Front Cover

The Clinical Biology of Sodium: The Physiology and Pathophysiology of Sodium in Mammals

Copyright Page

Table of Contents

Dedication

PREFACE

INTRODUCTION

Chapter 1. Body Sodium in Context: Distribution, Functions and Regulation

Introduction: Some Problems in Context

Distribution and Concentration of Sodium

Sodium in Brain and Cerebrospinal Fluid

Functions of Sodium

Sodium Transport: Na-K ATPase

Na+-H+ Exchange

Conclusion

Chapter 2. Renal Sodium Regulation

Introduction

Segmental Distribution of Sodium Reabsorption

Endocrine Aspects of Renal Sodium Regulation

Glomerular Filtration

Proximal Reabsorption

Loop of Henlé

Distal Nephron

Immaturity of Renal Function

Conclusion

Chapter 3. Enteric Sodium Uptake

Introduction

Enteric Sodium Transport

Enteric Sodium Regulation

Enteric Responses to Changes in Sodium Balance

Diarrhoea

Oral Rehydration

Sequestration: Third Space'

Iatrogenic Disturbances

Conclusion

Chapter 4. Behavioural Regulation of Sodium Intake

General Issues

Experimental Approaches

Early Studies of Salt Appetite

Studies in Sodium-Depleted Sheep

1. Neural Aspects

2. Humoral Aspects

3. Salt Appetite and Hypertension

4. Biological Role of Salt Appetite

Na, K and the Sodium Transport Hypothesis of Salt Appetite

Conclusion

Chapter 5. Physiological Basis of Nutritional Requirement for Sodium

Introduction

Definition of Requirement; Factorial, Empirical— and Pitfalls

Comparative Aspects of Sodium Requirement

Conclusion

Chapter 6. Comparative Aspects of Salt and Hypertension

Introduction

What Matters about Hypertension?

Nutrition and Blood Pressure; Influences other than Sodium

Sodium and Possible Mechanisms of Hypertension

Effects of Hypertension on Fluids and Electrolytes

Pregnancy Hypertension

Salt and Human Hypertension

Comparative Aspects of Hypertension

Conclusion: Salt and Hypertension—Whose Decision?

Chapter 7. Endocrine Effects on Normal and Abnormal Sodium Excretion

Introduction

Adrenal Steroids

Renin-Angiotensin System (RAS)

ANP

MSH

Kallikrein-Kinin System

Pregnancy

Haemodynamic Changes

Water Balance

Hormonal Changes

Chapter 8. Clinical Aspects of Extracellular Volume and Sodium Concentration

Introduction

Hypertonic, Hypotonic and Isotonic Dehydration

1. Volume Excess

Cardiac Oedema

Chronic Obstructive Pulmonary Disease

2. Sodium Concentration: Hypernatraemia and Hyponatraemia

3. Volume Depletion

4. Renal Dysfunction

Chapter 9. Interactions Between Sodium, Potassium, Calcium and Magnesium

Introduction

Cellular Interactions

Renal Interactions

Physiological and Clinical Implications

Conclusion

Chapter 10. Clinical Disturbances of Sodium Transport

Introduction

Cystic Fibrosis

Disorders of Muscle Excitation

Down's Syndrome: Alzheimer's Disease

Papillary Necrosis

Polycystic Kidney Disease

Gastric Cancer

Renal Tubular Acidosis (and Fanconi Syndrome)

Haemolytic Anaemia

Bartter's Syndrome

Chapter 11. Drugs Affecting Sodium Transport and Sodium Balance

Diuretics

Osmotic Diuretics (Michell, 1979d; Wilcox, 1989; Martinez-Maldonado and Benabe, 1990)

Thiazides

Potassium-Sparing Diuretics

Loop Diuretics

Other Side Effects

Other Diuretics

Cardiac Glycosides

NSAIs (Hall and Granger, 1994)

Other Drugs

Chapter 12. Concluding Synthesis

REFERENCES

ABBREVIATIONS

INDEX