Kidneys and Hormones

Topic: KH_04 Salt and Water Balance

Why do we need to regulate salt and water?

• Maintaining blood pressure for organ perfusion

• Maintain blood volume
• Maintain concentration of nutrients and ions within and
around cells
Symptoms of dehydration Symptoms of hyperhydration

Thirst Headache
Headache Nausea
Nausea Cramps
Cramps Mental confusion
Dry mucus membranes Irritability
Reduced urine output Muscle weakness
Mental confusion Seizures
Reduced skin turgor
Reduction in blood pressure
Increased hear rate
Cold extremities
Sunken orbits
Symptoms of dehydration Symptoms of hyperhydration

Thirst Headache
Headache Nausea
Nausea Cramps
Cramps Mental confusion
Dry mucus membranes Irritability
Reduced urine output Muscle weakness
Mental confusion Seizures
Reduced skin turgor
Reduction in blood pressure
Increased hear rate
Cold extremities
Sunken orbits
What would happen if this
were the brain?
Which way will the water go?
 Which way will the water
go?

a. →
b. ←
c. No movement
1 M NaCl 1 M NaCl
d. Not enough
information
 a. →
b. ←
c. No movement
0.9 M NaCl 0.9 M NaCl
d. Not enough
information
 a. →
b. ←
c. No movement
1 M NaCl 0.9 M NaCl
d. Not enough
information
 a. →
b. ←
1 M NaCl
c. No movement
1 M NaCl
d. Not enough
information
 a. →
b. ←
1 M NaCl
c. No movement
0.9 M NaCl
d. Not enough
information
 a. →
b. ←
c. No movement
1 M KCl 1 M KCl
d. Not enough
information
 a. →
b. ←
c. No movement
1 M NaCl 1 M KCl
d. Not enough
information
 a. →
b. ←
c. No movement
1 M NaCl 0.9 M KCl
d. Not enough
information
 a. →
b. ←
c. No movement
1 M NaCl 1 M MgCl2
d. Not enough
information
 To move water in this
direction (any number may
be right):

a. Add salt to the left

b. Add salt to the right
c. add pressure to the
1 M NaCl 1 M KCl
left
d. Add pressure to the
right
 To move water in this
direction (any number may
be right):

a. Add salt to the left

b. Add salt to the right
c. add pressure to the
1 M NaCl 1 M KCl
left
d. Add pressure to the
right
What has this got to do with the body?
 How can we turn this into
a model of the body’s
water compartments?

1 M NaCl 1 M KCl
vasculature Extracellular fluid Intracellular fluid
Suggested answer

140 mM NaCl 140 mM NaCl 100 mM KCl

5 mM KCl 5 mM KCl 1 mM NaCl
vasculature Extracellular fluid Intracellular fluid How would the water move?

140 mM NaCl 140 mM NaCl 100 mM KCl

5 mM KCl 5 mM KCl 1 mM NaCl
Why might this happen?

Add salt
vasculature Extracellular fluid Intracellular fluid How would the water move?

140 mM NaCl 140 mM NaCl 100 mM KCl

5 mM KCl 5 mM KCl 1 mM NaCl
Why might this happen?

Add
water
vasculature Extracellular fluid Intracellular fluid How would the water move?

140 mM NaCl 140 mM NaCl 100 mM KCl

5 mM KCl 5 mM KCl 1 mM NaCl
Why might this happen?

Remove
salt
vasculature Extracellular fluid Intracellular fluid How would the water move?

140 mM NaCl 140 mM NaCl 100 mM KCl

5 mM KCl 5 mM KCl 1 mM NaCl
Why might this happen?

Remove
water
vasculature Extracellular fluid Intracellular fluid How would the water move?

140 mM NaCl
140 mM NaCl 100 mM KCl
5 mM KCl
5 mM KCl 1 mM NaCl
Why might this happen?
vasculature Extracellular fluid Intracellular fluid How would the water move?

140 mM NaCl 100 mM KCl

140 mM NaCl 5 mM KCl 1 mM NaCl
5 mM KCl Why might this happen?
The balancing act – control systems
(set point)
 Post its:
ADH
Renin
Atrial natriuretic peptide
Angiotensin 1 Challenges:
Angiotensinogen
Angiotensin 2 1. Hypertension
Aldosterone 2. Haemorrhage (loss of significant
Sympathetic ns amount of blood)
Parasympathetic ns 3. Excessive production of ADH
4. Excessive excretion of salt

Control concepts:

Effector
Sensor
Controller
Variable
Set point
 Minute to Minute (longer term)
Sympathetic activity Angiotensinogen regulation of fluid balance
↓Na Granular cells
Macula densa
↓BP
Renin
Ang I

↑BP ACE

Ang II Vascular smooth muscle

Baroreceptors
(stretch) Vasoconstriction
↑plasma Osmo receptors
osmolality
Aldosterone Adrenal gland
↑ Peripheral resistance
ANP
ADH

↓ reabsorption of Na ↑ reabsorption of Na
Principle cells
and H2O
↑ reabsorption of H2O
Vasoconstriction
↑ Blood
volume
↑ Blood ↑ Peripheral resistance
volume
 Minute to Minute (longer term)
Sympathetic activity Angiotensinogen regulation of fluid balance
↓Na
Macula densa Granular cells E.g. eating salty food
↓BP
Renin
Ang I

↑BP
Elevated during ACE

haemorrhage
Baroreceptors
Ang II Vascular smooth muscle

(stretch) Vasoconstriction
↑plasma Osmo receptors
osmolality
Aldosterone Adrenal gland
↑ Peripheral resistance
ANP
ADH

↓ reabsorption of Na ↑ reabsorption of Na
Principle cells
and H2O
↑ reabsorption of H2O
Vasoconstriction
↑ Blood
volume
↑ Blood ↑ Peripheral resistance
volume