Disorders of water metabolism

Disorders of water metabolism are divided into:


 * 1) intracellular ,
 * 2) extracellular :
 * 3) * hyperhydration (hypervolemia),
 * 4) * dehydration (hypovolemia).

Cloudy swelling

 * Marking for the macroscopic appearance with increased water content in the cells of parenchymatous organs (liver, kidneys, myocardium, skeletal muscles).
 * The organs look like they have been boiled, they are paler, turbid (dull), swollen.
 * Microscopically, the cells are enlarged, with granular cytoplasm (enlarged mitochondria and ER).
 * The cause is phosphorylation disorders in the mitochondria - a lack of ATP leads to anaerobic glycolysis and subsequent acidification causes partial denaturation of cytoplasmic proteins and failure of the Na + /K + pump - this condition occurs, for example, with a lack of oxygen, sepsis, poisoning, nutritional disorders.

Vacuolar dystrophy

 * Small vacuoles filled with water (from mitochondria and ER) are found in the cell - microcystic, honeycomb-like appearance of cells (cytoplasm forms thin septa between vacuoles, nucleus on the periphery of the cell), examples are:
 * osmotic vacuolar dystrophy in cells of the proximal renal tubule after infusion of hypertonic glucose solution (osmotic nephrosis);
 * hydropic vacuolar dystrophy in hepatocytesech in "water intoxication";
 * disintegration vacuolar dystrophy in the kidneys and liver due to poisoning with CCl 4, dioxane, ethylene glycol, etc.

Balloon dystrophy

 * Accumulation of water in the cell, which enlarges, becomes rounded or even bursts - e.g. balloon degeneration of epidermis cells during viral infections (blisters in variola, varicella and herpes), septa from cell membranes remain - so-called reticular degeneration.

Extracellular changes in the amount of water

 * These are changes in volemia, which is one of the components of homeostasis and is subject to nervous-humoral regulation, mainly the activity of the GIT and kidneys is applied :
 * increase in volume by reducing diuresis – ADH – ADH (vasopressin) + renin-angiotensin-aldosterone;
 * decrease in volemia by increasing diuresis – ANP.


 * Dehydration (almost always associated with hyponatremia).
 * It manifests itself with reduced skin turgor, dryness and stickiness of the mucous membranes and serosas, the cheeks are sunken and the nose protrudes sharply - facies Hippokratica.
 * Hypotonic – greater loss of solutes than water (loss of hypertonic fluid).
 * Isotonic - loss of isotonic fluid (bleeding, diarrhea, vomiting...).
 * Hypertonic – greater loss of water than solutes (hypotonic fluid loss) or decreased water intake.
 * Hyperhydration – occurs either by the movement of water from the intravascular space into the interstitium (edema) or by the retention of Na + and water by the kidneys.
 * Hypotonic – greater intake (or retention) of water than solutes – eg water poisoning.
 * Isotonic - retention of isotonic fluid - formation of edema.
 * Hypertonic – greater retention of solutes than water.

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= Disorders of water metabolism = Disorders of water metabolism are divided into:


 * 1) intracellular ,
 * 2) extracellular :
 * 3) * hyperhydration (hypervolemia),
 * 4) * dehydration (hypovolemia).

Cloudy swelling

 * Marking for the macroscopic appearance with increased water content in the cells of parenchymatous organs ( liver, kidneys , myocardium , skeletal muscles ). The organs look like they have been boiled, they are paler, turbid (dull), swollen.
 * Microscopically, the cells are enlarged, with granular cytoplasm (enlarged mitochondria and ER ).
 * The cause is phosphorylation disorders in the mitochondria - a lack of ATP leads to anaerobic glycolysis and subsequent acidification causes partial denaturation of cytoplasmic proteins and failure of the Na + /K + pump - this condition occurs, for example, with a lack of oxygen, sepsis , poisoning , nutritional disorders.

Vacuolar dystrophy

 * Small vacuoles filled with water (from mitochondria and ER) are found in the cell - microcystic, honeycomb-like appearance of cells (cytoplasm forms thin septa between vacuoles, nucleus on the periphery of the cell), examples are:
 * osmotic vacuolar dystrophy in cells of the proximal renal tubule after infusion of hypertonic glucose solution (osmotic nephrosis );
 * hydropic vacuolar dystrophy in hepatocytes in "water intoxication";
 * disintegration vacuolar dystrophy in the kidneys and liver due to poisoning with CCl 4, dioxane, ethylene glycol, etc.

Balloon dystrophy

 * Accumulation of water in the cell, which enlarges, becomes rounded or even bursts - e.g. balloon degeneration of epidermis cells during viral infections (blisters in variola, varicella and herpes ), septa from cell membranes remain - so-called reticular degeneration.

Extracellular changes in the amount of water

 * These are changes in volemia, which is one of the components of homeostasis and is subject to nervous-humoral regulation, mainly the activity of the GIT and kidneys is applied :
 * increase in volume by reducing diuresis – ADH (vasopressin) + renin-angiotensin-aldosterone ;
 * decrease in volemia by increasing diuresis – ANP.


 * Dehydration (almost always associated with hyponatremia ). It manifests itself with reduced skin turgor, dryness and stickiness of the mucous membranes and serosas, the cheeks are sunken and the nose protrudes sharply - facies Hippokratica .
 * Hypotonic – greater loss of solutes than water (loss of hypertonic fluid).
 * Isotonic - loss of isotonic fluid (bleeding, diarrhea, vomiting...).
 * Hypertonic – greater loss of water than solutes (hypotonic fluid loss) or decreased water intake.


 * Hyperhydration – occurs either by the movement of water from the intravascular space into the interstitium ( edema ) or by the retention of Na + and water by the kidneys.
 * Hypotonic – greater intake (or retention) of water than solutes – eg water poisoning.
 * Isotonic - retention of isotonic fluid - formation of edema.
 * Hypertonic – greater retention of solutes than water.

Related Articles

 * Disorders of water and electrolyte balance (signpost)
 * Edema
 * Dehydration