this presentation gives a brief about the abnormality of water imabalnce such as dehydration and overhydration

1. Abnormalities of Water
Imbalance
Presented by- Ruchika Sharma

2. CONTENT
Positive water
balance
References
Water balance Water
imbalance
Negative Water
Balance

3. WATER
BALANCE
For an individual to
maintain water balance
The amount of water
consumed = the amount of
water lost from body
Water balance is
maintained by the thirst
mechanism and by
hormonal control

4. Water intake Water loss
Sources Liters Route Liters
Preformed water
(food)
0.75 Insensible- lungs
0.9
Metabolic water 0.25 Insensible- skin
Drinking 1.5 Feces 0.1
Urine 1.5
Total 2.5 Total 2.5
DAILY WATER BALANCE
Texttbook of Human Nutrition

5. Metabolic water -
produced by 1g of
nutrients
Carbohy
drates
0.6 mL
Proteins 0.4 mL
Fats 1.1 mL
WATER INTAKE
Exogenous
Endogenous
Water is the supply to the
body by
Requirements-
1 mL/kcal expended, or
35 mL/kg for adults and 1.5
mL/kcal and 150 mL/kg for
infants (IOM], 2004).

7. WATER IMBALANCE
NEGATIVE WATER BALANCE
POSITVE WATER BALANCE
WATER IMBALANCE
Water imbalance implies that there is a
disturbance in the water balance wherein
either water loss exceeds or vice versa.
Manifested by alterations in the body fluid osmolarity.
Sodium ions are a major determinant of plasma osmolarity
These disorders alter the plasma concentration of sodium ions

8. Fluid compartments are in
osmotic equilibrium
- water permeates the cell
membrane and diffuses freely
between the extracellular and
intracellular fluid compartments.
When ECF = hypertonic
water diffuses out of cells until
the osmolarities of the ECF and
ICF are equal; the reverse is true
when extracellular fluid
becomes hypotonic
FUNDAMENTAL
PHYSIOLOGICAL FACTS

9. NEGATIVE WATER BALANCE
OR
DEHYDRATION
Dehydration is a condition wherein output
(excretion) is far above (in excess) the amount of
water fluid consumed.
Loss of water can occur with or without the loss of
other components in body fluids.

10. DEHYDRATION
Occurs when water intake is inadequate and there is no parallel
loss of electrolytes in the secretions of the body.
Even if water intake is stopped, the obligatory water loss
continues, and there is some minimum excretion of urine to get
rid of the metabolic load. hence, the body water stores get
depleted.
At the same time, the concentration of electrolytes rises in the
ECF, which becomes hypertonic. In order to correct this
balance, water flows from the ICF, resulting in a reduction in ICF
and intracellular dehydration.
It may result from depletion of pure water and mixed type-
1.
2.
3.
Pure water-

11. It occurs when there is a loss of body fluids containing
sodium and chloride
On the one hand, there is an inadequate intake of water
In contrast to pure water depletion, the ECF is hypotonic in
the initial stages.
If water loss continues, then the loss of water exceeds the loss
of the electrolytes, making the ECF hypertonic.
In this, both ECF and ICF are reduced
Mixed Water

12. Isotonic
Hypertonic
Hypotonic
Proportionately
more sodium
than water is lost
from the body,
When loss of
water exceeds
the loss of
sodium
Equal loss of
sodium and water
The most
common type of
dehydration is
seen in humans.

13. Water diffuses out of the cells
volumes of both compartments will decrease
When water loss will exceed sodium loss
Osmolarity of ECF will increase
osmolarities will increase
The thirst mechanism is
stimulated, and AVP secretion
occurs. Kidneys will conserve
both electrolytes and water
during dehydration by
excreting a concentrated urine
low in sodium, But, the fluid
loss ultimately has to be
replaced by fluid intake

14. Causes-
Poor intake of water
and fluids
Excessive losses of fluid
due to vomiting,
diarrhea, sweating,
blood loss, polyurea,
burns, etc,.
Symptoms-
Extreme thirst,
Decreased urine output,
Concentrated urine,
Headaches,
Fatigue,
Muscle cramps,
Hypotension, and
Fever.

15. Transmitted through water and
food
Contaminated by Vibrio cholera
Produces toxin - stimulates the
intestinal cells to secrete many
ions ( Cl, Na, k,) into the intestinal
lumen
Osmotic imbalance and dehydration in
cholera
Ions collectively raise the
osmotic pressure and suck
the water into the lumen.
This will result in diarrhea

16. Overhydration or Water
Intoxication
POSITIVE WATER BALANCE

17. Increase total body water, diluting all the body fluid compartments
where the volumes of both the intracellular and the extracellular
compartments increase and their osmolarities decrease
(hyponatremia and hypervolemia)
Condition when water intake is excessively high and the body is not
able to handle the excess water load
Hyponatremia- - < 135 mEq/L
of sodium.
In healthy individuals, usually, no adverse effects are associated
with overconsumption of water because the resultant
hyponatremia inhibits the secretion of AVP and the excess
water is excreted to reestablish water balance.

18. Acute water intoxication caused by a too
rapid parenteral fluid replacement that
greatly exceeded the kidney’s maximal
rate of excretion will cause expansion of
brain cells. This swelling increases
intracranial pressure

19. Causes
Social situations such as
drinking contests,
Intensive exercise in a hot
environment during which a
large volume of fluid is
consumed without proper
replenishment of
electrolytes,
Polydipsia.
Renal failure, overproduction
of ADH
Symptoms
Headaches
Restlessness
Confusion
Change in personality
Blurred vision
Cramps ( and eventually
convulsions)
Welling of the brain
Coma, and in extreme
cases, death

20. Accumulation of excess fluid in body tissues
Occurs when there is an imbalance of forces governing the
diffusion of water across either the cell membrane or the
capillary endothelium
Most common edema occurs in the interstitial fluid
compartment, but intracellular edema is also possible.
Edema may also arise from the decrease in plasma oncotic
pressure that results from a decrease in plasma protein
concentration.
Intracellular edema can also occur when the permeability
of the cell membrane to solutes is increased.
Accumulation of Excess Fluid in Tissues:
Edema

21. References
Agarwal, A., & Udipi, S. A. (2014). Protein
and Amino acids. In Textbook of human
nutrition. essay, Jaypee Brothers Medical
Publishers (P) Ltd.
Biochemical, physiological, and molecular
aspects of human nutrition/[edited by]
Martha H. Stipanuk, Marie A. Caudill. – 3rd
ed
Satyanarayana, U., & Chakrapani, U. (2013).
Biochemistry. New Delhi: Elsevier Health
Sciences APAC.

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