Volume Regulation: Sodium, Edema and Diuretics
	Objectives
	Sodium handling
	Filtered load
	Sodium Handling and Volume Regulation: Slide 5
	FeNa=
	Sodium Handling and Volume Regulation: Slide 7
	Regulation of sodium content: renin-angiotensin system
	Regulation of sodium content: renin-angiotensin system
	Regulation of sodium content: sympathetic nervous system
	Regulation of sodium content: atrial natriuretic peptide (ANP)
	Sodium Handling and Volume Regulation: Slide 12
	Pathophysiology of volume depletion
	“Effective circulating volume”
	Body fluid compartments
	Body fluid compartments (cont.)
	Edematous states
	Edematous states (cont.)
	Starling’s law
	Edema formation
	Edema formation (cont.)
	Starling’s forces in skeletal muscle and lung
	Protective and safety mechanisms
	Pathophysiology of edema in heart failure (HF)
	Pathophysiology of edema in acute pulmonary edema
	Treatment of CHF
	Cirrhosis and ascites
	Sodium Handling and Volume Regulation: Slide 29
	Treatment of cirrhosis
	Nephrotic syndrome
	Treatment of the nephrotic syndrome
	Mechanism of action of commonly used diuretics
	Pathogenesis and treatment of refractory edema
	Fluid and electrolyte complications of diuretic therapy

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