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Renal Physiology (V) - Body Fluid Compartments(Clinical Correlation)
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Renal Physiology (V) - Body Fluid Compartments(Clinical Correlation)

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by dr Mohammed Abel Gawad (drgawad@gmail.com): Nephrology Specialist at Kidney & Urology Center - Alexandria - Egypt. website: www.nephrotube.blogspot.com

by dr Mohammed Abel Gawad (drgawad@gmail.com): Nephrology Specialist at Kidney & Urology Center - Alexandria - Egypt. website: www.nephrotube.blogspot.com

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    Renal Physiology (V) - Body Fluid Compartments(Clinical Correlation) Renal Physiology (V) - Body Fluid Compartments(Clinical Correlation) Presentation Transcript

    • 1 RENAL PHYSIOLOGY (V) mBODY FLUID COMPARTEMENTS (CLINICAL CORRELATION) Mohammed Abdel Gawad
    • OBJECTIVES2  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
    • OBJECTIVES3  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure (factors affecting)  Body Water – Clinical Correlation
    • Total Body Water (TBW)
    • TBW is affected by: Gender and Age
    • TBW is affected by body fatThe ideal weight is only accurate in thin patients while the adjusted weight is accurate in both thin and obese patients.
    • OBJECTIVES9  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
    • Total body water Compartments
    • Total body water Compartments
    • Intravascular Compartment
    • Intravascular Compartment
    • OBJECTIVES14  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
    • Electrolytes and Non-Electrolytesdissolved in the TBW
    • Total body water Compartments
    • Osmolality is the number of particles (mmol) contained in one liter of water, so measured in mmol/L. i.e. it is the concentration by number
    • Water, Electrolytes & Non-ElectrolytesDistribution (1)
    • Water, Electrolytes & Non-ElectrolytesDistribution (2)
    • Osmolality of all three compartments  Osmolality of all three compartments is the same, because water is able to move freely among all three compartments
    • OBJECTIVES21  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
    • Movement of water: Starling’s Forces & Membrane Permeability22 The amount of water in each body compartment is dependent on:  1- osmotic pressure  2- hydrostatic pressure  + Membrane characteristics
    • Osmolality is the number of particles (mmol) contained in one liter of water, so measured in mmol/L. i.e. it is the concentration by number
    • Starling’s Forces – Osmotic pressure
    • Starling’s Forces – Osmotic pressure
    • Starling’s Forces – Hydrostatic pressure
    • Starling’s Forces
    • Body Fluid Exchange 1- Osmosis 2- Filtration 3- Diffusion (the most important)
    • Membrane Factors Membrane permeability (s) is clinically relevant in disorders which disrupt membrane integrity (e.g., sepsis). Permeability of a membrane ranges from zero, completely permeable, to one, completely impermeable.
    • OBJECTIVES30  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure  Body Water – Clinical Correlation
    • Starling’s Forces – Net Filtration Pressure
    • Starling’s Forces – Net Filtration Pressure
    • Factors Affecting Net Filtration Pressure:1- Hydrostatic Pressure Changes
    • Factors Affecting Net Filtration Pressure:2- Osmotic Pressure Changes  Increased net filtration pressure can be due to decreased net osmotic pressure.
    • Factors Affecting Net Filtration Pressure:3- Membrane Permeability Changes  Increased net filtration pressure can be due to increased membrane permeability.  Capillary membrane damage (s rises) may be caused by infection, inflammation, sepsis, trauma, malignancy and adult respiratory distress syndrome (ARDS).
    • OBJECTIVES36  Total Body Water  Total Body Water Compartments  Electrolytes & Non-Electrolytes Distribution  Starling’s Forces & Membrane Permeability  Net Filtration Pressure (factors affecting)  Body Water – Clinical Correlation
    • Factors Affecting Net Filtration Pressure:Clinical Correlation  All fluid accumulations in the body are due to a change in one of the components of Starlings Forces: hydrostatic pressure, osmotic pressure or capillary permeability.  Determining amount of protein and other factors contained in the fluid → help to determine fluid collection is due to a change in which factor
    • Factors Affecting Net Filtration Pressure:Clinical Correlation (transudate & exudate)  Determining amount of protein and other factors contained in the fluid → help to determine fluid collection is due to a change in which factor:  1- change in hydrostatic pressure → collection with a low protein content and is called a transudate.  2- change in osmotic pressure → collection with a low protein content and is called a transudate.  3- change in membrane permeability (capillary damage) such as inflammation, infection and malignancy → collection with a high protein & LDH content and is called an exudate.
    • Factors Affecting Net Filtration Pressure:Clinical Correlation (transudate & exudate)
    • Factors Affecting Net Filtration Pressure:Clinical Correlation (Ascities albumin gradient)
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    • Gawad