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| Urine sodium | |
|---|---|
| Medical diagnostics |
Urine sodium is a measurement of the concentration of sodium in the urine.
Sodium is a chemical element with symbol Na (from Latin natrium) and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 of the periodic table, because it has a single electron in its outer shell, which it readily donates, creating a positively charged ion—the Na+ cation. Its only stable isotope is 23Na. The free metal does not occur in nature, and must be prepared from compounds. Sodium is the sixth most abundant element in the Earth's crust and exists in numerous minerals such as feldspars, sodalite, and rock salt (NaCl). Many salts of sodium are highly water-soluble: sodium ions have been leached by the action of water from the Earth's minerals over eons, and thus sodium and chlorine are the most common dissolved elements by weight in the oceans.
Urine is a liquid by-product of metabolism in humans and in many animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra.
The urine sodium is expressed as a concentration (such as milimoles per liter). The result must therefore be interpreted in the context of the degree of urine concentration present. Alternatively, the urine sodium can be standardized to the excretion of creatinine using a formula such as the fractional excretion of sodium (FENa).
Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body.
The fractional excretion of sodium (FENa) is the percentage of the sodium filtered by the kidney which is excreted in the urine. It is measured in terms of plasma and urine sodium, rather than by the interpretation of urinary sodium concentration alone, as urinary sodium concentrations can vary with water reabsorption. Therefore, the urinary and plasma concentrations of sodium must be compared to get an accurate picture of renal clearance. In clinical use, the fractional excretion of sodium can be calculated as part of the evaluation of acute kidney failure in order to determine if hypovolemia or decreased effective circulating plasma volume is a contributor to the kidney failure.
| Parameter | Value |
|---|---|
| renal blood flow | RBF=1000 ml/min |
| hematocrit | HCT=40% |
| glomerular filtration rate | GFR=120 ml/min |
| renal plasma flow | RPF=600 ml/min |
| filtration fraction | FF=20% |
| urine flow rate | V=1 mL/min |
| Sodium | Inulin | Creatinine | PAH |
|---|---|---|---|
| SNa=150 mEq/L | SIn=1 mg/mL | SCr=0.01 mg/ml | SPAH= |
| UNa=710 mEq/L | UIn=150 mg/mL | UCr=1.25 mg/mL | UPAH= |
| C Na=5 mL/min | CIn=150 ml/min | CCr=125 mL/min | CPAH=420 ml/min |
| ER=90% | |||
| ERPF=540 ml/min |
Because the hypothalamus/osmoreceptor system ordinarily works well to cause drinking or urination to restore the body's sodium concentrations to normal, this system can be used in medical treatment to regulate the body's total fluid content, by first controlling the body's sodium content. Thus, when a powerful diuretic drug is given which causes the kidneys to excrete sodium, the effect is accompanied by an excretion of body water (water loss accompanies sodium loss). This happens because the kidney is unable to efficiently retain water while excreting large amounts of sodium. In addition, after sodium excretion, the osmoreceptor system may sense lowered sodium concentration in the blood and then direct compensatory urinary water loss in order to correct the hyponatremic (low blood sodium) state.
The hypothalamus is a portion of the brain that contains a number of small nuclei with a variety of functions. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland. The hypothalamus is located below the thalamus and is part of the limbic system. In the terminology of neuroanatomy, it forms the ventral part of the diencephalon. All vertebrate brains contain a hypothalamus. In humans, it is the size of an almond. The hypothalamus is responsible for the regulation of certain metabolic processes and other activities of the autonomic nervous system. It synthesizes and secretes certain neurohormones, called releasing hormones or hypothalamic hormones, and these in turn stimulate or inhibit the secretion of hormones from the pituitary gland. The hypothalamus controls body temperature, hunger, important aspects of parenting and attachment behaviours, thirst, fatigue, sleep, and circadian rhythms. The hypothalamus derives its name from Greek ὑπό, under and θάλαμος, chamber.
An osmoreceptor is a sensory receptor primarily found in the hypothalamus of most homeothermic organisms that detects changes in osmotic pressure. Osmoreceptors can be found in several structures, including two of the circumventricular organs – the vascular organ of the lamina terminalis, and the subfornical organ. They contribute to osmoregulation, controlling fluid balance in the body. Osmoreceptors are also found in the kidneys where they also modulate osmolality.
A diuretic is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way. Alternatively, an antidiuretic, such as vasopressin, is an agent or drug which reduces the excretion of water in urine.
