Document Detail


Pathogenesis of sodium and water retention in high-output and low-output cardiac failure, nephrotic syndrome, cirrhosis, and pregnancy (2)
MedLine Citation:
PMID:  3050523     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This article has analyzed the pathogenesis of sodium and water retention in several circumstances. The initiator of retention has been proposed to be either a fall in cardiac output (e.g., low-output cardiac failure and vasoconstrictor hypovolemic nephrotic syndrome) or peripheral arterial vasodilatation (e.g., high-output cardiac failure, cirrhosis, arteriovenous fistula, and pregnancy). In the only state discussed, in which the kidney is diseased and not merely responding to extrarenal reflexes--i.e., nephrotic syndrome--intrarenal mechanisms may predominate and lead to expansion of the arterial vascular tree and suppression of the renin-angiotensin-aldosterone system (i.e., hypervolemic nephrotic syndrome). Otherwise, when kidneys are healthy, either a fall in cardiac output or peripheral arterial vasodilatation may diminish arterial vascular filling and thereby initiate a series of hemodynamic and hormonal events that result in renal sodium and water retention (Fig. 7). Finally, the approach presented in this article should be considered to be a vantage point from which to evaluate states of sodium and water retention, but not to be an exclusive position.
Authors:
R W Schrier
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The New England journal of medicine     Volume:  319     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1988 Oct 
Date Detail:
Created Date:  1988-11-15     Completed Date:  1988-11-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1127-34     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Colorado School of Medicine, Denver 80262.
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MeSH Terms
Descriptor/Qualifier:
Animals
Body Water / metabolism*
Cardiac Output
Female
Heart Failure / metabolism*
Humans
Liver Cirrhosis / metabolism
Nephrotic Syndrome / metabolism*
Pregnancy
Pregnancy Complications / metabolism
Sodium / metabolism*
Chemical
Reg. No./Substance:
7440-23-5/Sodium
Comments/Corrections
Comment In:
N Engl J Med. 1989 Jun 8;320(23):1561-2   [PMID:  2725590 ]
Erratum In:
N Engl J Med 1989 Mar 9;320(10):676

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


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