Pathophysiology
Low Serum Osmolality (Hypoosmolar Serum)
Psychogenic polydipsia: A psychiatric condition characterized by self-induced water intoxication. The disease process has three phases. First, polyuria and polydipsia, followed by the second phase, as the kidney cannot excrete the excess water, resulting in hypoosmolar plasma that manifests as hyponatremia. The final phase is water intoxication, manifesting as delirium, ataxia, nausea, seizures, and vomiting, which may ultimately be fatal.[9]
Syndrome of inappropriate antidiuretic hormone (SIADH): The condition occurs when the body produces an excessive amount of antidiuretic hormone (ADH) due to multiple causes, such as central nervous system tumors, medications, and lung cancers, resulting in the kidneys reabsorbing too much water, which manifests as a dilutional hypoosmolar plasma and hypertension. The treatment can involve medications that block the vasopressin receptor, such as tolvaptan, therapy with hypertonic saline, removing the medications inducing SIADH, or treating the primary cause.[10]
Nephrotic syndrome: A general term that describes the disease processes which result in excessive loss of protein in the urine (proteinuria over 3 grams/day), accompanied by hypertriglyceridemia, hypoalbuminemia, and a hypercoagulable state. The proteinuria occurs when there is damage to the podocyte foot processes or the glomerular basement membrane, which results in decreased serum osmolality and oncotic pressure.[11]
the absence of oxygen and nutrients will rapidly lead to major metabolic problems within renal cells.
Cell swelling occurs when the cell loses its ability to control the movement of ions and water into and out of the cytosol precisely
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