sodium and its medical importance for medical students

2. often touted as a
nutrition villain

4. total body
sodium
50% in
bone
40% in
ECF
10% in
soft
tissues

7. Sodium required for normal muscle irritability and cell permeability

8. Sodium necessary for initiating and maintaining heart beat.

10. Maintenance of osmotic pressure and fluid
balance

11.  Normal individuals, the requirement of sodium is about 5-10 g/day
 For persons with a family history of hypertension, the daily NaCl
intake should be less than 5 g.
For patients of hypertension, around 1 g/day is recommended.
 10 g of NaCl contains 4 g of sodium
Due to its flavour salt is taken more than the requirement

12. common salt (NaCl) is the major source of sodium.
The good sources of sodium include……
 Bread
 Whole grains
 Leafy vegetables
 Nuts
 Eggs
Milk

13. very little of it (< 2%) is normally found in feces
In diarrhea, large
quantities of sodium
is lost in feces.

14. Plasma
135-145mEq/L
Blood cell
35mEq/L
The mineralocorticoids, secreted by adrenal cortex,
influence sodium metabolism. A decrease in plasma
sodium and an increase in its urinary excretion are
observed in adrenocortical insufficiency.

15. Kidney is the major route of sodium excretion 800 g Na/day is filtered by the
glomeruli.
 99% of this is reabsorbed by the renal tubules by an active process.
 Controlled by aldosterone.
 Extreme sweating also causes considerable amount of sodium loss from the body

16. Sodium
diseased states
Hyponatremia
< 135meq/L
Hypernatremia
>145meq/L

17. Hyponatremia

20. Addison’s disease, also known as primary adrenal
insufficiency and hypocortisolism is a long-
term endocrine disorder in which the adrenal
glands do not produce enough steroid hormones.
Hormone replacement therapy is treatment of choice.
Oral corticosteroids or steroid injections are given
according to the need.

21. autoimmune disease
Tuberculosis
Other infections of the
adrenal glands
Spread of cancer to the
adrenal glands
Bleeding into the
adrenal glands, which
may present as adrenal
crisis without any
preceding symptoms.
Pitutary abnormalities
Hypothalamic
abnormalities
Congenital ACTH deficiency

23. Hypernatremia

24.  characterized by an elevation in the serum sodium level.
 The symptoms include increase in blood volume and blood
pressure.
 May occur due to hyperactivity of adrenal cortex (Cushing's
syndrome)
 May occur due to prolonged administration of cortisone,
ACTH and/or sex hormones.
 Diabetes insipidus, pregnancy, steroid and placental
hormones, administration of diuretic drugs .
 In the patients of hypertension and congestive cardiac failure
salt (Na+) restriction is advocated.

27. Also called hypercortisolism.