Nguyen Minhtri K, Nguyen Dai-Scott, Nguyen Minh-Kevin
David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California.
Am J Physiol Renal Physiol. 2016 Sep 1;311(3):F539-47. doi: 10.1152/ajprenal.00215.2016. Epub 2016 Jun 8.
Because changes in the plasma water sodium concentration ([Na(+)]pw) are clinically due to changes in the mass balance of Na(+), K(+), and H2O, the analysis and treatment of the dysnatremias are dependent on the validity of the Edelman equation in defining the quantitative interrelationship between the [Na(+)]pw and the total exchangeable sodium (Nae), total exchangeable potassium (Ke), and total body water (TBW) (Edelman IS, Leibman J, O'Meara MP, Birkenfeld LW. J Clin Invest 37: 1236-1256, 1958): [Na(+)]pw = 1.11(Nae + Ke)/TBW - 25.6. The interrelationship between [Na(+)]pw and Nae, Ke, and TBW in the Edelman equation is empirically determined by accounting for measurement errors in all of these variables. In contrast, linear regression analysis of the same data set using [Na(+)]pw as the dependent variable yields the following equation: [Na(+)]pw = 0.93(Nae + Ke)/TBW + 1.37. Moreover, based on the study by Boling et al. (Boling EA, Lipkind JB. 18: 943-949, 1963), the [Na(+)]pw is related to the Nae, Ke, and TBW by the following linear regression equation: [Na(+)]pw = 0.487(Nae + Ke)/TBW + 71.54. The disparities between the slope and y-intercept of these three equations are unknown. In this mathematical analysis, we demonstrate that the disparities between the slope and y-intercept in these three equations can be explained by how the osmotically inactive Na(+) and K(+) storage pool is quantitatively accounted for. Our analysis also indicates that the osmotically inactive Na(+) and K(+) storage pool is dynamically regulated and that changes in the [Na(+)]pw can be predicted based on changes in the Nae, Ke, and TBW despite dynamic changes in the osmotically inactive Na(+) and K(+) storage pool.
由于临床上血浆水钠浓度（[Na⁺]pw）的变化是由Na⁺、K⁺和H₂O的质量平衡变化引起的，因此，对钠代谢紊乱的分析和治疗取决于埃德尔曼方程在定义[Na⁺]pw与可交换钠总量（Nae）、可交换钾总量（Ke）和总体水（TBW）之间定量相互关系方面的有效性（埃德尔曼IS、莱布曼J、奥米拉MP、伯肯菲尔德LW。《临床研究杂志》37: 1236 - 1256，1958年）：[Na⁺]pw = 1.11（Nae + Ke）/TBW - 25.6。埃德尔曼方程中[Na⁺]pw与Nae、Ke和TBW之间的相互关系是通过考虑所有这些变量的测量误差凭经验确定的。相比之下，以[Na⁺]pw作为因变量对同一数据集进行线性回归分析得出以下方程：[Na⁺]pw = 0.93（Nae + Ke）/TBW + 1.37。此外，根据博林等人的研究（博林EA、利普金德JB。18: 943 - 949，1963年），[Na⁺]pw与Nae、Ke和TBW之间的线性回归方程如下：[Na⁺]pw = 0.487（Nae + Ke）/TBW + 71.54。这三个方程的斜率和y轴截距之间的差异尚不清楚。在本数学分析中，我们证明这三个方程的斜率和y轴截距之间的差异可以通过对渗透惰性Na⁺和K⁺储存池的定量计算方式来解释。我们的分析还表明，渗透惰性Na⁺和K⁺储存池是动态调节的，尽管渗透惰性Na⁺和K⁺储存池存在动态变化，但仍可根据Nae、Ke和TBW的变化来预测[Na⁺]pw的变化。
