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尿素诱导的渗透性利尿所致高钠血症：床边生理学

Hypernatremia due to Urea-Induced Osmotic Diuresis: Physiology at the Bedside.

作者信息

Vadi Sonali, Yim Kenneth

机构信息

Private Practitioner, Mumbai, Maharashtra, India.

Director of Inpatient Hemodialysis-Davita Dialysis, University of Maryland Midtown Campus, Maryland, USA.

出版信息

Indian J Crit Care Med. 2018 Sep;22(9):664-669. doi: 10.4103/ijccm.IJCCM_266_18.

DOI:10.4103/ijccm.IJCCM_266_18
PMID:30294134
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6161575/
Abstract

Hypernatremia secondary to urea-induced solute diuresis is due to the renal excretion of electrolyte-free water. This concept is explained here step-wise physiologically with the help of a clinical vignette.

摘要

尿素诱导的溶质利尿继发的高钠血症是由于无电解质水的肾脏排泄所致。在此借助一个临床案例从生理角度逐步解释这一概念。

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本文引用的文献

1
Evaluation of Polyuria: The Roles of Solute Loading and Water Diuresis.多尿评估：溶质负荷和水利尿的作用。
Am J Kidney Dis. 2016 Mar;67(3):507-11. doi: 10.1053/j.ajkd.2015.10.021. Epub 2015 Dec 11.
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Clinical review: practical approach to hyponatraemia and hypernatraemia in critically ill patients.临床综述：危重症患者低钠血症和高钠血症的实用处理方法
Crit Care. 2013 Feb 27;17(1):206. doi: 10.1186/cc11805.
3
Osmotic diuresis-induced hypernatremia: better explained by solute-free water clearance or electrolyte-free water clearance?渗透性利尿引起的高钠血症：溶质清除率还是电解质清除率能更好地解释？
Int Urol Nephrol. 2014 Jan;46(1):207-10. doi: 10.1007/s11255-012-0353-3. Epub 2013 Jan 20.
4
Electrolyte-free water clearance: a key to the diagnosis of hypernatremia in resolving acute renal failure.无电解质水清除率：解决急性肾衰竭时高钠血症诊断的关键。
Clin Exp Nephrol. 2008 Feb;12(1):74-8. doi: 10.1007/s10157-007-0021-6. Epub 2008 Jan 9.
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Derivation of a new formula for calculating urinary electrolyte-free water clearance based on the Edelman equation.基于埃德尔曼方程推导一种计算尿无电解质水清除率的新公式。
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Application of the clearance concept to hyponatremic and hypernatremic disorders: a phenomenological analysis.清除概念在低钠血症和高钠血症疾病中的应用：现象学分析
Clin Chem. 1994 Jul;40(7 Pt 1):1220-7.
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Differential diagnosis of acute renal failure.急性肾衰竭的鉴别诊断。
Clin Nephrol. 1980 Feb;13(2):73-7.
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Hypernatremia, azotemia, and dehydration ue to high-protein tube feeding.
Ann Intern Med. 1968 Apr;68(4):778-91. doi: 10.7326/0003-4819-68-4-778.
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Osmotic diuresis.渗透性利尿
N Engl J Med. 1974 Oct 3;291(14):714-20. doi: 10.1056/NEJM197410032911408.