Blood volume and water balance paper

The normal intake of water is approximately 3 liters through different sources like normal water, juice, food, and beverages. A little of this is also metabolically produced during respiration. The same amount of fluid is excreted by the body through kidneys, lungs, and skin, although maximum through the kidneys as urine. The kidneys have the mechanism to regulate the fluid level in the body. If there is less water intake, it tries to refilter the urine to increase urine concentration and retain the water inside the body as much as possible. The kidneys also can adjust the volume of blood to draw water from them. And if the water intake is excess or more than the output, the kidneys excrete more dilute urine to expel the excess water out of the body. Water is lost in other forms like through the lungs, while respiration, from the skin in sweat. Therefore the body must maintain its metabolism in a regulated way, and we need to take water in the required amount. If the body experiences dehydration, the extra water needed is extracted from the other body fluids like the blood plasma. The increased concentration of blood results in the thirst mechanism triggered by the hypothalamus.

Many functions of organs directly or indirectly depend on water. The water in the body is distributed in two compartments, namely, the intracellular fluid and the extracellular fluid. The intracellular fluid includes the fluid content inside the cells like the cytoplasm and the matrix inside the organelles. The extracellular water is distributed in the form of interstitial fluid and plasma. Plasma is the liquid matrix of the blood, which is a slightly pale-colored liquid. The blood plasma is the medium into which the blood cells are floating and can reach every cell quickly. Plasma constitutes about 55\%55% of total blood volume and majorly contains water. Other ingredients that constitute the plasma are the plasma proteins like globulins, fibrinogens, and albumins; minerals, hormones, and {\text{CO}_{{2}}}CO
. The plasma is the reason for the electrolyte balance of the body and the osmotic balance. It also helps in the immune system. The amount of plasma determines the blood volume and concentration.

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The increase in the hydration level of the body is also maintained by the kidneys by eliminating dilute urine. Diuresis is when the kidneys produce a large amount of urine due to ingestion of excessive fluid. The blood composition determines the absorption of water from the blood; therefore, the urine is dependent on the blood volume. The kidneys detect the volume of the blood through some protein receptors by the pressure of the blood. Thus, if the blood volume is low, the kidneys start to secrete an enzyme named rennin. Rennin activates another hormone, angiotensin, which in turn stimulates the restoration of the blood volume through the hypothalamus, the adrenal glands, and the surrounding muscles to the arteries. These stimulations again induce the kidneys to reabsorb the electrolytes from the already absorbed fluid. This enables the water to return to the blood to maintain its volume, and the urine becomes concentrated. Angiotensin also stimulates the hypothalamus to activate the body’s thirst mechanism so that one can feel the need for water and consume it. The absorption of the water through the renal tubules is also dependent on the antidiuretic hormone or vasopressin. The hypothalamus releases this hormone when there is an increase in the blood plasma concentration.

The adrenal glands have sensitivity towards the fluid concentration of the body. The lower concentration of fluid in the blood plasma results in the reduced sodium level and increased potassium level. The adrenal glands can detect this change in the concentration of the blood. As a result, the adrenal glands secrete the hormone aldosterone, which stimulates the reabsorption of sodium. The regulation of water concentration in the body also controls the electrolyte balance in the body. The regulation of water and electrolytes maintains homeostasis in a coordinated manner in a healthy person, but the persons with heart diseases or heart failure, indicate the reabsorption of water and sodium by the kidneys, thus increasing blood pressure. In such conditions, diuretics are given to the patients to minimize the renal response.


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