Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Clin Sci (Lond). 2023 May 18;137(9):755-767. doi: 10.1042/CS20220500.
Homeostasis of body fluid is a key component for maintaining health. An imbalance of body sodium and water causes various pathological states, such as dehydration, volume overload, hypertension, cardiovascular and renal diseases, and metabolic disorders. Conventional concepts regarding physiology and pathophysiology of body sodium and water balance have been established by several assumptions. These assumptions are that the kidneys are the master regulator of body sodium and water content, and that sodium moves inside the body in parallel with water. However, recent clinical and basic studies have proposed alternative concepts. These concepts are that body sodium and water balance are regulated by various organs and multiple factors, such as physical activity and the environment, and that sodium accumulates locally in tissues independently of the blood status and/or water. Various concerns remain unclear, and the regulatory mechanism of body sodium, fluid, and blood pressure needs to be readdressed. In the present review article, we discuss novel concepts regarding the regulation of body sodium, water, and blood pressure with a particular focus on the systemic water conservation system and fluid loss-triggered elevation in blood pressure.
体液平衡是维持健康的关键组成部分。体内钠和水的失衡会导致各种病理状态，如脱水、容量超负荷、高血压、心血管和肾脏疾病以及代谢紊乱。关于体内钠和水平衡的生理学和病理生理学的传统概念是基于几个假设建立的。这些假设是肾脏是体内钠和水含量的主要调节者，并且钠在体内与水平行移动。然而，最近的临床和基础研究提出了替代概念。这些概念是，体内钠和水的平衡由各种器官和多种因素调节，如身体活动和环境，并且钠在组织中局部积累，独立于血液状态和/或水。仍有各种问题尚不清楚，需要重新审视体内钠、液体和血压的调节机制。在本综述文章中，我们讨论了关于体内钠、水和血压调节的新观点，特别关注全身水保存系统和液体损失引发的血压升高。
