The measurement of serum osmolality and its application to clinical practice and
            laboratory: literature review

Faria, Daniel K.; Mendes, Maria Elizabete; Sumita, Nairo Massakazu

doi:10.5935/1676-2444.20170008

Cited by 11 publications

(13 citation statements)

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“…It should be pointed out that our experimental conditions are not completely physiologically relevant. The osmolality of the serum ranges from 275 mOsm to 295 mOsm and is tightly regulated (≤10%) even if suffering from compulsive water drinking [30]. If using such settings in an in vitro study, it would be much harder to demonstrate its effect on changes in the endothelial glycocalyx.…”

Section: Discussionmentioning

confidence: 99%

Membrane tension regulates syndecan-1 expression through actin remodelling

Wang

2019

Biochimica et Biophysica Acta (BBA) - General Subjects

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The endothelial glycocalyx, located at the interface of vascular lumen, is a carbohydrate-rich complex that controls vascular functions such as solute permeation, neutrophil extravasation and mechanotransduction. It anchors to the cell membrane through core proteins, e.g. syndecan-1, which couple to the actin cytoskeleton. Membrane tension plays an important role in the reorganisation of membrane-bound proteins, however, little is known on the effect of the membrane tension on the various components of the glycocalyx. In the current study, we use hypo-osmotic stress to investigate the effect of the membrane tension on syndecan-1 expression.Our results show that following 20 min exposure to hypo-osmotic medium, the expression of syndecan-1 in the endothelial glycocalyx layer is reduced to 84.7 ± 3.6 % (255 mOsm) and 64.7 ± 2.1 % (167 mOsm). This reduction, however, is transient and partial recovery is observed at the end of 2 h exposure to the hypo-osmotic medium. The transient reduction of syndecan-1 is associated with depolymerisation of the actin cytoskeleton. Further examination of the effect of actin manipulation reveals that actin depolymerisation by cytochalasin D results in sustained syndecan-1 reduction. In contrast, stabilising actin using jasplakinolide abolishes the transient reduction of syndecan-1completely. Taken together, we demonstrate, for the first time, that membrane tension plays an important role in the regulation of syndecan-1 expression and this effect is mediated by the reorganisation of the actin cytoskeleton. Findings in this study suggest a new venue of research on the protective role of the glycocalyx in vascular pathophysiology and diseases.

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Section: Discussionmentioning

confidence: 99%

Membrane tension regulates syndecan-1 expression through actin remodelling

Wang

2019

Biochimica et Biophysica Acta (BBA) - General Subjects

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“…Serum osmolality, defined as the total number of dispersed particles in a volume of serum, is the key factor regulated by the body to maintain fluid balance [31,32]. Hypernatremia reflects a deficit of water in relation to extracellular sodium stores and theoretically could result from either net water loss or hypertonic sodium gain [33].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Hyperosmolality, High Blood Pressure, and Decreased Estimated Glomerular Filtration Rate in US Adolescents, National Health and Nutrition Examination Survey 1999–2012

Chmielewski

Khalsa

Carmody

2019

Nephron

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Background: Experimental evidence suggests that hyperosmolality may be a causative factor in the development of both salt-sensitive hypertension and chronic kidney disease (CKD). There are no population-wide studies in young persons to assess the relationships among these factors. Objective: To determine the association of serum osmolality and serum sodium with high systolic blood pressure (SBP) and decreased estimated glomerular filtration rate (eGFR) among a nationally representative population of adolescents. Method: Relevant data among participants ages 12–14 were obtained from the National Health and Nutrition Examination Survey cycles 1999–2012. Serum osmolality was calculated using the Worthley equation. eGFR was calculated using the Counahan-Barratt equation, and values < 90 mL/min/1.73 m² were considered decreased. High SBP was defined as SBP ≥95th percentile for age, height, and sex. Results: A total of 4,168 adolescents were analyzed (representative population: 10,464,592). Adolescents with serum osmolality ≥290 mOsm/kg and/or serum sodium ≥143 mmol/L had increased odds for both high SBP (serum osmolality ≥290 mOsm/kg: OR 2.04; 95% CI 1.03–4.02; sodium ≥143 mmol/L: OR 4.36; 95% CI 1.58–12.04) and decreased eGFR (serum osmolality ≥290 mOsm/kg: OR 1.61; 95% CI 1.18–2.21; sodium ≥143 mmol/L: OR 3.27; 95% CI 1.77–6.03) when compared to participants with values below these thresholds. These thresholds remained significant even after multivariable adjustment. Conclusion: Among adolescents in a nationally representative survey, hypernatremia and hyperosmolality were associated with high SBP and decreased eGFR. These findings may support the hypothesis that an imbalance of salt and water contribute to hypertension and CKD.

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“…The measured serum osmolality was 303 mmol/kg, with a calculated osmolarity of 269.9 mmol/L (calc osmo = 2 x Na + + Urea + Glucose). This revealed an increased osmolal gap of 33.1 mmol/L (osmolal gap = measured osmolality – calculated osmolarity) ( 9 ). The triglyceride concentration was extremely high, with a concentration of 100.1 mmol/L after a 1:50 dilution.…”

Section: Case Reportmentioning

confidence: 99%

Case report: An index of suspicion in hyponatraemia

Barkhuizen

Hoffmann

Zöllner

et al. 2018

Biochem. med. (Online)

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Serum indices can give valuable information and should be interpreted as a result. Lipaemia can influence results through different mechanisms, an important one being the electrolyte exclusion effect. A case of pseudohyponatraemia due to this is reported. A 15-year-old female with type 2 diabetes was seen for follow-up. Her biochemistry results revealed severe hyponatraemia of 118 mmol/L. Her capillary glucose concentration was 13.7 mmol/L with a corrected sodium of 122 mmol/L. A lipaemic index of 3+ (absolute value 1320) was noted, which was not flagged by the laboratory information system, as it was below the critical lipaemia limit for sodium determination. Repeated analysis of the same sample using a direct ion selective electrode method, the serum sodium concentration was 134 mmol/L (sodium corrected for glucose = 138 mmol/L). A triglyceride concentration was requested, which was severely raised (100.1 mmol/L). The electrolyte exclusion effect is an analytical phenomenon that causes falsely low electrolyte concentrations in the presence of severe lipaemia or hyperproteinaemia when using indirect analytical methods. These methods are used on many modern-day automated chemistry analysers and should be considered in a patient with asymptomatic hyponatraemia.

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The measurement of serum osmolality and its application to clinical practice and laboratory: literature review

Cited by 11 publications

References 0 publications

Membrane tension regulates syndecan-1 expression through actin remodelling

Membrane tension regulates syndecan-1 expression through actin remodelling

Hyperosmolality, High Blood Pressure, and Decreased Estimated Glomerular Filtration Rate in US Adolescents, National Health and Nutrition Examination Survey 1999–2012

Case report: An index of suspicion in hyponatraemia

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