Document Detail


New method to compute mixed water and electrolyte changes in hyponatremia: a preliminary report.
MedLine Citation:
PMID:  19384846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We developed a new method that diagnoses when either Na or water alone are altered during electrolyte abnormalities. The aim of this study is to describe the preliminary report of an original method which can give exact or useful calculations even in mixed disorders. METHODS: when NaCl is lost, the plasma Cl (PCl) to plasma Na (PNa) ratio falls from 0.75 (the normal value) toward zero, the ratio of plasma anions other than Cl (POAN) to PNa rises toward unity and POAN/PPCl toward infinity. With subscript 0 or normal values and subscript 1 for those during derangement, PCl1/PCl0 falls below unity, while POAN 1 /POAN 0 rises above unity in these hyponatremic disorders. Based on these changes, we developed exact mathematical formulas to compute alterations in solvent and solutes. The boundary conditions of applicability were computer modeled. RESULTS: regression coefficients between true data fed oo the computer and those calculated with our formulas were 1.00 when the boundary conditions were entirely met (R2=1.00, <0.0001) and 0.93-0.96 (R2>0.94<0.99, <0.001) when the boundary conditions were allowed to extend beyond their limits of exclusive mathematical validity. The method was extended to patients whose data satisfied the boundary conditions. The results show that the computations satisfactorily predict the exact measurements obtained by the change in body weight (R2=0.61, <0.001). CONCLUSIONS: This new method represents useful adjunct in evaluating and treating hyponatremias. Although its validity is limited to rather strict boundary conditions, it represents an original way to evaluate mixed solvent/solute derangements.
Authors:
Ettore Bartoli; Luigi Castello; Luca Bergamasco; Pier Paolo Sainaghi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of nephrology     Volume:  22     ISSN:  1121-8428     ISO Abbreviation:  J. Nephrol.     Publication Date:    2009 Mar-Apr
Date Detail:
Created Date:  2009-04-22     Completed Date:  2009-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  273-80     Citation Subset:  IM    
Affiliation:
Division of Internal Medicine, Department of Clinical and Experimental Medicine, University of East Piedmont A. Avogadro, Novara, Italy. bartoli@med.unipmn.it
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / physiology
Body Water / physiology*
Body Weight
Chlorides / blood*
Computer Simulation*
Electrolytes / blood*
Humans
Hyponatremia / metabolism*,  physiopathology
Sodium / blood*
Chemical
Reg. No./Substance:
0/Chlorides; 0/Electrolytes; 7440-23-5/Sodium

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


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