RT Book, Section A1 Kasper, Dennis L. A1 Fauci, Anthony S. A1 Hauser, Stephen L. A1 Longo, Dan L. A1 Jameson, J. Larry A1 Loscalzo, Joseph SR Print(0) ID 1128781679 T1 Electrolytes/Acid-Base Balance T2 Harrison's Manual of Medicine, 19e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071828529 LK accessmedicine.mhmedical.com/content.aspx?aid=1128781679 RD 2024/04/25 AB Disturbances of sodium concentration [Na+] result in most cases from abnormalities of H2O homeostasis, which change the relative ratio of Na+ to H2O. Disorders of Na+ balance per se are, in contrast, associated with changes in extracellular fluid volume, either hypo- or hypervolemia. Maintenance of “arterial circulatory integrity” is achieved in large part by changes in urinary sodium excretion and vascular tone, whereas H2O balance is achieved by changes in both H2O intake and urinary H2O excretion (Table 1-1). Confusion can result from the coexistence of defects in both H2O and Na+ balance. For example, a hypovolemic pt may have an appropriately low urinary Na+ due to increased renal tubular reabsorption of filtered NaCl; a concomitant increase in circulating arginine vasopressin (AVP)—part of the defense of effective circulating volume (Table 1-1)—will cause the renal retention of ingested H2O and the development of hyponatremia.