Interrelationships among renal function, Na+ intake, water homeostasis, distribution of extracellular fluid volume, and mean arterial blood pressure. Pathophysiological.

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Presentation transcript:

Interrelationships among renal function, Na+ intake, water homeostasis, distribution of extracellular fluid volume, and mean arterial blood pressure. Pathophysiological mechanisms of edema formation. 1. Rightward shift of renal pressure natriuresis curve. 2. Excessive dietary Na+ intake. 3. Increased distribution of extracellular fluid volume (ECFV) to peritoneal cavity (eg, liver cirrhosis with increased hepatic sinusoidal hydrostatic pressure) leading to ascites formation. 4. Increased distribution of ECFV to lungs (eg, left-sided heart failure with increased pulmonary capillary hydrostatic pressure) leading to pulmonary edema. 5. Increased distribution of ECFV to venous circulation (eg, right-sided heart failure) leading to venous congestion. 6. Peripheral edema caused by altered Starling forces causing increased distribution of ECFV to interstitial space (eg, diminished plasma proteins in nephrotic syndrome, severe burns, and liver disease). Source: Drug Therapy of Hypertension, Edema, and Disorders of Sodium and Water Balance, Workbook and Casebook for Goodman and Gilman's The Pharmacological Basis of Therapeutics Citation: Rollins DE, Blumenthal DK. Workbook and Casebook for Goodman and Gilman's The Pharmacological Basis of Therapeutics; 2016 Available at: https://accesspharmacy.mhmedical.com/DownloadImage.aspx?image=/data/books/1697/rol_ch15_f005.png&sec=111005051&BookID=1697&ChapterSecID=111005026&imagename= Accessed: October 25, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved