Volume Overload
- causes and risk factors
- signs, symptoms and diagnosis
- pathophysiology
- treatments
- consequences and course
- resources and references
Causes and Risk Factors
Volume expansion occurs when salt and water intake exceeds renal and extrarenal losses.
Primary renal sodium retention, leading to increased effective circulating volume, occurs with:
- acute renal failure
- acute glomerulonephritis
- severe chronic renal failure
- nephritic syndrome
- nephrotic syndrome
- primary hyperaldosteronism
- Cushing's syndrome
- easrly stages of severe liver disease
- Conn's syndrome
- Gordon's syndrome
- Liddle's syndrome
Secondary renal sodium retention, leading to decreased effective circulating volume, occurs with:
- heart failure
- late stages of severe liver disease
- nephrotic syndrome (minimal change disease)
- pregnancy
Signs, Symptoms, and Diagnosis
- physical exam
- lab investigations
Physical Exam
cardiovascular
- Increased JVP
- normal/increased blood pressure
- S3
respiratory
- inspiratory crackles
skin
- normal/increased skin turgor
- edema in ankles/sacral areas
Lab Investigations
decreased hematocrit and serum protein
Pathophysiology
The net effect of causes of sodium and water retention is increased capillary hydrostatic pressures which shift fluids from the vasculature to the interstitial space.
Treatments
Dietary sodium restriction in combination with diuretics is the mainstay of treatment.
Consequences and Course
References