DIURESIS OSMOTICA DEFINICION PDF

Nivel elevado de calcio en la sangre. Poliuria: Diuresis superior a 2,5 litros diarios. Oliguria: Diuresis inferior a mililitros diarios. Anuria: Diuresis nula o inferior a mililitros diarios.

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Osmotic diuresis[ edit ] Osmotic diuresis is the increase of urination rate caused by the presence of certain substances in the small tubes of the kidneys. The substances cause an increase in the osmotic pressure within the tubule, causing retention of water within the lumen, and thus reduces the reabsorption of water, increasing urine output i.

The same effect can be seen in therapeutics such as mannitol , which is used to increase urine output and decrease extracellular fluid volume. Substances in the circulation can also increase the amount of circulating fluid by increasing the osmolarity of the blood. This has the effect of pulling water from the interstitial space, making more water available in the blood and causing the kidney to compensate by removing it as urine.

In hypotension , often colloids are used intravenously to increase circulating volume in themselves, but as they exert a certain amount of osmotic pressure, water is therefore also moved, further increasing circulating volume. As blood pressure increases, the kidney removes the excess fluid as urine.

Sodium , chloride and potassium are excreted in osmotic diuresis, originating from diabetes mellitus DM. Osmotic diuresis results in dehydration from polyuria and the classic polydipsia excessive thirst associated with DM. Forced diuresis[ edit ] "Forced diuresis", "Forced alkaline diuresis", and "Forced acid diuresis" redirect here.

Forced diuresis increased urine formation by diuretics and fluid may enhance the excretion of certain drugs in urine and is used to treat drug overdose or poisoning of these drugs and hemorrhagic cystitis. When urine is made alkaline , elimination of acidic drugs in the urine is increased. The converse applies for alkaline drugs. This method is only of therapeutic significance where the drug is excreted in active form in urine and where the pH of urine can be adjusted to levels above or below the pK value of the active form of drug.

For acidic drugs, urine pH should be above the pK value of that drug, and converse for the basic drugs. It is because the ionization of acidic drug is increased in alkaline urine and ionized drugs cannot easily cross a plasma membrane so cannot re-enter blood from kidney tubules. This method is ineffective for drugs that are strongly protein bound e.

Potassium replacement becomes of utmost importance in this setting because potassium is usually lost in urine. If blood levels of potassium are depleted below normal levels, then hypokalemia occurs, which promotes bicarbonate ion retention and prevents bicarbonate excretion, thus interfering with alkalinization of the urine.

Forced alkaline diuresis has been used to increase the excretion of acidic drugs like salicylates and phenobarbitone , and is recommended for rhabdomyolysis. Ammonium chloride has also been used for forced acid diuresis but it is a toxic compound.

Forced acid diuresis is rarely done in practice, [5] but can be used to enhance the elimination of cocaine , amphetamine , quinine , quinidine , and strychnine when poisoning by these drugs has occurred. Rebound diuresis[ edit ] An example of the pattern of urine flow and plasma creatinine levels following acute tubular necrosis Rebound diuresis refers to the sudden resurgence of urine flow that occurs during convalescence from acute kidney injury.

This debris obstructs the flow of filtrate, which results in reduced output of urine. The arterial supply of the nephron is linked to the filtration apparatus glomerulus , and reduced perfusion leads to reduced blood flow; usually this is the result of pre-renal pathology.

Thus, the kidney is particularly sensitive to reduction in blood supply. This phenomenon occurs because renal flow is restored prior to the normal resorption function of the renal tubule. As you can see in the graph, urine flow recovers rapidly and subsequently overshoots the typical daily output between mL and 2L in most people. A good reference range for plasma creatinine is between 0.

It is mainly caused by lower temperature and by pressure. The pressure component is caused by the hydrostatic pressure of the water directly increasing blood pressure. Its significance is indicated by the fact that the temperature of the water does not substantially affect the rate of diuresis. On the other hand, sitting up to the neck in a pool for a few hours clearly increases the excretion of water, salts, and urea. Overall, acute exposure to cold is thought to induce a diuretic response due to an increase mean arterial pressure.

The kidneys increase urine production and fill the bladder; when the bladder fills, the individual may then feel the urge to urinate. This phenomenon usually occurs after mental function has decreased to a level significantly below normal. Cold diuresis has been observed in cases of accidental hypothermia as well as a side effect of therapeutic hypothermia , specifically during the induction phase.

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