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Physiologic Basis

I. Urine Volume and Flow Rate for NSS and Water ingestion:

The addition of an isotonic solution such as normal saline (0.9% NaCl) results in
an increase in extracellular fluid volume only. The osmolarity of NSS is equal to
human cell osmolarity, thus, maintaining osmotic equilibrium. The absence of an
osmotic gradient does not produce fluid movement across the semi-permeable
membrane. Therefore, there is no increase in volume of intracellular fluid.

Water, being a hypotonic solution, produces an increase in both extracellular and


intracellular fluid volume. This is due to the osmotic gradient produced upon the
introduction of a slightly less osmolar liquid with regards to the intracellular
environment. The osmotic gradient favors movement of water from that of low
solute concentration into that of high solute concentration. Water movement
continues only until osmotic equilibrium is achieved. Thus, there is a slight
increase in intracellular fluid volume and an even greater increase in extracellular
fluid volume.

The increase in the extracellular fluid volume leads to an increase in effective


circulating volume, consequently decreasing sympathetic activity. A decrease in
sympathetic activity is sensed by the high-pressure (carotid sinus, aortic arch,
juxtaglomerular apparatus) and low-pressure (cardiac atria and large pulmonary
vessels) volume sensors. Atrial Natriuretic Peptide is released in response to the
stimulus, which favors increased NaCl and water excretion. An increase in ECV
and urine sodium levels indicate an increase in glomerular filtration rate, which
attribute to the urine volume and flow rate in this experiment.

II. Urine Specific Gravity


The specific gravity of urine is an indicator of urine concentration. Increased
specific gravity corresponds to concentrated urine, while a decreased specific
gravity corresponds to dilute urine. The countercurrent mechanism plays a vital
role in the concentration and dilution of urine.

III. Urine Chloride Clearance


Using the urine clearance formula as basis, any amount of increase in urine
volume and urine chloride consequently increases its clearance rate. The addition
of water and NSS both produced an increase in ECV, thus there was an expected
rise in chloride clearance.

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