复旦大学：《内科学》课程教学资源（PPT课件讲稿）顾勇－水电解介酸碱平衡

Disorders of fluid and eletrolyte meta bolism 2005-3-10 Huashan Hospital, Fudan University

1 Disorders of Fluid and eletrolyte Metabolism 2005-3-10 Huashan Hospital,Fudan University

Water and Sodium metabolism Control of water excretion Control of sodium excretion Hyponatremia and hypernatremia

2 Water and Sodium Metabolism • Control of water excretion • Control of sodium excretion • Hyponatremia and hypernatremia

Control of water excretion Regulation of thirst Antidiuretic hormone

3 Control of Water Excretion • Regulation of thirst • Antidiuretic hormone

Control of sodium excretion Nephron segmental reabsorption Regulation of sodium balance

4 Control of Sodium Excretion • Nephron segmental reabsorption • Regulation of sodium balance

Nephron Segmental reabsorption Glomerulotubular balance Proximal tubule Henle's loop Distal convoluted tubule Collecting tubule

5 Nephron Segmental reabsorption • Glomerulotubular balance • Proximal tubule • Henle’s loop • Distal convoluted tubule • Collecting tubule

Regulation of Sodium balance Extrarenal mechanisms intrarenal mechanisms

6 Regulation of Sodium Balance • Extrarenal mechanisms • intrarenal mechanisms

Extrarenal mechanisms Renal nerves Renin-angiotensin System Atrial natriuretic peptide Vasopressin Endogenous Na-K-ATPase inhibitors

7 Extrarenal mechanisms • Renal nerves • Renin-angiotensin System • Atrial natriuretic peptide • Vasopressin • Endogenous Na-K-ATPase inhibitors

intrarenal mechanisms Renal hemodynamics Physical factors Prostaglandins Kallikrein-kinin system Endothelium-derived factors

8 intrarenal mechanisms • Renal hemodynamics • Physical factors – Prostaglandins – Kallikrein-kinin system – Endothelium-derived factors

Hyponatremia Etiology and classification Clinical features Treatment

9 Hyponatremia • Etiology and classification • Clinical features • Treatment

Etiology and Classification Isotonic hyponatremia Hypertonic hyponatremia hypotonic hyponatremia

10 Etiology and Classification • Isotonic hyponatremia • Hypertonic hyponatremia • hypotonic hyponatremia