Disorders of Electrolyte Metabolism

• Published in: Pediatric annals Vol. 10; no. 8; pp. 28 - 43
• Main Authors: Segar, William E, Chesney, Russell W
• Format: Journal Article
• Language: English
• Published: Thorofare SLACK INCORPORATED 01.08.1981
• Subjects: Anatomy; Body Weight; Children & youth; Coma; Cystic fibrosis; Diabetes; Diabetic ketoacidosis; Diuretics; Electrolytes; Encephalitis; Etiology; Exhibits; Guillain-Barre syndrome; Head injuries; Hyperkalemia; Hypernatremia; Hypokalemia; Hyponatremia; Hypothalamus; Kidney diseases; Lungs; Meningitis; Narcotics; Nervous system; Patients; Pediatrics; Skin; Sodium; Tuberculosis; Urine; Water
• ISSN: 0090-4481; 1938-2359
• DOI: 10.3928/00904481-19810801-05

An average solute load of 30 mOs/100 cal. can be excreted in as little as 25 ml. or as much as 500 ml. of urine. [...]the water required by an adult to excrete his solute load may vary from 525 to 12,500 ml. of urine per day. Hypotonic dehydration Diabetic ketoacidosis Adrenal insufficiency Renal disease Diuretic therapy Cystic fibrosis Table 1 Causes of Hyponatremia Due to Sodium Loss with Decreased or Normal Total Body Water Hypotonic dehydration is the most common cause of hyponatremia in infants and children and is usually due to diarrheal dehydration, in which proportionately more sodium than water has been lost. Because of the disproportionate loss of extracellular fluid, these children exhibit dramatic evidence of dehydration, including tenting of the skin and vascular instability. An elevated blood-glucose concentration exerting an osmotic effect that pulls water from the intracellular compartment, re-expanding extracellular space and thereby lowering the extracellular Na and Cl concentration, is the most important of these. [...]an elevated blood lipid concentration may cause a factitious decrease in the concentration of all of the serum electrolytes. Since these children may be unable to conserve water as well, hypotonic dehydration can occur whenever sodium and water intake are inadequate.