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The reasons for raising and lowering sodium in the urine
Last reviewed: 19.10.2021
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Reference values (norm) of sodium excretion in urine: men - 40-220 meq / day (mmol / day); women - 27-287 meq / day (mmol / day).
Sodium is excreted mainly through the kidneys. The release of sodium is regulated mainly by the hormones of the adrenal cortex and the posterior lobe of the pituitary gland. Normally, the excretion of sodium in the urine relatively evenly throughout the day, in contrast to the excretion of potassium, which has a clear peak in the morning hours, accordingly increases the ratio of K / Na, which correlates with the activity of glucocorticosteroids. Aldosterone causes sodium retention in the body, increasing the ratio of K / Na urine.
Sodium refers to threshold substances, and an increase in its concentration in the blood leads to an increase in its excretion. To judge the balance of sodium in the body, it is necessary to simultaneously determine its content in blood and urine.
Diseases and conditions in which the release of sodium in the urine changes
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Increased sodium secretion |
Decrease in the secretion of sodium |
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Increased sodium intake Postmenstrual diuresis Jade with loss of salts Adrenal insufficiency Renal tubular acidosis (Lightwood syndrome) Treatment with diuretics Diabetes Syndrome of inappropriate ADH secretion Alkalosis Conditions accompanied by the release of alkaline urine |
Inadequate sodium intake Premenstrual retention of sodium and water Hypercortisy Adrenal loss of sodium with adequate water intake During the first 24-48 h after the operation (syndrome of stress diuresis) Conditions with a decrease in GFR, for example, congestive heart failure Acute oliguria and prerenal azotemia, in contrast to acute tubular necrosis with oliguria |
The study of the daily excretion of sodium by its concentration in urine and the amount of diuresis makes it possible to evaluate the basic physiological losses of sodium. The ratio of Na / K urine is an indirect indicator of the mineral-corticoid function of the adrenal glands and in the case of extra-stress states it is 3-3.3.