CASE STUDY 1

A woman sees her physician because of excessive thirst and urination. During the previous week, she urinated hourly during the day and four or five times each night. Her physician tests her urine using dipstick and detects glucose. She is asked to fast overnight and to report the following morning for a glucose tolerance test. After drinking a glucose solution, increases from 200 mg/dl to 800 mg/dl. Urine is collected at timed intervals throughout the test to measure urine volume and glucose concentration. The womans glomerular filtration rate is estimated to be 120 ml/min from her endogenous creatinine clearance. When the reabsorption rate of glucose is calculated ( filtered load of glucose-excretion rate of glucose ), it is found to be constant at 375 mg/min. The physician concludes that the cause of the womans glucosuria is type I DM ( rather than a defect in the renal glucose transpot mechanism).

CASE STUDY 2
A 50 year old man is referred to his physician for evaluation of weakness and hypertension. On physical examination, his systolic and diastolic blood pressures are elevated (160/110) in the supine position. The following blood and urine values are obtained Venous blood Urine Na+, 142 mEq/L Na + 60 mEq/L K+, 2.1 mEq/L K + 55mEq/L Cl- , 98mEq/L Osmolarity 520 mosm/L Osmolarity 289 mOsm/L

CASE STUDY 3
A 45 year old woman is admitted to the hospital following a head injury. She has severe polyuria ( producing 1L of urine every 2 hours) and polydipsia ( drinking 3 to 4 glasses of water every hour). During a 24 hour period in the hospital, the woman produces 10 L of urine, which contain no glucose. She is placed on overnight water restriction for further evaluation. The following morning , she is weak and confused. Her serum osmolarity is 330 mOsm/L, her serum Na+ is 164mEq/L, and her urine osmolarity is 70mOsm/L. She is treated with dDAVP by nasal spray. Within 24 hours of initiating the treatment , her serum osmolarity is 295 mOsm/L and her urine osmolarity is 620 mEq/L.