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Specific Gravity

Sample

Distilled
Water

5%
Glucose

Normal
Saline

None

1st collection

1.010

1.025

1.025

1.030

2nd
collection

1.005

1.030

1.025

1.025

3rd collection

1.005

1.015

1.030

1.025

4th collection

1.005

1.005

1.030

1.025

Specific Gravity
Refers to the ratio of the density of a
substance (urine) to the density of a
reference substance (water)
An indicator of urine concentration
A SG value that is closer to 1.0 means
that the density of urine is almost that
of water (diluted)
A higher value means that the urine is
more concentrated

Total Body Water

The response of the kidneys to the taken


fluid (or lack thereof) depends on how the
fluid affects the different parameters
(volume, tonicity) concerning body water

The response of the kidney can be measured


by how concentrated the produced urine is:
higher SG = more conc. = fluid is retained
less SG = less conc. = fluid is excreted

A. Distilled Water
Hyposmotic
Ingestion will result to
hyposmotic overhydration
Distributed throughout the
total body water
The amount of water that will
go to each compartment is in
proportion to the contribution
of that compartment to the
total body water

Effects of Drinking 1L Distilled Water


on Body Water Volume

+ 88mL
+ 350mL
+ 262mL

+
1000mL
+ 650mL

The volume changes in the plasma (intravascular) is not


enough (just 3% compared to the 7-10% threshold) to
trigger detection by volume receptors (low pressure
baroreceptor), ANP will NOT be released

Effects of Drinking 1L Distilled Water


on Body Water Osmolality
Initially, water enters the plasma
Plasma osmolality decreases
Water shifts to the interstitium
Interstitial osmolality decreases
Water shifts to ICF
ICF osmolality decreases
Bottomline: both ECF and ICF osmolality decrease.
The osmolality decrease will be detected by
osmoreceptors (in the hypothalamus) which will
inhibit the release of ADH

Distilled Water
Due to the lack of ADH:
Urea transporters in the
collecting ducts are not
expressed on the cells luminal
surface = low urea permeability
and recycling = low
countercurrent multiplier
Principal cells do not express
aquaporins = low water
reabsorption
The acute increase in the
sodium reabsorption in the
ascending loop of henle is not
observed = low countercurrent
multiplier
All of these contribute to the
production of urine whose SG is
close to 1.000

Distilled Water Summary


No ANP
ADH is decreased
Dilute Urine

Production of dilute urine is due to


a decrease in ADH production and
not by ANP production. In theory,
however, the decrease in SG should
have been observed 1 hour 1.5
hours after the introduction of
distilled water to the system since
changes have to be detected
centrally and then ADH levels need 3
half-lives (ADHs half-life is 30
minutes) to fall to a new steady state

5% Glucose
Isosmotic (when glucose is still
present)
After glucose is taken in by the
cells, the net effect is that of pure
water
Ingestion will result to hyposmotic
overhydration
Distributed throughout the total
body water
The amount of water that will go to
each compartment is in proportion
to the contribution of that
compartment to the total body
water

Effects of Drinking 1L 5% Glucose


Solution on Body Water Osmolality

Initially, the solution enters the plasma


Since it is isosmotic, the solution will remain in the plasma
Glucose will be taken in by the cells
After all the glucose has been taken up by the cells, plasma
will become hyposmotic
Plasma osmolality decreases
Water shifts to the interstitium
Interstitial osmolality decreases
Water shifts to ICF
ICF osmolality decreases
Bottomline: both ECF and ICF osmolality decrease. The
osmolality decrease will be detected by osmoreceptors (in the
hypothalamus) which will inhibit the release of ADH

Effects of Drinking 1L 5% Glucose


Solution on Body Water Volume

+ 88mL
+ 350mL
+ 262mL

+
1000mL
+ 650mL

The volume changes in the plasma (intravascular) is not


enough (just 3% compared to the 7-10% threshold) to
trigger detection by volume receptors (low pressure
baroreceptor), ANP will NOT be released

5% Glucose Solution
Due to the lack of ADH:
Urea transporters in the
collecting ducts are not
expressed on the cells luminal
surface = low urea permeability
and recycling = low
countercurrent multiplier
Principal cells do not express
aquaporins = low water
reabsorption
The acute increase in the
sodium reabsorption in the
ascending loop of henle is not
observed = low countercurrent
multiplier
All of these contribute to the
production of urine whose SG is
close to 1.000

5% Glucose Solution
Summary

No ANP
ADH is decreased
Dilute Urine

Production of dilute urine is due


to a decrease in ADH production
and not by ANP production. The
decrease in SG took place 1.5
hours (interval between 2nd and 4th
collection) after the introduction
of the solution since ADH levels
need 3 half-lives (ADHs half-life is
30 minutes) to fall to a new
steady state

Normal Saline Solution


(0.9% NaCl)
Isosmotic
Similar to ECF in
composition due to
the presence of NaCl
Distribution is
restricted to ECF

Effects of Drinking 1L NSS on Body


Water Volume

+ 250mL

+
1000mL

+
1000mL

+ 750mL

The volume changes in the plasma (intravascular) is


not enough to trigger detection by volume receptors
(low pressure baroreceptor), ANP will NOT be released

Effects of Drinking 1L NSS on Body


Water Osmolality
Initially, NSS enters the plasma
The NSS will distribute itself in the
ECF compartments in proportion to
their contribution to ECF volume (3
ISF: 1 Plasma)
Bottomline: both ECF and ICF
osmolality will remain the same. ADH
production will not be inhibited

NSS
Since NSS do not contain protein,
oncotic pressure is decreased in the
plasma
Movement of fluid to glomerulus is
favored
Also, the decreased oncotic pressure
means a decrease in water
reabsorption in the proximal tubule
This results in a glomero-tubular
imbalance
The rest of the tubule will function
normally
The added fluid will be excreted
despite the non-disturbance of the
body water volume and osmolarity
Urinary output = fluid input
Urine is of typical specific gravity
and therefore, concentration
(neither highly concentrated nor
diluted)

NSS summary
No ANP
ADH production is
not decreased
Normal Urine

No fluid taken
Mild dehydration
Body will continue on
losing water through
normal metabolic
processes (e.g.
breathing, sweating)
Without replenishing the
fluid loss, the body will
try to minimize fluid loss
by concentrating urine

No fluid taken
The fluid loss will
result to a plasma
with higher
osmolarity
The osmolarity
changes will be
detected by the
hypothalamus
which will trigger
ADH production by
the pituitary gland

No fluid taken
Due to the high amount of ADH:
Urea transporters in the
collecting ducts are expressed
on the cells luminal surface =
high urea permeability and
recycling = low
countercurrent multiplier
Principal cells express
aquaporins = high water
reabsorption
There is an acute increase in
the sodium reabsorption in
the ascending loop of henle =
high countercurrent multiplier
All of these contribute to the
production of a concentrated
urine

No fluid taken

No fluid taken summary


No ANP
ADH production
increased
Concentrated Urine