Читать книгу Disorders of Fluid and Electrolyte Metabolism - Группа авторов - Страница 36

This is the most common mechanism underlying the pathogenesis of hypotonic hyponatremia. Vasopressin renders the CD permeable to water by increasing the expression of AQP2. Vasopressin release is controlled by both osmotic and non-osmotic pathways. The inhibitory effect of hypotonicity can be overridden by non-osmotic stimulation of vasopressin release. These non-osmotic pathways are activated by a 15% decrease of effective arterial blood volume (EABV) [23]. This reflects the greater importance of maintaining adequate circulating volume at the expense of osmotic dysregulation.