Water & Electrolyte

Balance
Water is essential to life
50% or more of body
weight, age & sex differences
newborn to 70 years: 73% to 45% water
young adult male: 60%
young adult female: 50%

key is muscle to fat ratio; total muscle

mass

 need to regulate fluid balance inside

cells & outside
blood pressure
blood volume
electrolyte balance

Body fluids
Water
40 liters; 60% of body weight

Solutes
electrolytes: ionic compounds
salts: NaCl, NaHCO3
acids, bases: H2CO3
some proteins: most negatively charged

 Nonelectrolytes
usually covalent
no electrical charge
organic

glucose
lipids
creatinine
urea

Fluids fill 2 compartments

Intracellular
within cells
25/40 liters or 63%

Extracellular
15 liters or 46%
two parts
plasma: 3 liters
interstitial fluid: 12 liters

water moves between

compartments by osmosis

Fluid composition differs between

compartments
Due
primarily to
membrane
activity
Na / K
balance

Fluid is lost continually

Obligate losses

lungs
skin
G.I. Tract
minimal urine flow (500 ml/day)

Facultative
excess urine production

 Balance of gain and loss

approximately 2,500 ml / day

Intake:
drinking - 1500 ml, 60%
eating - 750 ml, 30%
metabolism (water of oxidation) - 250 ml,
10%

Loss:

lungs & skin - insensible - 700 ml, 28%

perspiration - 200 ml, 8%
feces - 100 ml, 4%
kidneys - 1500 ml, 60%

Primary mechanism for water

replacement is thirst reflex
Decrease ECF volume
Hypothalamic
thirst center

thirst

Increase concentration
of ECF
Decrease
saliva

Raise volume
lower concentration

Dry mouth

drink

Regulating water loss /

electrolytes
Obligate losses cannot be controlled
Solute concentrations & urine
production are mechanisms for
regulating facultative loss
Na+ is principal electrolyte
90-95% of all soluted in ECF

Sodium & water regulation tightly linked

Sodium Balance
No specific receptors
regulated through
blood volume
blood pressure

Aldosterone is primary regulator

sodium uptake
release triggered mostly by
AngiotensinII

 Renin from JG cells

Sympathetic
n.s.
low solutes
less stretch (low
pressure)
angiotensin II
vasoconstrict
stimulate
aldosterone
release

Effect of aldosterone depends on

ADH levels
Hypothalamus
high sodium

release ADH

ANP also affects water

balance
Stretch atria (high BP)

ANP

JG apparatus

posterior
pituitary

adrenal
cortex

renin

ADH

aldosterone

Collecting ducts

kidney tubules

vasodilate

Na+ & water reabsorption

 Other factors that affect water

balance
estrogens
aldosterone-like: enhance Na+ uptake

glucocorticoids
enhance tubular reabsorption of Na+
especially at high concentrations

enhance glomerular filtration

Calcium regulation
PTH: from parathyroid
activate osteoclasts
enhance intestinal absorption
increase kidney reabsorption

most calcium in bones as calcium

phosphate
PO4- reabsorbed in proximal tubules
regulated by PTH

pH (acid-base) balance
buffering systems in blood &
tissues
CO2 + H2O
bicarbonate

Carbonic
anhydrase

phosphate
PO4--- + H+
protein

R - COOH

H2CO3

HPO4-R - COO- + H+

HCO3- + H+

H2PO4-

Why do we need buffering

capacity?
Metabolism produces wastes
CO2
aerobic & anaerobic respiration

lactic acid
anaerobic respiration of glucose

phosphoric acid
protein metabolism

ketone bodies
fat metabolism

 pH changes that follow

alter enzymes
change metabolism
ACIDOSIS*
7.0 - 7.35

NORMAL
7.4
arterial blood
7.35 venous blood,
ECF
7.0
cells

ALKALOSIS
> 7.45

* Blood & tissues never really acidic;

only relatively more or less so

 Different buffering systems

operate in different fluids

PLASMA

EXTRA-CELLULAR
FLUID

INTRA-CELLULAR
FLUID

proteins
HCO3-

HCO3-

proteins
HCO3HPO4---

How is pH regulated?
Respiratory
CO2 effects on breathing rate & depth
medullary centers
high capacity
0 - 15 fold change in ventilation
2 fold change moves pH from 7.2 to 7.6
beyond normal limits

 Renal
HCO3 by regulating H+
secretion:
CO2
H+
secreted
PCT, collecting
duct
from CO2 , H20
reaction in filtrate
carbonic
anhydrase in PCT

 HPO4 protects against

dangerous pH in
filtrate
binds excess H+