The "chloride theory", a unifying hypothesis for renal handling and body fluid distribution in heart failure pathophysiology.
Med Hypotheses
; 104: 170-173, 2017 Jul.
Article
en En
| MEDLINE
| ID: mdl-28673579
ABSTRACT
Body fluid volume regulation is a complex process involving the interaction of various afferent (sensory) and neurohumoral efferent (effector) mechanisms. Historically, most studies focused on the body fluid dynamics in heart failure (HF) status through control of the balance of sodium, potassium, and water in the body, and maintaining arterial circulatory integrity is central to a unifying hypothesis of body fluid regulation in HF pathophysiology. The pathophysiologic background of the biochemical determinants of vascular volume in HF status, however, has not been known. I recently demonstrated that changes in vascular and red blood cell volumes are independently associated with the serum chloride concentration, but not the serum sodium concentration, during worsening HF and its recovery. Based on these observations and the established central role of chloride in the renin-angiotensin-aldosterone system, I propose a unifying hypothesis of the "chloride theory" for HF pathophysiology, which states that changes in the serum chloride concentration are the primary determinant of changes in plasma volume and the renin-angiotensin-aldosterone system under worsening HF and therapeutic resolution of worsening HF.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Líquidos Corporales
/
Cloruros
/
Insuficiencia Cardíaca
/
Riñón
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Med Hypotheses
Año:
2017
Tipo del documento:
Article