antagonize the respiratory and cardiac manifestations of magnesium.

285,286 The dose

of the calcium can be repeated as necessary because its effect is short lived. In

patients with good renal function without life-threatening complications, IV

furosemide, plus 0.45% sodium chloride to replace lost urine volume, will enhance

urinary magnesium excretion while preventing volume depletion. Hemodialysis or

peritoneal dialysis is indicated for patients with significant renal function impairment

and possibly for those with severe hypermagnesemia.

KEY REFERENCES AND WEBSITES

A full list of references for this chapter can be found at

http://thepoint.lww.com/AT11e. Below are the key references for this chapter, with

the corresponding reference number in this chapter found in parentheses after the

reference.

Key References

Agus Z. Hypomagnesemia. J Am Soc Nephrol. 1999;10:1616. (274)

Alfrey AC. Normal and abnormal magnesium metabolism. In: Schrier RW, ed. Renal and Electrolyte Disorders.

6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:278. (275)

Allon M. Hyperkalemia in end stage renal disease: mechanism and management. J Am Soc Nephrol. 1995;6:1134.

(167)

Davidson TG. Conventional treatment of hypercalcemia of malignancy. Am J Health Syst Pharm. 2001;58(Suppl

3):S8. (189)

Gross P. Treatment of severe hyponatremia. Kidney Int. 2001;60:2417. (61)

Lehrich RW et al. Role of vaptans in the management of hyponatremia. Am J Kidney Dis. 2013;62:364–383. (83)

Morrison G et al. Hyperosmolal states. In: Narins RG, ed. Maxwell & Kleeman’s Clinical Disorders of Fluid and

Electrolyte Metabolism. 5th ed. New York, NY: McGraw-Hill; 1994:617. (104)

Rose BD. Introduction to disorders of osmolality. In: Rose BD et al, eds. Clinical Physiology of Acid-Base and

Electrolyte Disorders. 5th ed. New York, NY: McGraw-Hill; 2000:682. (3)

Rose BD. Renal function and disorders of water and sodium balance. In: Rubenstein E, Federman DD, eds.

Scientific American Medicine. New York, NY: Scientific American Inc., 1994; Section 10:1. (2)

Rubin MF, Narins RG. Hypophosphatemia: pathophysiological and practical aspects of its therapy. Semin Nephrol.

1990;10:536. (229)

Stanaszek WF, Romankiewicz JA. Current approaches to management of potassium deficiency. Drug Intell Clin

Pharm. 1985;19:176. (134)

COMPLETE REFERENCES CHAPTER 27 FLUID AND

ELECTROLYTE DISORDERS

Fanestil DD. Compartmentation of body water. In: Narins RG, ed. Maxwell & Kleeman’s Clinical Disorders of

Fluid and Electrolyte Metabolism. 5th ed. New York, NY: McGraw-Hill; 1994:3.

Rose BD. Renal function and disorders of water and sodium balance. In: Rubenstein E, Federman DD, eds.

Scientific American Medicine. New York, NY: Scientific American Inc., 1994; Section 10:1.

Rose BD. Introduction to disorders of osmolality. In: Rose BD et al, eds. Clinical Physiology of Acid-Base and

Electrolyte Disorders. 5th ed. New York, NY: McGraw-Hill; 2000:682.

Oster JR, Singer I. Hyponatremia, hyposmolality, and hypotonicity: tables and fables. Arch Intern Med.

1999;159:333.

Rose BD, Post T. Proximal tubule. In: Rose BD, Post T. Clinical Physiology of Acid-Base and Electrolyte

Disorders. 5th ed. New York, NY: McGraw-Hill; 2000:71.

Rose BD, Post T. Loop of Henle and the countercurrent mechanism. In: Rose BD, Post T. Clinical Physiology

of Acid-Base and Electrolyte Disorders. 5th ed. New York, NY: McGraw-Hill; 2000:112.

Rose BD, Post T. Functions of the distal nephron. In: Rose BD, Post T. Clinical Physiology of Acid-Base and

Electrolyte Disorders. 5th ed. New York: McGraw-Hill; 2000:143.

Sands JM et al. Vasopressin effects on urea and H 2O transport in inner medullary collecting duct subsegments.

Am J Physiol. 1987;253(5 Pt 2):F823.

Gines P et al. Vasopressin in pathophysiologicalstates. Semin Nephrol. 1994;14:384.

Zerbe RL et al. Osmotic and nonosmotic regulation of thirst and vasopressin secretion. In: Narins RG, ed.

Maxwell & Kleeman’s Clinical Disorders of Fluid and Electrolyte Metabolism. New York, NY: McGraw-Hill;

1994:81.

Rose BD, Post T. Regulation of the effective circulating volume. In: Rose BD, Post T. Clinical Physiology of

Acid-Base and Electrolyte Disorders. 5th ed. New York, NY: McGraw-Hill; 2000:258.

Goetz KL. Renal natriuretic peptide (urodilatin?) and atriopeptin: evolving concepts. Am J Physiol. 1991;261:F921.

Goetz K et al. Evidence that urodilatin, rather than ANP, regulates renal sodium excretion. J Am Soc Nephrol.

1990;1:867.

Rose BD, Post T. Hypovolemic states. In: Rose BD, Post T. Clinical Physiology of Acid-Base and Electrolyte

Disorders. 5th ed. New York, NY: McGraw-Hill; 2000:415.

Rose BD, Post T. Meaning and application of urine chemistries. In: Rose BD, Post T, eds. Clinical Physiology of

Acid-Base and Electrolyte Disorders. 5th ed. New York, NY: McGraw-Hill; 2000:405.

Kaysen GA. Proteinuria and the nephrotic syndrome. In: Schrier RW, ed. Renal and Electrolyte Disorders. 6th

ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:580.

Harris RC, Ismail N. Extrarenal complications of the nephrotic syndrome. Am J Kidney Dis. 1994;23:477.

Saborio P, Scheinman JI. Sickle cell nephropathy. J Am Soc Nephrol. 1999;10:187.

Klotman PE. HIV-associated nephropathy. Kidney Int. 1999;56:1161.

Feinfeld DA et al. Nephrotic syndrome associated with the use of the nonsteroidal anti-inflammatory drugs. Case

report and review of the literature. Nephron. 1984;37:174.

Kaysen GA, de Sain-van der Velden MG. New insights into lipid metabolism in the nephrotic syndrome. Kidney

Int. 1999;56(Suppl 71):S18.

Chonko AM et al. Treatment of edema states. In: Narins RG, ed. Maxwell & Kleeman’s Clinical Disorders of

Fluid and Electrolyte Metabolism. 5th ed. New York, NY: McGraw-Hill; 1994:545.

Glassock RJ. Management of intractable edema in nephrotic syndrome. Kidney Int. 1997;51(Suppl 58):S75.

Schrier RW. Body fluid volume regulation in health and disease: a unifying hypothesis. Ann Intern Med.

1990;113:155.

Schrier RW. An odyssey into the milieu interieur: pondering the enigmas. J Am Soc Nephrol. 1992;2:1549.

Brown EA et al. Sodium retention in nephrotic syndrome is due to an intrarenal defect: evidence from steroidinduced remission. Nephron. 1985;39:290.

Koomans HA et al. Renal function during recovery from minimal lesions nephrotic syndrome. Nephron.

1987;47:173.

Schrier RW, Fassett RG. A critique of the overfill hypothesis of sodium and water retention in the nephrotic

syndrome. Kidney Int. 1998;53:1111.

Bank N. External compression for treatment of resistant edema. N EnglJ Med. 1980;302:969.

Davidson AM et al. Salt-poor human albumin in the management of nephrotic syndrome. Br Med J. 1974;1:481.

Fancheld P et al. An evaluation of ultrafiltration as treatment of diuretic-resistant oedema in nephrotic syndrome.

Acta Med Scand. 1985;17:127.

Yeun JY et al. Nephrotic syndrome: nutritional consequences and dietary management. In: Mitch WE, Klahr S,

eds. Handbook of Nutrition and the Kidney. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2002:132.

Soupart A, Decaux G. Therapeutic recommendations for management of severe hyponatremia: current concepts

on pathogenesis and prevention of neurologic complications. Clin Nephrol. 1996;46:149.

Narins RG et al. Diagnostic strategies in disorders of fluid, electrolyte and acid-base homeostasis. Am J Med.

1982;72:496.

Goldman MB et al. Mechanisms of altered water metabolism in psychotic patients with polydipsia and

hyponatremia. N EnglJ Med. 1988;318:397.

Illowsky B, Kirch DG. Polydipsia and hyponatremia in psychiatric patients. Am J Psychiatry. 1988;145:6.

Sterns RH et al. Hyponatremia: pathophysiology, diagnosis, and therapy. In: Narins RG, ed. Maxwell &

Kleeman’s Clinical Disorders of Fluid and Electrolyte Metabolism. New York, NY: McGraw-Hill; 1994:583.

Weisberg LS. Pseudohyponatremia: a reappraisal. Am J Med. 1989;86:315.

Rothenberg DM et al. Isotonic hyponatremia following transurethral prostate resection. J Clin Anesth. 1990;2:48.

Faber MD et al. Common fluid-electrolyte and acid-base problems in the intensive care unit: selected issues.

Semin Nephrol. 1994;14:8.

Ashraf N et al. Thiazide-induced hyponatremia associated with death or neurologic damage in outpatients. Am J

Med. 1981;70:1163.

Ashouri OS. Severe diuretic-induced hyponatremia in the elderly. A series of eight patients. Arch Intern Med.

1986;146:1355.

Shah PJ, Greenburg WM. Water intoxication precipitated by thiazide diuretics in polydipsic psychiatric patients.

Am J Psychiatry. 1991;48:1424.

Vassal G et al. Hyponatremia and renalsodium wasting in patients receiving cisplatinum. Pediatr Hematol Oncol.

1987;4:337.

Hutchison FN et al. Renalsalt wasting in patients treated with cisplatin. Ann Intern Med. 1988;108:21.

Vaamonde CA. Renal water handling in liver disease. In: Epstein M, ed. The Kidney in Liver Disease. 3rd ed.

Baltimore, MD: Williams & Wilkins; 1988:67.

Papadakis MA et al. Hyponatraemia inpatients with cirrhosis. Q J Med. 1990;76:675.

Carpenter CCJ et al. Oral rehydration therapy—the role of polymeric substrates. N EnglJ Med. 1988;319:1346.

Leier CV et al. Clinical relevance and management of the major electrolyte abnormalities in congestive heart

failure: hyponatremia, hypokalemia, and hypomagnesemia. Am Heart J. 1994;128:564.

Gore SM et al. Impact of rice based oral rehydration solution on stool output and duration of diarrhoea: metaanalysis of 13 clinical trials. BMJ. 1992;304:287.

Allon M et al. Renalsodium and water handling in hypothyroid patients: the role of renal insufficiency. J Am Soc

Nephrol. 1990;1:205.

Linas SL et al. Role of vasopressin in the impaired water excretion of glucocorticoid deficiency. Kidney Int.

1980;18:58.

DeFronzo RA et al. Normal diluting capacity in hyponatremic patients: reset osmostat or variant of the syndrome

of inappropriate antidiuretic hormone secretion. Ann Intern Med. 1976;84:538.

Schwartz WB et al. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate

secretion of antidiuretic hormone. Am J Med. 1957;23:529.

Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med.

1967;42:790.

Cooke RC et al. The syndrome of inappropriate antidiuretic hormone secretion (SIADH): pathophysiologic

mechanisms in solute and volume regulation. Medicine (Baltimore). 1979;58:240.

Marchioli CC, Graziano SL. Paraneoplastic syndromes associated with small cell lung cancer. Chest Surg Clin N

Am. 1997;7:65.

Rose BD. New approach to disturbances in the plasma sodium concentration. Am J Med. 1986;81:1033.

Cluitmans FH, Meinders AE. Management of severe hyponatremia: rapid or slow correction? Am J Med.

1990;88:161.

Sterns RH. The treatment of hyponatremia: first, do no harm. Am J Med. 1990;88:557.

Gross P. Treatment of severe hyponatremia. Kidney Int. 2001;60:2417.

Arieff AI. Hyponatremia, convulsions, respiratory arrest, and permanent brain damage after elective surgery in

healthy women. N EnglJ Med. 1986;314:1529.

Ayus JC et al. Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med.

1992;117:891.

Lien Y et al. Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia:

implications for the pathogenesis of central pontine myelinolysis. J Clin Invest. 1991;88:303.

Berl T. Treating hyponatremia: damned if we do and damned if we don’t. Kidney Int. 1990;37:1006.

Chung HM et al. Post-operative hyponatremia. Arch Intern Med. 1986;146:333.

Cochrane JP et al. Arginine vasopressin release following surgical operations. Br J Surg. 1981;68:209.

DeFronzo RA et al. Water intoxication in man after cyclophosphamide therapy. Time course and relation to drug

activation. Ann Intern Med. 1973;78:861.

Morgan DB et al. Water intoxication and oxytocin infusion. Br J Obstet Gynaecol. 1977;84:6.

Cheng JC et al. Long-term neurologic outcome in psychogenic water drinkers with severe symptomatic

hyponatremia: the effect of rapid correction. Am J Med. 1990;88:561.

Laureno R, Karp BI. Pontine and extrapontine myelinolysis following rapid correction of hyponatraemia. Lancet.