Chronic kidney disease (CKD) is a major public health problem that often goes unrecognized until late-stagedisease. Patients with chronic kidney disease face with uremic toxins and hyperkalemia. Also fluid overloadin CKD patients is associated with rapid decline in kidney function. Lactulose is a hyper osmotic agent andas a prebiotic plays an important role in regulating serum urea and potassiu...

The mechanisms involved in the maintenance of sodium homeostasis are reviewed. Emphasis is placed on localization of sodium reabsorption, effects of physical factors on glomerular ultrafiltration and tubular reabsorption, and action of certain hormones. Responses to arterial hypovolemia and hypervolemia are reviewed.

Fluid overload may occur in critically ill patients as a result of aggressive resuscitation therapies. In such circumstances, persistent fluid overload must be avoided since it does not benefit the patient while it may be harmful. In the septic patient, early volume expansion seems to be beneficial. Beyond that threshold, when organ failure develops, fluid overload has been shown to be associat...

Dry weight has most frequently been defined by the patient becoming symptomatic when fluid removal is attempted. Hypervolemia and fluid removal require ongoing evaluation and the use of a number of strategies. This article reviews strategies for removing fluid during hemodialysis, hemodynamics of fluid removal, and interventions associated with the strategies for fluid removal.

Fluid overload may occur in critically ill patients as a result of aggressive resuscitation therapies. In such circumstances, persistent fluid overload must be avoided since it does not benefit the patient while it may be harmful. In the septic patient, early volume expansion seems to be beneficial. Beyond that threshold, when organ failure develops, fluid overload has been shown to be associat...

James D. Gladden, Blake R. Zelickson, Jason L. Guichard, Mustafa I. Ahmed, Danielle M. Yancey, Scott Ballinger, Mayilvahanan Shanmugam, Gopal J. Babu, Michelle S. Johnson, Victor Darley-Usmar, and Louis J. Dell’Italia University of Alabama at Birmingham (UAB) Comprehensive Cardiovascular Center, UAB Birmingham, Alabama; Department of Medicine, Division of Cardiovascular Disease, UAB, Birmingham...

Fluid overload may occur in critically ill patients as a result of aggressive resuscitation therapies. In such circumstances, persistent fluid overload must be avoided since it does not benefit the patient while it may be harmful. In the septic patient, early volume expansion seems to be beneficial. Beyond that threshold, when organ failure develops, fluid overload has been shown to be associat...

Fluid overload may occur in critically ill patients as a result of aggressive resuscitation therapies. In such circumstances, persistent fluid overload must be avoided since it does not benefit the patient while it may be harmful. In the septic patient, early volume expansion seems to be beneficial. Beyond that threshold, when organ failure develops, fluid overload has been shown to be associat...

Perioperative fluid therapy is the subject of much controversy, and the results of the clinical trials investigating the effect of fluid therapy on outcome of surgery seem contradictory. The aim of this chapter is to review the evidence behind current standard fluid therapy, and to critically analyse the trials examining the effect of fluid therapy on outcome of surgery. The following conclusio...