Compre o eBook Interpretação Clínica do Metabolismo Hidroeletrolítico e do equilíbrio hidroeletrolítico, ou seja, da água, dos sais e do distúrbio ácido-básico. Hiponatremia é o distúrbio hidroeletrolítico mais comum em pacientes hospitalizados. A presença de hiponatremia está associada a uma série de desfechos. dissociação proteino-citológica relativa (6) e séptica (4), hipoglicorraquia moderada (4%), hipoglicorraquia severa (4%), distúrbio hidroeletrolítico (3%).

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The inclusion criteria were HIV positivity and acute consciousness compromise: We included only the first CSF of our patients; so, those that had a previous diagnosis of NCC in our laboratory were excluded from this series. Vol 1 Ed Plenum Medical.

The most frequent CSF syndromes were: The relative rarity of this diagnosis was not a surprise, since we included only hidroeletroolitico with acute presentation.


Mortality associated with low serum sodium concentration in maintenance hemodialysis. Urinary sodium is low and urine osmolality is high, demonstrating an appropriate salt and water retention in response to the true hypovolemia Hypervolemia History and physical examination suggest an edematous syndrome, such as CHF, cirrhosis or nephrotic syndrome.

Tex Med ; All the contents of hidroeletroliticco journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Short-term hidroeletrklitico effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: The mean time of consciousness compromise and the CSF examination was 3 days.


Regardless of the approach, the phsyician must always be vigilant to avoid an overly rapid correction of chronic hyponatremia, to minimize the risks of pontine myelinolysis. One case of subarachnoid hemorrhage shows that, naturally, it also happens in HIV-positive individuals. Although vaptans were indicated, such medications are still unavailable for clinical use in Brazil Table 6. Am J Physiol ; Disturio of the patient with hyponatremia.

How much water can the kidneys excrete? Nephrol Ther ; 3 Suppl 2: Isolated xantochromia, with no erythrocytes nor hyperproteinorrachia, present in one case, may reflect seric elevation of bilirrubins.

Pseudohyponatremia in acute hyperlipemic pancreatitis. Severe hyponatremia without severe hypoosmolality following transurethral resection of the prostate TURP in end-stage renal disease. However, with severe symptomatic hyponatremia, the treatment with hypertonic saline is hidrleletrolitico to reduce cerebral edema.

Riella Disturbios Hidroeletroliticos – Capítulo do livro de Nefrologia de Riella

When vasopressin ADH binds to its receptors in the collecting ducts V2it promotes the hidroeletro,itico and phosphorylation of aquaporins — these are proteins that can insert pores in the membrane of the tubular cell, making it water-permeable. Establishing an etiological diagnosis also helps to determine the most appropriate sodium chloride solution normal versus hypertonic hidroeletrooitico.

So, if the renal capacity to excrete water is maintained, a person would need to ingest more than 16L of water to develop hyponatremia. Commonly, HIV-positive patients present to emergency rooms with acute alterations of consciousness. The groups were composed of: One may notice that even in hypovolemic hyponatremia there is a relative excess of water in relation to total sodium.


Hypovolemic hyponatremias tend to be mild and they usually do not dominate the patient’s clinical picture. The evaluation of volume status is typically based on several aspects of the history and physical exam, as well as laboratory studies.

Symptomatology This is usually a function of the duration and severity of hyponatremia. They cause nephrogenic diabetes insipidus and increase the urinary excretion of free water. Pathophysiology of edema formation. Serum osmolality must be low in true hyponatremia; if it is normal or high, there is pseudohyponatremia.

We do not intend to describe physiopathological interactions between HIV and hosts. Since serum hidroelettrolitico analysis is not performed in many Brazilian hospitals and laboratories and, when it is, the result may take a whilein practice, it is very common to rule out pseudohyponatremia based on readily available clinical and laboratory data, such as idsturbio glucose, total proteins and fractions, and lipid profile. Five of these also had pleocytosis. In our casuistic, we believe that the viral syndrome may partly be caused by the own HIV infection.

The retrovirus are highly neurotropic, being present in the CNS early in the infection. Using the sodium deficit formula, the calculation would be as follows Formula 7: