Document Detail


Body fluid volume regulation in health and disease: a unifying hypothesis.
MedLine Citation:
PMID:  2193561     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In studies in experimental animals and in edematous patients, the nonosmotic release of vasopressin has been found to be consistently associated with activation of the sympathetic nervous and renin-angiotensin-aldosterone systems. Moreover, the sympathetic nervous system is known to modulate the nonosmotic release of vasopressin and activation of the renin-angiotensin-aldosterone system. These findings led to our proposal that body fluid volume regulation involves dynamic interaction between cardiac output and peripheral arterial resistance. In this context, neither total extracellular fluid volume nor total blood volume are determinants of renal sodium and water excretion. With a decrease in effective arterial blood volume (EABV) initiated by either decreased cardiac output or peripheral arterial vasodilation, the acute response involves vasoconstriction mediated by angiotensin, sympathetic mediators, and vasopressin. The renal vasoconstriction, which accompanies either decreased cardiac output or peripheral arterial vasodilation, causes a decreased distal tubular delivery of sodium and water, thus maximizing the water-retaining effect of vasopressin and impairing normal escape from the sodium-retaining effect of aldosterone. The elevated glomerular filtration rate and filtered sodium load seen in pregnant women allow increased distal sodium and water delivery despite a decrease in EABV, thus limiting edema formation during gestation.
Authors:
R W Schrier
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of internal medicine     Volume:  113     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-08-02     Completed Date:  1990-08-02     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  155-9     Citation Subset:  AIM; IM    
Affiliation:
University of Colorado School of Medicine, Denver.
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / physiology
Animals
Blood Volume / physiology
Body Fluids / physiology*
Humans
Renin-Angiotensin System / physiology
Sympathetic Nervous System / physiology,  physiopathology
Vasopressins / physiology
Chemical
Reg. No./Substance:
11000-17-2/Vasopressins; 52-39-1/Aldosterone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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