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- Title
Zaburzenia gospodarki sodowej u chorych z nadciśnieniem tętniczym.
- Authors
Surma, Stanisław; Więcek, Andrzej; Adamczak, Marcin
- Abstract
Sodium is the main cation in the extracellular space. The concentration of sodium in plasma is in the range 135-145 mmol/L. The kidneys play the most important role in regulation of sodium balance. During recent years, a significant role of glycosaminoglycans localized mainly in the subcutaneous tissue and the glycocalyx of vascular endothelial cells in the regulation of sodium metabolism was documented. Hyponatremia is defined when plasma sodium concentration is lower than 135 mmol/L. In clinical practice, the most common type of hyponatremia is hyponatremia with normal water balance. Hyponatremia significantly worsens the prognosis of patients with chronic diseases. In patients with arterial hypertension, the risk of hyponatremia is 1,5 times higher than in the general population. One of the causes of hyponatremia in patients with arterial hypertension is the use of thiazide or thiazide-like diuretics (TIH). Risk factors of TIH are advanced age, female gender, use of thiazide and thiazide-like diuretics in summer, mutation of the KCNJ1 potassium channel gene and mutation of the SLCO2A1 prostaglandin transporter gene. The symptoms of hyponatremia are caused by oedema of the cells in the central nervous system. Treatment of hyponatremia depends on natremia and clinical symptoms. Too fast correction of natremia can result in a potentially fatal osmotic demyelinating syndrome. Hypernatremia is defined when plasma sodium concentration is higher than 145 mmol/L. Risk factors of hypernatremia are old age, mechanical ventilation, impaired consciousness, and parenteral nutrition only. Treatment of hypernatremia is primarily based on the administration of fluids without effective osmolytes.
- Publication
Heart & Vascular Diseases / Choroby Serca & Naczyn, 2022, Vol 19, Issue 1, p19
- ISSN
1733-2346
- Publication type
Article
- DOI
10.5603/ChSiN.2022.0003