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i was wondering what is the serum Na in Low vol states? Since aldosterone would kick in and increase reabsorption at DCT, it would increase. However, Dr. ******* (pass program) said that hyponat states accompanied with low vol states and he explained as dilutional effect. Can someone confirm this? And if this is the case would patients like to be in high depolarize states interm of cellular level? Since hyponatriema would cause more like to depolarize states according to Dr. ******* as well due to Ca and Mg rush into cell. Thanks for u time.
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It depends on the reason why there is a low volume state [in ecf]. Its possible to have low volume state.. say diarrhea but you lose isotonic loss.. so serum na is not affected. In another low volume state, say in adrenocortical deficiency.. (lack of aldosterone), you would lose out more na+ than water.. so you become hyponatremic.
To get into dilutional effect: lets say you have less sodium in your ecf. the osmalarity of ECF decreases.. (less sodium more water). To equilibrate to this change in the ICF, ie. it has to decrease its osmalarity too to equal it with ecf. It sucks up the water from ecf into icf. Thus, you get swelling of the icf, and loss of water in ecf.
as for depolarization.. maybe lil more input would help or change of phrase.