- Section 1 Assessment of the patient with renal disease
- Section 2 The Patient with fluid, electrolyte, and renal tubular disorders
- Chapter 20 An overview of tubular function
- Chapter 21 Sodium transport and balance
- Chapter 22 Water homeostasis
- Chapter 23 Potassium homeostasis
- Chapter 24 Renal acid–base homeostasis
- Chapter 25 Phosphate homeostasis
- Chapter 26 Calcium homeostasis
- Chapter 27 Magnesium homeostasis
- Chapter 28 Approach to the patient with hyponatraemia
- Chapter 29 Approach to the patient with hypernatraemia
- Chapter 30 Approach to the patient with oedema
- Chapter 31 Approach to the patient with salt-wasting tubulopathies
- Chapter 32 Approach to the patient with polyuria
- Chapter 33 Clinical use of diuretics
- Chapter 34 Approach to the patient with hypo-/hyperkalaemia
- Chapter 35 Approach to the patient with metabolic acidosis or alkalosis
- Chapter 36 Approach to the patient with renal tubular acidosis
- Chapter 37 Approach to the patient with hypercalcaemia
- Chapter 38 Approach to the patient with hypocalcaemia
- Chapter 39 Approach to the patient with hypo-/hyperphosphataemia
- Chapter 40 Approach to the patient with hypomagnesaemia
- Chapter 41 Approach to the patient with renal Fanconi syndrome, glycosuria, or aminoaciduria
- Section 3 The patient with glomerular disease
- Section 4 The patient with interstitial disease
- Section 5 The patient with reduced renal function
- Section 6 The patient with another primary diagnosis
- Section 7 The patient with urinary tract infection
- Section 8 The patient with infections causing renal disease
- Section 9 The patient with urinary stone disease
- Section 10 The Patient with Hypertension
- Section 11 The patient with acute kidney injury (and critical care nephrology)
- Section 12 The patient on dialysis
- Section 13 The transplant patient
- Section 14 Renal disease at different stages of life (infancy, adolescence, pregnancy, old age)
- Section 15 The patient with genetic renal disease
- Section 16 The patient with structural and congenital abnormalities
- Section 17 Drugs and renal disease
- Section 18 Nephrology in the future
(p. 197) Water homeostasis
- Chapter:
- (p. 197) Water homeostasis
- Author(s):
David Marples
, and Søren Nielsen
- DOI:
- 10.1093/med/9780199592548.003.0022_update_001
Update:
Seven figures have been added
The section on factors controlling aquaporin 2 insertion and retrieval has been expanded and updated.
6 new references
Under normal circumstances, the maintenance of water balance is a question of balancing urine output against oral water intake, after allowance for the largely unregulated loss of water through other routes (respiratory, transcutaneous, and via the gastrointestinal tract). Normally, this is managed by the feedback mechanisms controlling thirst and diuresis, but in a medical context it is important to allow for other forms of administration that may not be under the control of the patient, and other routes of fluid loss, such as haemorrhage and drains. Electrolyte and water homeostasis are closely interrelated: the major trigger for both antidiuretic hormone (vasopressin) release (and hence renal water retention) and thirst is plasma osmolality. Sodium and chloride are the major solutes in extracellular fluid so are major determinants of body water content and circulating volume.
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- Section 1 Assessment of the patient with renal disease
- Section 2 The Patient with fluid, electrolyte, and renal tubular disorders
- Chapter 20 An overview of tubular function
- Chapter 21 Sodium transport and balance
- Chapter 22 Water homeostasis
- Chapter 23 Potassium homeostasis
- Chapter 24 Renal acid–base homeostasis
- Chapter 25 Phosphate homeostasis
- Chapter 26 Calcium homeostasis
- Chapter 27 Magnesium homeostasis
- Chapter 28 Approach to the patient with hyponatraemia
- Chapter 29 Approach to the patient with hypernatraemia
- Chapter 30 Approach to the patient with oedema
- Chapter 31 Approach to the patient with salt-wasting tubulopathies
- Chapter 32 Approach to the patient with polyuria
- Chapter 33 Clinical use of diuretics
- Chapter 34 Approach to the patient with hypo-/hyperkalaemia
- Chapter 35 Approach to the patient with metabolic acidosis or alkalosis
- Chapter 36 Approach to the patient with renal tubular acidosis
- Chapter 37 Approach to the patient with hypercalcaemia
- Chapter 38 Approach to the patient with hypocalcaemia
- Chapter 39 Approach to the patient with hypo-/hyperphosphataemia
- Chapter 40 Approach to the patient with hypomagnesaemia
- Chapter 41 Approach to the patient with renal Fanconi syndrome, glycosuria, or aminoaciduria
- Section 3 The patient with glomerular disease
- Section 4 The patient with interstitial disease
- Section 5 The patient with reduced renal function
- Section 6 The patient with another primary diagnosis
- Section 7 The patient with urinary tract infection
- Section 8 The patient with infections causing renal disease
- Section 9 The patient with urinary stone disease
- Section 10 The Patient with Hypertension
- Section 11 The patient with acute kidney injury (and critical care nephrology)
- Section 12 The patient on dialysis
- Section 13 The transplant patient
- Section 14 Renal disease at different stages of life (infancy, adolescence, pregnancy, old age)
- Section 15 The patient with genetic renal disease
- Section 16 The patient with structural and congenital abnormalities
- Section 17 Drugs and renal disease
- Section 18 Nephrology in the future