Sodium and Volume Disorders in Advanced Chronic Kidney Disease.
The kidney has a remarkable ability to modulate sodium and water excretion to maintain homeostasis despite a widely varying dietary intake. However, as glomerular filtration rate falls to less than 30 mL/min, this ability can be compromised leading to an increased risk for disorders of serum sodium and extracellular volume. In all cases, these disorders are associated with an increased rate of morbidity and mortality. Management strategies to both prevent and treat these conditions are available but requiring special attention to the unique circumstance of advanced CKD to maximize therapeutic response and prevent complications.
Division of Nephrology, University of Virginia Health System, Charlottesville, VA; and Department of Nephrology and Dialysis, G. Brotzu Hospital, Cagliari, Italy.
Sana
S
Khan
Division of Nephrology, University of Virginia Health System, Charlottesville, VA; and Department of Nephrology and Dialysis, G. Brotzu Hospital, Cagliari, Italy.
Matteo
M
Floris
Division of Nephrology, University of Virginia Health System, Charlottesville, VA; and Department of Nephrology and Dialysis, G. Brotzu Hospital, Cagliari, Italy.
Antonello
A
Pani
Division of Nephrology, University of Virginia Health System, Charlottesville, VA; and Department of Nephrology and Dialysis, G. Brotzu Hospital, Cagliari, Italy. Electronic address: mhr9r@virginia.edu.
Mitchell H
MH
Rosner
D045604:Extracellular Fluid; D006801:Humans; D006955:Hypernatremia / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D007010:Hyponatremia / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D007671:Kidney Concentrating Ability; D009994:Osmolar Concentration; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy; D012964:Sodium / Q000097:blood*; D014883:Water-Electrolyte Imbalance / Q000628:therapy
D012964:Sodium
Diuretics; Hypernatremia; Hyponatremia; Sodium; Volume