

2. OBJECTIVES
2
 Total Body Water
 Total Body Water Compartments
 Electrolytes & Non-Electrolytes Distribution
 Starling’s Forces & Membrane Permeability
 Net Filtration Pressure
 Body Water – Clinical Correlation

3. OBJECTIVES
3
 Total Body Water
 Total Body Water Compartments
 Electrolytes & Non-Electrolytes Distribution
 Starling’s Forces & Membrane Permeability
 Net Filtration Pressure (factors affecting)
 Body Water – Clinical Correlation

4. Total Body Water (TBW)

5. TBW is affected by: Gender and Age

7. TBW is affected by body fat
The ideal weight is only accurate in thin patients while the adjusted weight is
accurate in both thin and obese patients.

9. OBJECTIVES
9
 Total Body Water
 Total Body Water Compartments
 Electrolytes & Non-Electrolytes Distribution
 Starling’s Forces & Membrane Permeability
 Net Filtration Pressure
 Body Water – Clinical Correlation

10. Total body water Compartments

11. Total body water Compartments

12. Intravascular Compartment

13. Intravascular Compartment

14. OBJECTIVES
14
 Total Body Water
 Total Body Water Compartments
 Electrolytes & Non-Electrolytes Distribution
 Starling’s Forces & Membrane Permeability
 Net Filtration Pressure
 Body Water – Clinical Correlation

15. Electrolytes and Non-Electrolytes
dissolved in the TBW

16. Total body water Compartments

17. Osmolality
 is the number of particles (mmol) contained in
one liter of water, so measured in mmol/L.
 i.e. it is the concentration by number

18. Water, Electrolytes & Non-Electrolytes
Distribution (1)

19. Water, Electrolytes & Non-Electrolytes
Distribution (2)

20. Osmolality of all three compartments
 Osmolality of all three compartments is the
same, because water is able to move freely
among all three compartments

21. OBJECTIVES
21
 Total Body Water
 Total Body Water Compartments
 Electrolytes & Non-Electrolytes Distribution
 Starling’s Forces & Membrane Permeability
 Net Filtration Pressure
 Body Water – Clinical Correlation

22. Movement of water:
Starling’s Forces & Membrane Permeability
22
 The amount of water in each body compartment is
dependent on:
 1- osmotic pressure
 2- hydrostatic pressure
 + Membrane characteristics

23. Osmolality
 is the number of particles (mmol) contained in
one liter of water, so measured in mmol/L.
 i.e. it is the concentration by number

24. Starling’s Forces – Osmotic pressure

25. Starling’s Forces – Osmotic pressure

26. Starling’s Forces – Hydrostatic pressure

27. Starling’s Forces

28. Body Fluid Exchange
 1- Osmosis
 2- Filtration
 3- Diffusion (the most important)

29. Membrane Factors
 Membrane permeability (s) is clinically relevant in disorders which
disrupt membrane integrity (e.g., sepsis).
 Permeability of a membrane ranges from zero, completely
permeable, to one, completely impermeable.

30. OBJECTIVES
30
 Total Body Water
 Total Body Water Compartments
 Electrolytes & Non-Electrolytes Distribution
 Starling’s Forces & Membrane Permeability
 Net Filtration Pressure
 Body Water – Clinical Correlation

31. Starling’s Forces – Net Filtration Pressure

32. Starling’s Forces – Net Filtration Pressure

33. Factors Affecting Net Filtration Pressure:
1- Hydrostatic Pressure Changes

34. Factors Affecting Net Filtration Pressure:
2- Osmotic Pressure Changes
 Increased net filtration pressure can be due to
decreased net osmotic pressure.

35. Factors Affecting Net Filtration Pressure:
3- Membrane Permeability Changes
 Increased net filtration pressure can be due to increased
membrane permeability.
 Capillary membrane damage (s rises) may be caused
by infection, inflammation, sepsis, trauma, malignancy
and adult respiratory distress syndrome (ARDS).

36. OBJECTIVES
36
 Total Body Water
 Total Body Water Compartments
 Electrolytes & Non-Electrolytes Distribution
 Starling’s Forces & Membrane Permeability
 Net Filtration Pressure (factors affecting)
 Body Water – Clinical Correlation

37. Factors Affecting Net Filtration Pressure:
Clinical Correlation
 All fluid accumulations in the body are due to a change in one of the
components of Starling's Forces: hydrostatic pressure, osmotic pressure or
capillary permeability.
 Determining amount of protein and other factors contained in the fluid →
help to determine fluid collection is due to a change in which factor

38. Factors Affecting Net Filtration Pressure:
Clinical Correlation (transudate & exudate)
 Determining amount of protein and other factors contained in the fluid →
help to determine fluid collection is due to a change in which factor:
 1- change in hydrostatic pressure → collection with a low protein content and is
called a transudate.
 2- change in osmotic pressure → collection with a low protein content and is
called a transudate.
 3- change in membrane permeability (capillary damage) such as inflammation,
infection and malignancy → collection with a high protein & LDH content and is
called an exudate.

39. Factors Affecting Net Filtration Pressure:
Clinical Correlation (transudate & exudate)

40. Factors Affecting Net Filtration Pressure:
Clinical Correlation (Ascities albumin gradient)

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42. Gawad