about fluid metabolism includes mainly about Na,K and K metabolism in the body

2. FLUID BALANCE MAINLY
DEALS WITH METABOLISMS:-
1.Sodium
2.Pottassium
3.Chlorine
4.Water

3.  ECF- extra cellular fluid it is present outside the cell
>> comprises about 50% of body weight
>>main cation of ECF – Na
>> Cl exists with Na as ECF
 ICF – Intra cellular fluid is present inside the cell .
>> comprises about 20% of body weight
including :
* Plasma
* Interstitial fluid
>> main cation of ICF is - K
ECF & ICF

4. Sodium is the primary cation of ECF.
Most of the body’s sodium is located in
blood and in the fluid arround the cells
Body obtains Na through food and
drink and looses it primarily in sweat
and urine .
Healthy kidneys maintains constiency
in excretion of urine
SODIUM :

5. It helps the body to keep fluids in a
normal balance
It plays a key role in normal nerve
and muscle function
Helps in osmo-regulation
Helps in preservation of permeability
of cell
 helps to maintain normal blood
pressure.
FUNCTIONS:-

6. It is present mainly in blood serum
Normal serum conc. Of Na–320mg
/100ml
Na is also seen in erythrocytes , but
very less in conc.
Distribution:

7.  When the conc. Of sodium in blood is
too low – HYPO NATREMIA
 When the conc. Of Sodium in blood is
too high – HYPER NATREMIA
Imbalance of Sodium Ions
Causes:

8.  Hyponatremia –true loss of sodium
 Poor renal reabsorption
 Indicated by excessive vomiting,weight
loss
 Renal diseases with acidosis
 Hyponatremia -due to overhydration
 Accumulation of fluid due to odema
 Occurs more in cirrhosis of liver
 heart failure

9. • In case of HYPONATREMIA - decrease in its
concentration, there is more release of water to
store more sodium which the body needs clearly.
• A low sodium level has many causes, including
consumption of too many fluids, kidney failure,
heart failure, cirrhosis, and use of diuretics.
• At first, people become sluggish and confused, and
if hyponatremia worsens, they may have muscle
twitches and seizures and become progressively
unresponsive.

10.  Increased sodium level in serum
May occur due to ;-
 Hyper activity of adrenal cortex
Cushing’s Syndrome.
 Prolonged administration of cortisone
,ACTH etc.
Hypernatremia:

11. Cushing’s syndrome

12. Sources
Mono sodiun glutamate
(msg)
Olives
Sources

13. RDA of sodium – 3,000mg/day
It is to be noted about the difference
between Sodium and Salt….
Na – mineral
Table salt contains only 40% of Na….
Increase of intake of salt on other
hand causes HYPERTENTION

14. Most of the potassium is located inside
the cells (inter cellular ion).
It is an essential macro nutrient
K+ is one of the most permeable ion
across cell membranes and exits the
cells mostly via K channels (and in
some cells via K-H exchange or via K-
Cl co - transport)
Potassium:

15. Lesser amount of K is present in
serum
Normal serum conc. Of K is –
19mg/100ml
In erythrocytes is – 440mg/100ml
Distribution:

16. It is necessary for normal functioning
of cells and muscles conduction
Maintains membrane potential
Maintains Fluid balance
Helps in Neuro transmission
Acid – base regulation
Its deficiency conditions
are:-
Functions:

17.  A low potassium level(3.5 mmol/L) has
many causes but usually results from
vomiting, prolonged diarrhea, adrenal
gland disorders(Cushing’s syndrome).
 ”FAMILIAL PERIODIC PARALYSIS”
 A low potassium level can make muscles
feel weak, cramp, twitch, or even become
paralyzed, and abnormal heart rhythms
may develop.
Hypokalemia;

18.  It occurs due to mutation of
membranes of electrolyte channels
 Symptoms :
>loss of muscle movement due
to weakness
> occurs in hips , shoulders
‘’FAMILIAL PERIODIC
PARALYSIS”

20. A high potassium level has many causes,
including kidney disorders, drugs that affect
kidney function, and consumption of too much
supplemental potassium.
Usually, hyperkalemia must be severe before it
causes symptoms, mainly abnormal heart
rhythms.
Treatment includes reducing consumption of
potassium, stopping drugs that may cause
hyperkalemia, and using drugs to increase
potassium excretion.
Hyperkalemia:

21. Infants – 0-6 months – 400 mg/day
 - 1-3 yrs -- 3000 mg/day
 -- 9-13 yrs -- 4500 mg / day
Children older than 13 yrs and adults –
4700mg/day
Lactating women – 5100 mg /day
RDA

22. Sources
Spinach
Apricot

23. Avacadoes
Broccoli

24. Chief ECF anion
Present in plasma and expressed as NaCl
Normal plasma conc. 500-550mg/100ml.
Cl conc. Is more in CSF than in plasma
Chlorine:

25. It is present in plasma - 500-
550mg/100ml
But Cl conc. is more in CSF – 600-
620mg/100ml
Distribution:

26. Acid – base balance
Chloride shift
Helps in formation of HCl in gastric juice
Salivary amylase is activated by chlorine
Are its Functions

27. NaCl- 5-10gms
Dietary req.

28. Sources

29. Hypochloremia- a reduction in the serum
Chlorine level
Which will occur due to
Vomiting
Diarrhea
respiratory alkalosis
Addison’s disease and excessive sweating
Disease State:

30.  Disorder in which the adrenal glands do not
produce sufficient steroid hormones
Addison's disease

31. An increase in serum chloride
level conc.
Which may lead to
 Dehydration
respiratory acidosis
Cushing’s syndrome
Hyperchloremia:

32. Water forms 60-70% of the body weight
distributed throughout the body
It is closely associated with electrolyte
distribution in body
Intercellular compartment ,comprises fluid
present inside the cells
Extracellular compartment ,comprises the
fluid present outside the cells.
Water:

33.  Solvent for electrolytes
 Regulator of body temperature
 Carrier of nutrients
 Regulates electrolyte balance
Are its Functions…

34. Water intake (in
gm /day)
Water output (in
gm / day)
Water intake daily = 1100 Water excreated in urine =
1000
Water intake in diet = 900 Water excreted in stools =
200
Water produced during
metabolism = 200
Water lost through skin
and lungs = 1000
Total intake = 2200 Total output = 2200

35. • Water gain: water consumed
during drinking,in foods, formed
during oxidation of foods,
metabolic process
 Water lost: from skin, sweat etc.

37.  The kidneys stimulate the adrenal glands to
secrete the hormone aldosterone.
 Aldosterone causes the kidneys to retain
sodium and to excrete potassium. When
sodium is retained, less urine is produced,
eventually causing blood volume to increase.
 The pituitary gland secretes antidiuretic
hormone. Antidiuretic hormone causes the
kidneys to conserve fluid. Then blood volume
increases.
Mechanism of Na:

38. When the conc. of Na increases in body info
is passed through:
 Sensors in heart
Blood vessels
 (finally)
Kidneys detect the increase and stimulates
 it to be in normal
Beauty of the body!..

39. Potassium homeostasis depends on maintenance of
external and internal potassium balance
External potassium balance -potassium intake
(100 meq/day) and rate of urinary (90 meq/day)
and fecal excretion (10 meq/day).
Internal potassium balance - distribution of
potassium between muscle, bone, liver, and red
blood cells (RBC) and the extracellular fluid (ECF).
Potassium homeostasis

40.  Hyperkalemia :- high level of
potassium in blood
 The serious consequences of these
condition are:- abnormal heart
rhythm, cardiac arrest
 Hypokalemia :- Low level of
potassium in blood

41.  K is consumed in food & drinks that
contain electrolytes and lost primarily in
urine
 Some K is lost through sweat.
 Healthy kidneys can adjust the
excreation of K to match changes in
consumption.
Mechanism how the body
maintains …

42. Body maintains the right level of K by
matching the amount of K consumed that of
the amount lost….
regulated by alterations in excretion in the
distal renal tubule, where mineralocorticoid
hormones and Na-K ATPase are the major
regulating factors. The distribution of
potassium across cell membranes is influenced
by changes in acid-base status, by pancreatic
hormones and by the autonomic nervous
system

43. Na and Cl metabolism is so much inter
related as,
The loss of Na in sweat ,urine is
accompanied with more loss of Cl
It results in low level of plasma chloride,and
thus there is increase in Bicarbonates with
consequent alkalosis
Metabolism of Cl:

44.  Health is wealth!!...
 Due to action of ADH
Regulates the excess loss of
water by Kidneys
 Exception:- in diabetes insipidus
 Balancing is seen when
water intake=water output
Balancing of water !!

45. Finally,
FLUID METABOLISM in body is
looked after by our KIDNEYS
and our cell membranes which will
help in transportation of ions and
maintains the acid-base balance….
Body has a very good mechanism to
manage everything ….