Enumerate the body fluid volume disorders mentioning their causes. Discuss the role of ADH in maintaining the body fluid volume.

Body fluid volume disorders are as follows.

1)     Hypovolemic disorders:

a)      Isotonic hypovolemia

Causes:

·        Severe hemorrhage

·        Loss of small intestinal content by fistula

·        Secretory diarrhea

·        Polyuric chronic renal failure

·        Intestinal obstruction

      b) Hypertonic hypovolemia

            Causes:

·        Severe diarrhea

·        Persistent vomiting or NG suction

·        Profuse sweating

·        Severe burn

·        Salt loosing nephritis

·        Osmotic dieresis & diuretic abuse

·        Collecting duct dysfunction

      c)  Hypotonic hypovolemia

            Causes

·        Extrarenal causes

o   Hemorrhage

o   Vomiting

o   Diarrhea

o   Burn

·        Renal causes

o   Salt loosing nephritis

o   Osmotic diuresis

o   Diuretics abuse

o   Adrenal deficiency

2) Hypervolemic disorders:

a)      Isotonic hypervolemia

(i)     Excess infusion of normal saline

b)     Hypertonic hypevolemia

(i)     Excess infusion of hypertonic fluid

(ii)   Conn’s syndrome

(iii) Cushing syndrome

(iv) Sea water intake

c)      Hypotonic hypervolemia

(i)     Congestive heart failure

(ii)   Nephrotic syndrome

(iii) Cirrhosis of liver, hepatic failure

(iv) Kwashiorkor

(v)   Protein loosing enteropathies.