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Understanding Fluid & Electrolyte Balance in the Human Body

Learn about the distribution of body fluids, electrolytes, and the essential functions of regulating fluid balance. Explore how organs like the kidney, heart, lungs, pituitary, adrenal, and parathyroid glands play a crucial role in maintaining homeostasis.

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Understanding Fluid & Electrolyte Balance in the Human Body

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  1. Fluid & Electrolyte Balance Dr Grace Ann Varghese Submitted by Aiswaria Varghese

  2. BODY FLUID Body fluid refers to the body water and its dissolved substance

  3. DISTRIBUTION OF BODY FLUIDS & ELECTROLYTES • Adult man- 60% body weight • Adult women-50% body weight • Infants-70% body weight • Total body water varies with body fat , sex &age • Fat cell- less water • Women<men…..(fluid)

  4. DISTRIBUTION FLUID Intracellular fluid (ICF) Extracellular fluid(ECF) intravascular fluid interstitial fluid (btwn cell/tissue)

  5. DISTRIBUTION • Body fluid = water + electrolytes • Electrolyte- substance that develop electric charge when dissolved in water • They are Cations – develop +ve charge Anions – develop –ve charge

  6. List of cations & anions • .

  7. Homeostatic mechanism • Kidney • Heart & ANF • Lungs • Pituitary gland • Adrenal gland • parathyroid gland

  8. kidney • Vital to regulate fluid & electrolyte balance • Filter-180 l plasma/day • Excrete-1.8 l urine/day Major functions • Regulation of ECF volume & osmolarity • Regulation of electrolyte levels • Regulation of acid-base • Excretion of metabolic waste

  9. Renal blood flow Blood volume Blood pressure -ve Secretion of renin angiotensinogen angiotensin 1 BP ANTINATRIURETIC angiotensin 2 HORMONE vasoconstriction Sodium retained by kidney Blood Na level kidney

  10. Heart & anf HEART • Pumping action provide circulation thro kidney under sufficient pressure for urine to form ANF • Atrial natriuretic factor-released in right atrium • This hormone causes diuresis of Na+ & water by acting on kidney , thus decreases the intravascular volume

  11. lungs • Vital in maintaining homeostasis • Under the control of medulla the lung act to correct metabolic acid-base disturbance by regulating the levels of CO2 in ECF. • (CO2- a potential acid) • To compensate alkalosis , the lung hypoventilate to retain CO2,the increased acidity helps correct excess alkalinity of the body fluid • To compensate for metabolic acidosis , the lung hyperventilate to remove CO2,thus helps excess acidity • Lung remove-300 L water/day thro’ exhalation

  12. Pituitary gland • Specialized cell-hypothalamus manufacture a substance- ADH-stored in posterior lobe of pituitary gland • ADH helps body retain water- WATER CONSERVING HORMONE ADH renal water retension ADH renal water retension & urinary output

  13. Pituitary gland Blood osmotic pressure -ve +ve Osmoreceptors in hypothalamus Stimulates posterior pituitary gland • secretion of ADH Re absorption of H2o by kidney Blood osmotic pressure lowered

  14. ADRENAL GLAND • Primary adrenocortical hormone in influence of fluid balance is ALDOSTERONE • Promote Na + retention in exchange for K+ & H+ ions • Causes Na + retension & excretion of K+ • Primary regulator for aldosterone secretion-ANGIOTENSIN II • Na + con/ K+ con stimulate aldosterone • CORTISOL, another adrenocortical hormone, produce Na+ in large amt & K+ deficit

  15. Parathyroid gland • Regulate Ca2+ & phosphate balance by parathyroid hormone (PTH) • A receprocal relationship exists between Ca2+ & phosphate level. • CALCITONIN- action on Ca2+ is opposite to PTH. • Reduces Ca2+ concentration increased Ca ions Stimulate PTH secretion Depress PTH secretion Ca2+ releases No Ca2+ releases from bone into ECF from bone into ECF

  16. FUNCTIONS OF ELECTROLYTES • Maintenance of acid base balance • Maintain proper osmolarity and volume of body fluids • Determine specific physiologic function • Maintenance of electroneutrality • Initiate the production of energy • In impulse transmission

  17. FLUID IMBALANCES • Soduim • Potassium • Calcium • Magnesium • Phosphorus

  18. Sodium imbalance

  19. Sodium imbalance • Most plentiful electrolyte in ECF • Normal value : 135 – 145 mEq/L • 95% bodys active Na + is present in ECF, in ICF – small • Distribution across membrane requires ATP pump….providing energy • The salt intake per day : 50-90 mEq as NaCL

  20. SODIUM IMBALANCE HYPONATREMIA • Low Na+ LEVEL • Diluted ECF • Water drawn Into cells HYPERNATREMIA • High serum Na + level • Concentrated ECF • Water pulled out of cells

  21. Hyponatremia • Refers to reduced serum sodium level below 135 mEq/l • Most frequent electrolyte disorder • In Marked hyperlipidemia/hypoproteinemia….serum Na+ may appear to be lower than the actual value---PSEUDOHYPONATREMIA

  22. ETIOLOGY • GI LOSS • ADRENAL INSUFFICIENCY • SWEATING • SALT LOSING NEPHRITIS

  23. SINGS & SYMPTOMS • Anorexia • Nausea • Vomiting • Lethargy • Confusion • Muscle twitching • Seizures • coma

  24. TREATMENT WATER RESTRICTION • Chronic asymptomatic hyponatremia-water restriction • Attempts made to increase water excretion • Administration of loop diuretics in conjuntion with Na+ & K+ SODIUM REPLACEMENT • Accomplished by nasogastric tube/parenteral route. • Patients able to eat/drink Na+ replacement easy coz Na+is plenty in diet. • If plasma vol is below normal ,lactated ringers solution can be used

  25. HYPERNATREMIA • Refers to greater than normal serum concentration of 145mEq/l • Non hospitalized patients-condition seen in elderly. • Hospitalized patients-condition seen in all ages • Mortality rate ranges : 40-60%

  26. ETIOLOGY • Water deprivation • Insensible water loss • Water diarrhoea • Excessive sodium intake • Diabetes insipidus

  27. SIGNS & SYMPTOMS • Thirst • Fever • Disorientation • Hallucination • Lethargy • Irritability • Seizures • coma

  28. TREATMENT • By addition of water or by removal of sodium depending on imbalance • Children & adult- fluid replacement therapy • Chronic hypernatremia should not be corrected faster than 0.7mEq/l • Acute hypernatremia ,sodium level in serum may be reduced to 6-8 mEq/l in first 3-4 hrs,then decline should not be more than 1mE/l • Std treatment- ADH replacement by means of vasopressin administration

  29. MAGNESIUM IMBALANCE • Normal value – 1.3 – 2.1 mEq/L • 2/3 rd located in skeleton , 1/3 rd in ICF & 1% in ECF • Involved in enzymatic reaction • In production & utilization of ATP • In neuronal control • In NM transmission • In CV tone • Kidney – primary route of excretion

  30. HYPOMAGNESIA • Total serum Mg level lower than 1.3mEq/L • Common in both ambulatory & hospitalized patients

  31. ETIOLOGY • GI Loses • Alcohol • Re feeding after starvation • Drugs disrupting Mg homeostasis

  32. Signs & symptoms

  33. TREATMENT • Mg replacement • Dietary source of Mg – encouraged • Mg orally administered • Mg – tablet form (diarrhea – side effect) • Given IV/ intramuscular • Mg sulfate - IV

  34. HYPERMAGNESEMIA • Total serum Mg level > 2.1 mEq/L • Less common than hypomagnesemia • Occur more frequently • Cause – iatrogenic

  35. ETIOLOGY • Renal failure • Mg administered for therapeutic purpose

  36. SIGNS & SYMPTOMS • Peripheral vasodilation with facial flushing, sense of warmth, tendency for hypotension, nausea & vomiting • Drowsiness , muscle weakness • Hypotension • Bradycardia • Respiratory depression • Paralysis • Coma • Cardiac arrest

  37. TREATMENT • Tx – prevention • Avoid administration of Mg salts –patients with renal failure • Mg oral / IV – patient with hypermagnesemia / deep tendon reflexes • neuromuscular & cardiac toxicity of hypermagnesemia – IV administration of Ca gluconate • Dialysis

  38. Potassium imbalance

  39. Potassium imbalance • Major IC electrolyte • 98% in ICF • 2% IN ECF • Normal renal function is needed for maintaining potassium balance • 80% excreted through kidney • 20% excreted – bowel &sweat glands • Potassium distribution requires Na+/K+pump • Normal value : 3.5-5mE/l

  40. HYPOKALEMIA • Refers to below normal serum K+ concentration • Mild hypokalemia : 3-3.5mEq/l • Moderate hypokalemia : 2.5-3mEq/l • Severe hypokalemia : 2..5mEq/l or less

  41. ETIOLOGY • Renal losses • GI loses • Shift into cells • Sweat loses

  42. Signs & symptoms

  43. TREATMENT • Best treatment– prevention • Hypokalemia due to alkalosis be given KCL • Loop & thiazide diuretics+ potassium sparing diuretics • K+ given thro oral / IV route • Potassium acetate –patients with acidosis • Potassium phosphate used whn patient deficit in potassium & phosphate

  44. hyperkalemia • Refers to greater than normal serum potassium level • Often due to iatrogenic causes • More dangerous coz associated with cardiac arrest

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