Language Guiding Therapy: The Case of Dehydration versus Volume Depletion
Authors: Kevin Mange
Journal: Annals of Internal Medicine (1997)

Medical Writings1 November 1997Language Guiding Therapy: The Case of Dehydration versus Volume DepletionKevin Mange, MD, Dean Matsuura, MD, Borut Cizman, MD, Haydee Soto, MD, Fuad N. Ziyadeh, MD, Stanley Goldfarb, MD, and Eric G. Neilson, MDKevin Mange, MDUniversity of Pennsylvania Philadelphia, PA 19104, Dean Matsuura, MDUniversity of Pennsylvania Philadelphia, PA 19104, Borut Cizman, MDUniversity of Pennsylvania Philadelphia, PA 19104, Haydee Soto, MDUniversity of Pennsylvania Philadelphia, PA 19104, Fuad N. Ziyadeh, MDUniversity of Pennsylvania Philadelphia, PA 19104, Stanley Goldfarb, MDUniversity of Pennsylvania Philadelphia, PA 19104, and Eric G. Neilson, MDUniversity of Pennsylvania Philadelphia, PA 19104Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-9-199711010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Patients presenting with orthostatic hypotension and normal plasma sodium concentrations are frequently admitted to the hospital with a diagnosis of dehydration. If they are fortunate, they receive fluids containing sodium chloride instead of free water to correct obvious extracellular fluid volume depletion. Confusing this diagnosis highlights the growing and pernicious habit of using the terms dehydration and volume depletion interchangeably at the bedside when the two describe clearly different disturbances.The heuristic value of describing discrete body fluid spaces affected by disorders of salt and water is a well-established bedside strategy [1-5]. 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Arieff AI, Kleeman CR. Studies on mechanisms of cerebral edema in diabetic comas. Effects of hyperglycemia and rapid lowering of plasma glucose in normal rabbits. J Clin Invest. 1973; 52:571-83. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania Philadelphia, PA 19104Grant Support: In part by grant DK-07006 from the National Institutes of Health and by the DCI RED fund. Drs. Mange, Matsuura, Cizman, and Soto are first-year renal fellows in the Renal-Electrolyte and Hypertension Division.Corresponding Author: Eric G. Neilson, MD, Renal-Electrolyte and Hypertension Division, 700 Clinical Research Building, University of Pennsylvania, 415 Curie Boulevard, Philadelphia, PA 19104-6144.Current Author Addresses: Drs. Mange, Matsuura, Cizman, Soto, Ziyadeh, Goldfarb, and Neilson: Renal-Electrolyte and Hypertension Division, 700 Clinical Research Building, University of Pennsylvania, 415 Curie Boulevard, Philadelphia, PA 19104-6144.Acknowledgments: The authors thank Dr. Richard Tannen, Professor and Vice-Dean for Research at the University of Pennsylvania, for critically reading this manuscript.Current Author Addresses: Drs. Mange, Matsuura, Cizman, Soto, Ziyadeh, Goldfarb, and Neilson: Renal-Electrolyte and Hypertension Division, 700 Clinical Research Building, University of Pennsylvania, 415 Curie Boulevard, Philadelphia, PA 19104-6144. 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