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Disorders of water metabolism: diabetes insipidus and the syndrome of inappropriate antidiuretic hormone secretion.

Abstract
Disorders of body fluids are among the most commonly encountered problems in the practice of clinical medicine. This is in large part because many different disease states can potentially disrupt the finely balanced mechanisms that control the intake and output of water and solute. It therefore behooves clinicians treating such patients to have a good understanding of the pathophysiology, the differential diagnosis and the management of these disorders. Since body water is the primary determinant of the osmolality of the extracellular fluid (ECF), disorders of body water homeostasis can be divided into hypoosmolar disorders, in which there is an excess of body water relative to body solute, and hyperosmolar disorders, in which there is a deficiency of body water relative to body solute. The classical hyperosmolar disorder is diabetes insipidus (DI), and the classical hypoosmolar disorder is the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This chapter first reviews the regulatory mechanisms underlying water and sodium metabolism, the two major determinants of body fluid homeostasis. The major disorders of water metabolism causing hyperosmolality and hypoosmolality, DI and SIADH, are then discussed in detail, including the pathogenesis, differential diagnosis and treatment of these disorders.
AuthorsJoseph G Verbalis
JournalHandbook of clinical neurology (Handb Clin Neurol) Vol. 124 Pg. 37-52 ( 2014) ISSN: 0072-9752 [Print] Netherlands
PMID25248578 (Publication Type: Journal Article, Review)
Copyright© 2014 Elsevier B.V. All rights reserved.
Chemical References
  • Water
  • Vasopressins
Topics
  • Animals
  • Diabetes Insipidus (diagnosis, metabolism)
  • Diagnosis, Differential
  • Humans
  • Hypernatremia (diagnosis, metabolism)
  • Inappropriate ADH Syndrome (diagnosis, metabolism)
  • Vasopressins (metabolism)
  • Water (metabolism)
  • Water-Electrolyte Imbalance (diagnosis, metabolism)

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