<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg1.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">1 </span></div><div class="t m0 x3 h6 y5 ff5 fs2 fc2 sc0 ls2e wsa">VOL<span class="_2 blank"></span>EMI<span class="_2 blank"></span>A NOR<span class="_2 blank"></span>MAL -<span class="ws7"> </span></div><div class="t m0 x1 h6 y6 ff5 fs2 fc2 sc0 ls2f wsb">MEC<span class="_3 blank"> </span>ANISMOS<span class="_3 blank"> </span> REGU<span class="_3 blank"> </span>LADO<span class="_3 blank"> </span>RES<span class="ls28 ws7"> </span></div><div class="t m0 x3 h3 y7 ff4 fs1 fc0 sc0 ls1 ws7"> </div><div class="t m0 x1 h7 y8 ff5 fs1 fc1 sc0 ls2 wsc">La volemia</div><div class="t m0 x4 h8 y9 ff6 fs1 fc0 sc0 ls3 wsd"> puede definirse como <span class="_2 blank"></span>el </div><div class="t m0 x1 h8 ya ff6 fs1 fc0 sc0 ls6 wse">volumen to<span class="_3 blank"> </span>tal de san<span class="_3 blank"> </span>gre de un ind<span class="_3 blank"> </span>ividuo. La </div><div class="t m0 x1 h8 yb ff6 fs1 fc0 sc0 ls8 wsf">sangre human<span class="_3 blank"> </span>a normal se halla constituido<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 yc ff6 fs1 fc0 sc0 ls8 ws10">básicamente po<span class="_3 blank"> </span>r una porción líquida </div><div class="t m0 x1 h8 yd ff6 fs1 fc0 sc0 ls4 ws7">llamada <span class="_4 blank"> </span><span class="ff7 ls5 ws1">plasma</span><span class="ls6 ws11"> que representa el 55% del </span></div><div class="t m0 x1 h8 ye ff6 fs1 fc0 sc0 ls30 ws12">total <span class="_3 blank"> </span>y otra porción<span class="_3 blank"> </span> <span class="ff7 ls31 ws2">celu lar </span><span class="ls7 ws13"> cons<span class="_3 blank"> </span>tituida por </span></div><div class="t m0 x1 h8 yf ff6 fs1 fc0 sc0 ls13 ws14">glóbulos rojos (eritrocitos) que forman el </div><div class="t m0 x1 h8 y10 ff6 fs1 fc0 sc0 ls8 ws15">45% <span class="_3 blank"> </span>y en <span class="_3 blank"> </span>menor medida por plaque<span class="_3 blank"> </span>tas y </div><div class="t m0 x1 h8 y11 ff6 fs1 fc0 sc0 lsf ws16">glóbulos blanc<span class="_3 blank"> </span>os (leucocitos) que </div><div class="t m0 x1 h8 y12 ff6 fs1 fc0 sc0 lsb ws17">representan el 1<span class="_3 blank"> </span>% y el 0,5%<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y13 ff6 fs1 fc0 sc0 ls9 ws18">respectivamente. <span class="_3 blank"> </span>Estos porcentajes pueden<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y14 ff6 fs1 fc0 sc0 lsa ws19">variar de un<span class="_3 blank"> </span>a persona a otra según la edad,<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y15 ff6 fs1 fc0 sc0 ls32 ws1a">el sex<span class="_2 blank"></span>o y otro<span class="_2 blank"></span>s fact<span class="_2 blank"></span>ores<span class="_2 blank"></span>. </div><div class="t m0 x1 h8 y16 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y17 ff6 fs1 fc0 sc0 ls4 ws1b">El plasma consiste e<span class="_3 blank"> </span>n una solución acuosa </div><div class="t m0 x1 h8 y18 ff6 fs1 fc0 sc0 lsb ws1c">de color am<span class="_3 blank"> </span>arillento que contiene proteínas, </div><div class="t m0 x1 h8 y19 ff6 fs1 fc0 sc0 lsb ws1d">electrólitos (predominantemente Na y<span class="_3 blank"> </span> Cl) <span class="_2 blank"></span>y </div><div class="t m0 x1 h8 y1a ff6 fs1 fc0 sc0 ls3 ws1e">moléculas orgánicas (aminoácidos, gluco<span class="_3 blank"> </span>sa, </div><div class="t m0 x1 h8 y1b ff6 fs1 fc0 sc0 lsc ws1f">ácidos grasos) entre otros. </div><div class="t m0 x1 h8 y1c ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y1d ff6 fs1 fc0 sc0 lsd ws20">La volemia normal en los adulto<span class="_3 blank"> </span>s representa </div><div class="t m0 x1 h8 y1e ff6 fs1 fc0 sc0 lse ws21">en promedio un 8% del peso corporal total, </div><div class="t m0 x1 h8 y1f ff6 fs1 fc0 sc0 ls6 ws22">eso hace que<span class="_3 blank"> </span> en un individuo <span class="_3 blank"> </span>de 70 Kg<span class="_3 blank"> </span> de </div><div class="t m0 x1 h8 y20 ff6 fs1 fc0 sc0 ls9 ws23">peso, su vo<span class="_3 blank"> </span>lemia corresponda a 5.600 <span class="_5 blank"></span> </div><div class="t m0 x1 h8 y21 ff6 fs1 fc0 sc0 lsf ws24">aproximadamente, de los cuales 3.000 ml.<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y22 ff6 fs1 fc0 sc0 ls6 ws25">representen al p<span class="_3 blank"> </span>lasma y 2.600 ml. <span class="_3 blank"> </span>a los </div><div class="t m0 x1 h8 y23 ff6 fs1 fc0 sc0 ls33 ws7">eritroci<span class="_3 blank"> </span>tos. </div><div class="t m0 x1 h8 y24 ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 x1 h8 y25 ff6 fs1 fc0 sc0 ls34 ws26">Como vimos, el mayor porcentaje de l<span class="_2 blank"></span>a </div><div class="t m0 x1 h8 y26 ff6 fs1 fc0 sc0 lsb ws27">volemia está representada <span class="_3 blank"> </span>por agua, ello </div><div class="t m0 x1 h8 y27 ff6 fs1 fc0 sc0 lse ws28">hace nece<span class="_3 blank"> </span>sario revisar algunos conceptos </div><div class="t m0 x1 h8 y28 ff6 fs1 fc0 sc0 ls11 ws29">fundamenta<span class="_3 blank"> </span>les a cerca del a<span class="_3 blank"> </span>gua. </div><div class="t m0 x1 h8 y29 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y2a ff5 fs1 fc1 sc0 ls12 ws2a">AGUA CORPORAL TOTAL<span class="_2 blank"></span>: </div><div class="t m0 x1 h8 y2b ff6 fs1 fc0 sc0 ls9 ws2b">El agua corporal total represen<span class="_3 blank"> </span>ta en </div><div class="t m0 x1 h8 y2c ff6 fs1 fc0 sc0 ls7 ws2c">términos medios <span class="_3 blank"> </span>un 60% <span class="_3 blank"> </span>del peso corporal </div><div class="t m0 x1 h8 y2d ff6 fs1 fc0 sc0 ls7 ws2d">total de u<span class="_3 blank"> </span>n individuo, ello <span class="_3 blank"> </span>hace que en una </div><div class="t m0 x1 h8 y2e ff6 fs1 fc0 sc0 ls7 ws2e">persona de 70 Kg de peso su agua corporal </div><div class="t m0 x1 h8 y2f ff6 fs1 fc0 sc0 lsa ws2f">total corresponda<span class="_3 blank"> </span> a 42 litros, aunque este </div><div class="t m0 x1 h8 y30 ff6 fs1 fc0 sc0 ls8 ws30">porcentaje puede va<span class="_3 blank"> </span>riar según le edad, el </div><div class="t m0 x1 h8 y31 ff6 fs1 fc0 sc0 ls35 ws31">sexo y el gra<span class="_3 blank"> </span>do de obes<span class="_3 blank"> </span>idad del indiv<span class="_3 blank"> </span>iduo. <span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y32 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y33 ff6 fs1 fc0 sc0 ls8 ws32">El to<span class="_3 blank"> </span>tal de los líquidos corporales está </div><div class="t m0 x1 h8 y34 ff6 fs1 fc0 sc0 ls6 ws33">distribuido en dos <span class="_3 blank"> </span>grandes compartimento<span class="_3 blank"> </span>s: </div><div class="t m0 x1 h9 y35 ff8 fs1 fc0 sc0 lsa ws34">1 - <span class="ff6 lsc ws1f">L.I.C. (líquido intracelular)<span class="_2 blank"></span> y </span></div><div class="t m0 x1 h9 y36 ff8 fs1 fc0 sc0 lsa ws35">2 - <span class="ff6 lsb ws36">L.E.C.(líquido extracelular) que a <span class="_3 blank"> </span>su vez </span></div><div class="t m0 x1 h8 y37 ff6 fs1 fc0 sc0 ls13 ws37">se subdivide en <span class="_3 blank"> </span>intersticial, plasma y </div><div class="t m0 x1 h8 y38 ff6 fs1 fc0 sc0 ls13 ws7">transcelular.7 </div><div class="t m0 x1 h8 y39 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y3a ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h9 y3b ff6 fs1 fc3 sc0 ls10 ws7"> <span class="ff8 fc1 ls26 ws38">COMPARTIMENTOS: </span></div><div class="t m0 x1 ha y3c ff1 fs3 fc3 sc0 ls14 ws7">1 </div><div class="t m0 x1 ha y3d ff1 fs3 fc3 sc0 ls14 ws7">1 <span class="_6 blank"></span>1 </div><div class="t m0 x1 ha y3c ff1 fs3 fc3 sc0 ls14 ws39">1 -</div><div class="t m0 x5 ha y3d ff1 fs3 fc3 sc0 ls28 ws3">-<span class="_7 blank"></span>-</div><div class="t m0 x5 ha y3c ff1 fs3 fc3 sc0 ls36 ws7">- </div><div class="t m0 x6 ha y3d ff1 fs3 fc3 sc0 ls28 ws7"> <span class="_8 blank"></span> </div><div class="t m0 x6 ha y3c ff1 fs3 fc3 sc0 ls15 ws3a"> L.I.C.<span class="_2 blank"></span>:</div><div class="t m0 x7 ha y3d ff1 fs3 fc3 sc0 ls15 ws4">L.I.C.<span class="_2 blank"></span>:<span class="_9 blank"></span>L.I.C.<span class="_2 blank"></span>:</div><div class="t m0 x7 ha y3c ff1 fs3 fc3 sc0 ls15 ws5">L.I.C.<span class="_2 blank"></span>:<span class="ls37 ws3b"> <span class="_3 blank"> </span>2/3 del agua <span class="_2 blank"></span>c</span></div><div class="t m0 x8 ha y3d ff1 fs3 fc3 sc0 ls37 ws3b"> 2/3 del agua c<span class="_a blank"></span> 2/3 del agua c</div><div class="t m0 x8 ha y3c ff1 fs3 fc3 sc0 ls37 ws3b"> 2/3 del agua corporal tot<span class="_2 blank"></span>al </div><div class="t m0 x9 ha y3d ff1 fs3 fc3 sc0 ls38 ws3c">orpo<span class="_3 blank"> </span>ral total <span class="_b blank"></span>orpo<span class="_3 blank"> </span>ral total </div><div class="t m0 x9 ha y3c ff1 fs3 fc3 sc0 ls38 ws3c">orpo<span class="_3 blank"> </span>ral total </div><div class="t m0 x7 ha y3e ff1 fs3 fc3 sc0 ls16 ws3d">(28 lit<span class="_2 blank"></span>ros)</div><div class="t m0 x7 ha y3f ff1 fs3 fc3 sc0 ls16 ws3d">(28 lit<span class="_2 blank"></span>ros)<span class="_c blank"></span>(28 lit<span class="_2 blank"></span>ros)</div><div class="t m0 x7 ha y3e ff1 fs3 fc3 sc0 ls16 ws3d">(28 lit<span class="_2 blank"></span>ros) </div><div class="t m0 x4 ha y3f ff1 fs3 fc3 sc0 ls28 ws7"> <span class="_8 blank"></span> </div><div class="t m0 x4 ha y3e ff1 fs3 fc3 sc0 ls28 ws7"> </div><div class="t m0 x1 hb y40 ff8 fs3 fc3 sc0 ls17 ws7"> <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> </div><div class="t m0 xa hb y41 ff8 fs3 fc3 sc0 ls18 ws3e"> 2 <span class="_4 blank"> </span><span class="ff1 ls28 v0">-</span></div><div class="t m0 xb ha y42 ff1 fs3 fc3 sc0 ls28 ws3">-<span class="_7 blank"></span>-</div><div class="t m0 xb ha y43 ff1 fs3 fc3 sc0 ls36 ws7">- </div><div class="t m0 xc ha y42 ff1 fs3 fc3 sc0 ls28 ws7"> <span class="_8 blank"></span> </div><div class="t m0 xc ha y43 ff1 fs3 fc3 sc0 ls39 ws3f"> L.E.C.:<span class="_2 blank"></span> </div><div class="t m0 xd ha y42 ff1 fs3 fc3 sc0 ls39 ws7">L.E.C.:<span class="_2 blank"></span> <span class="_d blank"></span>L.E.C.:<span class="_2 blank"></span> </div><div class="t m0 xd ha y43 ff1 fs3 fc3 sc0 ls39 ws7">L.E.C.:<span class="_2 blank"></span> <span class="_4 blank"> </span><span class="ls37 ws40 v0">1/3 del agua corporal t<span class="_2 blank"></span>otal<span class="_2 blank"></span> </span></div><div class="t m0 xe ha y44 ff1 fs3 fc3 sc0 ls37 ws40">1/3 del agua corporal<span class="_2 blank"></span> tot<span class="_2 blank"></span>al <span class="_e blank"></span>1/3 del agua corporal<span class="_2 blank"></span> tot<span class="_2 blank"></span>al </div><div class="t m0 xe ha y45 ff1 fs3 fc3 sc0 ls37 ws40">1/3 del agua corporal<span class="_2 blank"></span> tot<span class="_2 blank"></span>al </div><div class="t m0 xd ha y46 ff1 fs3 fc3 sc0 ls3a ws41">(14 lit<span class="_2 blank"></span>ros) </div><div class="t m0 xd ha y47 ff1 fs3 fc3 sc0 ls3a ws41">(14 lit<span class="_2 blank"></span>ros) <span class="_f blank"></span>(14 lit<span class="_2 blank"></span>ros) </div><div class="t m0 xd ha y46 ff1 fs3 fc3 sc0 ls3a ws41">(14 lit<span class="_2 blank"></span>ros) <span class="_3 blank"> </span> </div><div class="t m0 xf ha y47 ff1 fs3 fc3 sc0 ls28 ws7"> <span class="_8 blank"></span> </div><div class="t m0 xf ha y46 ff1 fs3 fc3 sc0 ls28 ws7"> </div><div class="t m0 xd ha y48 ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y49 ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_10 blank"></span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y48 ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y4a ff1 fs3 fc3 sc0 ls3b ws42">*Int<span class="_2 blank"></span>erst<span class="_2 blank"></span>icial (<span class="_2 blank"></span>9 litro<span class="_2 blank"></span>s)</div><div class="t m0 xd ha y4b ff1 fs3 fc3 sc0 ls3b ws42">*Int<span class="_2 blank"></span>erst<span class="_2 blank"></span>icial (<span class="_2 blank"></span>9 litro<span class="_2 blank"></span>s)<span class="_11 blank"></span>*Int<span class="_2 blank"></span>erst<span class="_2 blank"></span>icial (<span class="_2 blank"></span>9 litro<span class="_2 blank"></span>s)</div><div class="t m0 xd ha y4a ff1 fs3 fc3 sc0 ls3b ws42">*Int<span class="_2 blank"></span>erst<span class="_2 blank"></span>icial (<span class="_2 blank"></span>9 litro<span class="_2 blank"></span>s) </div><div class="t m0 x10 ha y4b ff1 fs3 fc3 sc0 ls28 ws7"> <span class="_8 blank"></span> </div><div class="t m0 x10 ha y4a ff1 fs3 fc3 sc0 ls28 ws7"> </div><div class="t m0 xd ha y4c ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y4d ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_12 blank"></span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y4c ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 x11 ha y4d ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_13 blank"></span> <span class="_3 blank"> </span> </div><div class="t m0 x11 ha y4c ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y4e ff1 fs3 fc3 sc0 ls3c ws43">*Plasm<span class="_2 blank"></span>a (<span class="_2 blank"></span>3 lit<span class="_2 blank"></span>ro<span class="_2 blank"></span>s)</div><div class="t m0 xd ha y4f ff1 fs3 fc3 sc0 ls3c ws43">*Plasm<span class="_2 blank"></span>a (<span class="_2 blank"></span>3 lit<span class="_2 blank"></span>ro<span class="_2 blank"></span>s)<span class="_14 blank"></span>*Plasm<span class="_2 blank"></span>a (<span class="_2 blank"></span>3 lit<span class="_2 blank"></span>ro<span class="_2 blank"></span>s)</div><div class="t m0 xd ha y4e ff1 fs3 fc3 sc0 ls3c ws43">*Plasm<span class="_2 blank"></span>a (<span class="_2 blank"></span>3 lit<span class="_2 blank"></span>ro<span class="_2 blank"></span>s) </div><div class="t m0 x12 ha y4f ff1 fs3 fc3 sc0 ls28 ws7"> <span class="_8 blank"></span> </div><div class="t m0 x12 ha y4e ff1 fs3 fc3 sc0 ls28 ws7"> </div><div class="t m0 xd ha y50 ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y51 ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_10 blank"></span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y50 ff1 fs3 fc3 sc0 ls19 ws7"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xd ha y52 ff1 fs3 fc3 sc0 ls1a ws44">*Transce<span class="_2 blank"></span>lular(<span class="_2 blank"></span>2 litr<span class="_2 blank"></span>os)</div><div class="t m0 xd ha y53 ff1 fs3 fc3 sc0 ls1a ws44">*Transce<span class="_2 blank"></span>lular(<span class="_2 blank"></span>2 litr<span class="_2 blank"></span>os)<span class="_15 blank"></span>*Transce<span class="_2 blank"></span>lular(<span class="_2 blank"></span>2 litr<span class="_2 blank"></span>os)</div><div class="t m0 xd ha y52 ff1 fs3 fc3 sc0 ls1a ws44">*Transce<span class="_2 blank"></span>lular(<span class="_2 blank"></span>2 litr<span class="_2 blank"></span>os) </div><div class="t m0 x13 ha y53 ff1 fs3 fc3 sc0 ls28 ws7"> <span class="_8 blank"></span> </div><div class="t m0 x13 ha y52 ff1 fs3 fc3 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y54 ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 xa h7 y55 ff5 fs1 fc1 sc0 ls3d ws45">INGRESOS Y EGRESO<span class="_2 blank"></span>S NORMALES </div><div class="t m0 xa h7 y56 ff5 fs1 fc1 sc0 ls3e ws46">DE AGUA:<span class="_2 blank"></span><span class="ff6 fc0 ls4 ws47 v0"> los ingresos y los egresos <span class="_2 blank"></span>de </span></div><div class="t m0 xa h8 y57 ff6 fs1 fc0 sc0 lsb ws48">agua deben ser equivalentes<span class="_3 blank"> </span> en <span class="_2 blank"></span>condiciones </div><div class="t m0 xa h8 y58 ff6 fs1 fc0 sc0 lsf ws49">de estabilidad.<span class="_3 blank"> </span> El ingreso de líq<span class="_3 blank"> </span>uidos en el </div><div class="t m0 xa h8 y59 ff6 fs1 fc0 sc0 lsb ws4a">organismo es <span class="_3 blank"> </span>muy variable en condiciones </div><div class="t m0 xa h8 y5a ff6 fs1 fc0 sc0 lsf ws4b">de norma<span class="_3 blank"> </span>lidad y debe igualarse </div><div class="t m0 xa h8 y5b ff6 fs1 fc0 sc0 lsa ws4c">cuidadosamen<span class="_3 blank"> </span>te con unas pérdidas análogas </div><div class="t m0 xa h8 y5c ff6 fs1 fc0 sc0 ls7 ws4d">de los m<span class="_3 blank"> </span>ismos para evitar que aumente o<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y5d ff6 fs1 fc0 sc0 ls3 ws4e">disminuya el volumen de líquidos corporales </div><div class="t m0 xa h8 y5e ff6 fs1 fc0 sc0 ls7 ws4f">y por ende e<span class="_3 blank"> </span>l volumen sanguíneo.<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y5f ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y60 ff9 fs1 fc1 sc0 ls1b ws7"> <span class="ff5 ls1c ws50 v0">INGRESOS DIARIOS DE <span class="_2 blank"></span>AGUA:<span class="ff6 fc0 ls1d ws51 v0"> los </span></span></div><div class="t m0 xa h8 y61 ff6 fs1 fc0 sc0 ls7 ws2d">ingresos de agua varían de una persona a </div><div class="t m0 xa h8 y62 ff6 fs1 fc0 sc0 ls8 ws52">otro y en<span class="_3 blank"> </span> el mismo individuo de unos días<span class="_3 blank"> </span> a </div><div class="t m0 xa h8 y63 ff6 fs1 fc0 sc0 ls8 ws53">otros, depend<span class="_3 blank"> </span>iendo del clima, costumbres y </div><div class="t m0 xa h8 y64 ff6 fs1 fc0 sc0 lsf ws54">el grado <span class="_3 blank"> </span>de ejercicio físico que realiza, pero </div><div class="t m0 xa h8 y65 ff6 fs1 fc0 sc0 ls9 ws55">en cond<span class="_3 blank"> </span>iciones basale<span class="_3 blank"> </span>s podemos decir que </div><div class="t m0 xa h8 y66 ff6 fs1 fc0 sc0 ls11 ws29">el agua provie<span class="_3 blank"> </span>ne de : </div><div class="t m0 xa h9 y67 ff8 fs1 fc3 sc0 ls1e ws56">1 -Lí<span class="_2 blank"></span>quidos ingeridos<span class="_2 blank"></span> (f<span class="_2 blank"></span>orma l<span class="_2 blank"></span>íquida + <span class="_16 blank"></span> <span class="_16 blank"></span> </div><div class="t m0 xd h9 y68 ff8 fs1 fc3 sc0 ls30 ws57">alimen<span class="_3 blank"> </span>tos sólidos<span class="_3 blank"> </span>) 2.<span class="_3 blank"> </span>100 ml/dí<span class="_3 blank"> </span>a. </div><div class="t m0 xa h9 y69 ff8 fs1 fc3 sc0 ls3f ws58">2 -Agu<span class="_3 blank"> </span>a de o<span class="_3 blank"> </span>rigen <span class="_3 blank"> </span>metabólico<span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xa h9 y6a ff8 fs1 fc3 sc0 ls1f ws59"> 200<span class="_3 blank"> </span> ml/d<span class="_3 blank"> </span>ía. </div><div class="t m0 xa h9 y6b ff8 fs1 fc4 sc0 ls40 ws5a">Ingr<span class="_3 blank"> </span>esos to<span class="_3 blank"> </span>tales <span class="_3 blank"> </span> <span class="_3 blank"> </span>2.300 ml/d<span class="_3 blank"> </span>ía. </div><div class="t m0 xa h8 y6c ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 xa hc y6d ff6 fs1 fc0 sc0 ls10 ws7"> <span class="ff5 fc1 ls20 ws5b v0">EGRESOS DIARIOS DE AGUA:</span><span class="ls1d ws5c"> los<span class="_2 blank"></span> </span></div><div class="t m0 xa h8 y6e ff6 fs1 fc0 sc0 ls8 ws5d">egresos de agua deben igualar a los </div><div class="t m0 xa h8 y6f ff6 fs1 fc0 sc0 lsa ws5e">ingresos, pudiendo va<span class="_3 blank"> </span>riar de <span class="_2 blank"></span>acuerdo a la </div><div class="t m0 xa h8 y70 ff6 fs1 fc0 sc0 lsb ws5f">ingesta, clima y actividad física ,pero en </div><div class="t m0 xa h8 y71 ff6 fs1 fc0 sc0 lse ws60">promedio representan: </div><div class="t m0 x14 h9 y72 ff8 fs1 fc3 sc0 ls1f ws59"> <span class="_17 blank"> </span>Orin<span class="_3 blank"> </span>a <span class="_3 blank"> </span> 1.400 ml<span class="_3 blank"> </span>/día. </div><div class="t m0 x14 h9 y73 ff8 fs1 fc3 sc0 ls41 ws61"> <span class="_17 blank"> </span>Sudor <span class="_3 blank"> </span> 100 ml/día<span class="_2 blank"></span>. </div><div class="t m0 x14 h9 y74 ff8 fs1 fc3 sc0 ls21 ws62"> <span class="_17 blank"> </span>Heces <span class="_3 blank"> </span> 100 <span class="_3 blank"> </span>ml/dí<span class="_3 blank"> </span>a. </div><div class="t m0 x14 h9 y75 ff8 fs1 fc3 sc0 ls21 ws62"> <span class="_17 blank"> </span>Pérd<span class="_3 blank"> </span>idas i<span class="_3 blank"> </span>nsensib<span class="_3 blank"> </span>les cután<span class="_3 blank"> </span>eas <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xa h9 y76 ff8 fs1 fc3 sc0 ls22 ws63"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> 350 ml<span class="_3 blank"> </span>/día. </div><div class="t m0 x14 h9 y77 ff8 fs1 fc3 sc0 ls42 ws64"> <span class="_17 blank"> </span>Pérd<span class="_3 blank"> </span>idas i<span class="_3 blank"> </span>nsensib<span class="_3 blank"> </span>les pulm<span class="_3 blank"> </span>onar<span class="_3 blank"> </span>es <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> </div><div class="t m0 xa h9 y78 ff8 fs1 fc3 sc0 ls23 ws65"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> 350 ml<span class="_3 blank"> </span>/día. </div><div class="t m0 xa h9 y79 ff8 fs1 fc4 sc0 ls43 ws66"> Egr<span class="_3 blank"> </span>esos totales<span class="ffa ls24 ws7"> </span><span class="ls25 ws67"> <span class="_3 blank"> </span> 2.300 <span class="_3 blank"> </span>ml/dí<span class="_3 blank"> </span>a. </span></div><div class="t m0 xa h8 y7a ff6 fs1 fc0 sc0 lsb ws68"> E<span class="_3 blank"> </span>stos <span class="_4 blank"> </span>valores <span class="_4 blank"> </span>pueden <span class="_4 blank"> </span>variar <span class="_18 blank"> </span>por <span class="_18 blank"> </span>ejem<span class="_3 blank"> </span>plo </div><div class="t m0 xa h8 y7b ff6 fs1 fc0 sc0 ls9 ws69">tras un ejercicio físico vigoroso,<span class="_3 blank"> </span> donde las </div><div class="t m0 xa h8 y7c ff6 fs1 fc0 sc0 lsf ws6a">pérdidas por sudor pue<span class="_3 blank"> </span>den representar </div><div class="t m0 xa h8 y7d ff6 fs1 fc0 sc0 lsb ws6b">varios litros, y <span class="_2 blank"></span>tras una patología diarreica </div><div class="t m0 xa h8 y7e ff6 fs1 fc0 sc0 ls6 ws6c">donde la<span class="_3 blank"> </span>s pérdidas por heces también se </div><div class="t m0 xa h8 y7f ff6 fs1 fc0 sc0 lsb ws7">incrementarían. </div><div class="t m0 xa h8 y80 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y81 ff5 fs1 fc1 sc0 ls26 ws6d">OSMOLARIDAD DE LOS LÍQ<span class="_2 blank"></span>UIDOS </div><div class="t m0 xa h7 y82 ff5 fs1 fc1 sc0 ls44 ws7">CORP<span class="_3 blank"> </span>ORAL<span class="_3 blank"> </span>ES: </div><div class="t m0 xa h8 y83 ff6 fs1 fc0 sc0 ls28 ws7"> </div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x15 y84 w2 hd" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg2.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">2 </span></div><div class="t m0 x1 h8 y85 ff6 fs1 fc0 sc0 ls34 ws6f">La osmolaridad normal de<span class="_3 blank"> </span> los líquidos </div><div class="t m0 x1 h8 y86 ff6 fs1 fc0 sc0 lse ws70">corporales corresponde <span class="_3 blank"> </span>a 288 mOsmol/K<span class="_3 blank"> </span>g de </div><div class="t m0 x1 h8 y87 ff6 fs1 fc0 sc0 lse ws2f">H2O (entre 285 a<span class="_3 blank"> </span> 295 mOsmol/K<span class="_3 blank"> </span>g de H2O) </div><div class="t m0 x1 h8 y88 ff6 fs1 fc0 sc0 ls13 ws71">Alrededor del <span class="_3 blank"> </span>80% de la osmolaridad total </div><div class="t m0 x1 h8 y89 ff6 fs1 fc0 sc0 ls13 ws72">del líquido intersticial y plasma se debe a<span class="_3 blank"> </span> la </div><div class="t m0 x1 h8 y8a ff6 fs1 fc0 sc0 lsf ws24">presencia de los iones Na + y Cl-, mientras </div><div class="t m0 x1 h8 y8b ff6 fs1 fc0 sc0 ls8 ws73">que en e<span class="_3 blank"> </span>l intracelular, casi el 50% de la </div><div class="t m0 x1 h8 y8c ff6 fs1 fc0 sc0 ls13 ws74">osmolaridad se <span class="_3 blank"> </span>debe a los iones K<span class="_3 blank"> </span>+ y el </div><div class="t m0 x1 h8 y8d ff6 fs1 fc0 sc0 ls8 ws75">resto se dis<span class="_3 blank"> </span>tribuye entre otras muchas </div><div class="t m0 x1 h8 y8e ff6 fs1 fc0 sc0 ls8 ws76">sustancias intracelulares. Como e<span class="_3 blank"> </span>l Na+ es el </div><div class="t m0 x1 h8 y8f ff6 fs1 fc0 sc0 lsd ws77">principal ión extracelular es necesario </div><div class="t m0 x1 h8 y90 ff6 fs1 fc0 sc0 ls4b ws78">ref<span class="_3 blank"> </span>erirno<span class="_3 blank"> </span>s a<span class="_3 blank"> </span> él.<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y91 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y92 ff9 fs1 fc1 sc0 ls1b ws7"> <span class="ff5 ls1 ws79 v0">PRIN<span class="_2 blank"></span>CIPA<span class="_2 blank"></span>LES INGR<span class="_2 blank"></span>ESO<span class="_2 blank"></span>S Y </span></div><div class="t m0 x1 h7 y93 ff5 fs1 fc1 sc0 ls45 ws7a">EGRESOS DE Na+:<span class="_2 blank"></span><span class="ff6 fc0 ls13 ws7b v0"> al igual que el agua, </span></div><div class="t m0 x1 h8 y94 ff6 fs1 fc0 sc0 lsd ws7c">el ingreso y <span class="_3 blank"> </span>egreso del Na+ puede variar </div><div class="t m0 x1 h8 y95 ff6 fs1 fc0 sc0 lsb ws7d">enormemente,<span class="_3 blank"> </span> pero en promedio podemos </div><div class="t m0 x1 h8 y96 ff6 fs1 fc0 sc0 ls4c ws7e">afirmar que: </div><div class="t m0 x1 h8 y97 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h9 y98 ff8 fs1 fc3 sc0 ls1e ws7f">1-I<span class="_2 blank"></span>ngresos diarios de Na<span class="_2 blank"></span>+: </div><div class="t m0 x1 h9 y99 ff8 fs1 fc3 sc0 ls4d ws80"> *Aliment<span class="_2 blank"></span>os + líquidos 100 - 40<span class="_2 blank"></span>0 mmol/día. </div><div class="t m0 x1 h9 y9a ffa fs1 fc3 sc0 ls4e ws6e">Total<span class="ff8 ls40 ws5a"> <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> 100 - 400 m<span class="_3 blank"> </span>mol/d<span class="_3 blank"> </span>ía. </span></div><div class="t m0 x1 h9 y9b ff8 fs1 fc3 sc0 ls6 ws33">2-Egresos <span class="_3 blank"> </span>diarios d<span class="_3 blank"> </span>e Na+: </div><div class="t m0 x1 h9 y9c ff8 fs1 fc3 sc0 ls25 ws67"> *Or<span class="_3 blank"> </span>ina <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> 100 - 4<span class="_3 blank"> </span>00 mmol<span class="_3 blank"> </span>/día. </div><div class="t m0 x1 h9 y9d ff8 fs1 fc3 sc0 ls46 ws81">* Sudor <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> Insigni<span class="_2 blank"></span>fican<span class="_2 blank"></span>te. </div><div class="t m0 x1 h9 y9e ff8 fs1 fc3 sc0 ls4f ws82">*Mater<span class="_3 blank"> </span>ia fecal <span class="_3 blank"> </span> <span class="_3 blank"> </span> Insign<span class="_3 blank"> </span>ificante. </div><div class="t m0 x1 h9 y9f ff8 fs1 fc4 sc0 ls25 ws67">Total <span class="_3 blank"> </span> <span class="_3 blank"> </span> <span class="_3 blank"> </span> 100<span class="_3 blank"> </span> - 400 mm<span class="_3 blank"> </span>ol/día<span class="_3 blank"> </span>. </div><div class="t m0 x1 h9 ya0 ff8 fs1 fc3 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 ya1 ff6 fs1 fc0 sc0 lsb ws68"> Co<span class="_3 blank"> </span>mo <span class="_19 blank"> </span>puede <span class="_19 blank"> </span>apreciarse, <span class="_19 blank"> </span>e<span class="_3 blank"> </span>l <span class="_19 blank"> </span>pri<span class="_2 blank"></span>ncipal </div><div class="t m0 x1 h8 ya2 ff6 fs1 fc0 sc0 ls7 ws13">órgano <span class="_3 blank"> </span>encargado de la regulación de<span class="_3 blank"> </span>l Na+ </div><div class="t m0 x1 h8 ya3 ff6 fs1 fc0 sc0 ls13 ws83">es el riñón, a través de la eliminación por </div><div class="t m0 x1 h8 ya4 ff6 fs1 fc0 sc0 ls8 ws84">orina, aunque tam<span class="_3 blank"> </span>bién exis<span class="_2 blank"></span>ten pérdidas </div><div class="t m0 x1 h8 ya5 ff6 fs1 fc0 sc0 ls49 ws85">extrarrenales de <span class="_3 blank"> </span>Na+ (sudor y materia fecal) </div><div class="t m0 x1 h8 ya6 ff6 fs1 fc0 sc0 ls6 ws86">que en condicione<span class="_3 blank"> </span>s basales son </div><div class="t m0 x1 h8 ya7 ff6 fs1 fc0 sc0 lsb ws87">insignificantes, pero la<span class="_3 blank"> </span>s pérdidas por sudor </div><div class="t m0 x1 h8 ya8 ff6 fs1 fc0 sc0 lsb ws88">pueden ser importantes tras un ejercicio </div><div class="t m0 x1 h8 ya9 ff6 fs1 fc0 sc0 ls49 ws89">físico inten<span class="_3 blank"> </span>so y las pérdidas por<span class="_2 blank"></span> materia </div><div class="t m0 x1 h8 yaa ff6 fs1 fc0 sc0 lsd ws8a">fecal pued<span class="_3 blank"> </span>en ser <span class="_2 blank"></span>notorias en un individuo </div><div class="t m0 x1 h8 yab ff6 fs1 fc0 sc0 ls50 ws8b">con<span class="_2 blank"></span> pato<span class="_2 blank"></span>logí<span class="_2 blank"></span>a di<span class="_2 blank"></span>ar<span class="_2 blank"></span>re<span class="_2 blank"></span>ic<span class="_2 blank"></span>a. </div><div class="t m0 x1 h8 yac ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 x1 h8 yad ff6 fs1 fc0 sc0 ls47 ws8c">Los mecanismo<span class="_3 blank"> </span>s de regulación de la volemia </div><div class="t m0 x1 h8 yae ff6 fs1 fc0 sc0 lsa ws8d">representan u<span class="_3 blank"> </span>n conjunto de m<span class="_3 blank"> </span>ecanismos </div><div class="t m0 x1 h8 yaf ff6 fs1 fc0 sc0 lsf ws8e">puestos en marcha por el organismo para </div><div class="t m0 x1 h8 yb0 ff6 fs1 fc0 sc0 lse ws8f">mantener el volu<span class="_3 blank"> </span>men sanguíneo dentro de </div><div class="t m0 x1 h8 yb1 ff6 fs1 fc0 sc0 ls7 ws4d">sus límites de normalidad.<span class="_3 blank"> </span> Dichos factores </div><div class="t m0 x1 h8 yb2 ff6 fs1 fc0 sc0 ls7 ws90">actúan <span class="_3 blank"> </span>simultáneamente y so<span class="_3 blank"> </span>n imposibles </div><div class="t m0 x1 h8 yb3 ff6 fs1 fc0 sc0 ls8 ws91">dividirlos, aquí s<span class="_3 blank"> </span>e los separa únicamente </div><div class="t m0 x1 h8 yb4 ff6 fs1 fc0 sc0 lse ws92">para su mejo<span class="_3 blank"> </span>r estudio y comprensión <span class="_3 blank"> </span>en: </div><div class="t m0 x1 h9 yb5 ff8 fs1 fc1 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 yb6 ff5 fs1 fc1 sc0 ls30 ws93">1-CONTROL NERVI<span class="_3 blank"> </span>OSO. </div><div class="t m0 x1 h7 yb7 ff5 fs1 fc1 sc0 ls51 ws94">2-CON<span class="_3 blank"> </span>TROL RE<span class="_3 blank"> </span>NAL Y HORM<span class="_3 blank"> </span>ONAL </div><div class="t m0 x16 h7 yb8 ff5 fs1 fc1 sc0 ls4e ws7">ASOCIAD<span class="_2 blank"></span>OS. </div><div class="t m0 x1 h8 yb9 ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 x1 h8 yba ff6 fs1 fc0 sc0 ls52 ws95"> <span class="_1a blank"></span>El volumen<span class="_3 blank"> </span> del L.E.C. <span class="_3 blank"> </span>y por consiguiente el </div><div class="t m0 x1 h8 ybb ff6 fs1 fc0 sc0 ls9 ws96">volumen sa<span class="_3 blank"> </span>nguíneo e<span class="_3 blank"> </span>stá determinado </div><div class="t m0 x1 h8 ybc ff6 fs1 fc0 sc0 ls11 ws97">fundamenta<span class="_3 blank"> </span>lmente por e<span class="_3 blank"> </span>l equilibrio entre la </div><div class="t m0 x1 h8 ybd ff6 fs1 fc0 sc0 ls6 ws98">ingesta y le excreción de a<span class="_3 blank"> </span>gua y sales. Para </div><div class="t m0 xa h8 ybe ff6 fs1 fc0 sc0 ls9 ws99">mantener la vida, un individu<span class="_3 blank"> </span>o debe excretar </div><div class="t m0 xa h8 ybf ff6 fs1 fc0 sc0 ls7 ws9a">a largo plazo una cantidad de Na+ </div><div class="t m0 xa h8 yc0 ff6 fs1 fc0 sc0 ls8 ws9b">exactamente igual al que ingiere. El gr<span class="_2 blank"></span>ueso </div><div class="t m0 xa h8 yc1 ff6 fs1 fc0 sc0 lsf ws9c">de la regulación radica en<span class="_3 blank"> </span> los r<span class="_2 blank"></span>iñones, que </div><div class="t m0 xa h8 yc2 ff6 fs1 fc0 sc0 ls6 wse">han de adaptar su excreción de Na+ y H2O,<span class="_3 blank"> </span> </div><div class="t m0 xa h8 yc3 ff6 fs1 fc0 sc0 lse ws9d">alterando tanto <span class="_3 blank"> </span>el IFG (índice de filt<span class="_3 blank"> </span>rado </div><div class="t m0 xa h8 yc4 ff6 fs1 fc0 sc0 ls48 ws9e">glomerular) c<span class="_2 blank"></span>omo la reabsorción <span class="_2 blank"></span>tubular, </div><div class="t m0 xa h8 yc5 ff6 fs1 fc0 sc0 ls8 ws9b">para mantener <span class="_3 blank"> </span>la ingesta de los mismos en </div><div class="t m0 xa h8 yc6 ff6 fs1 fc0 sc0 ls7 ws4f">condiciones de e<span class="_3 blank"> </span>quidad. </div><div class="t m0 xa h8 yc7 ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 xa h8 yc8 ff6 fs1 fc0 sc0 lsd ws9f"> <span class="_1b blank"></span>Los mecanismos<span class="_3 blank"> </span> de regulación de la </div><div class="t m0 xa h8 yc9 ff6 fs1 fc0 sc0 lse wsa0">volemia <span class="_3 blank"> </span>pueden captar alteracione<span class="_3 blank"> </span>s tanto del </div><div class="t m0 xa h8 yca ff6 fs1 fc0 sc0 ls4 wsa1">volumen como de la osmolaridad plasmática. </div><div class="t m0 xa h8 ycb ff6 fs1 fc0 sc0 lsd wsa2">La variación d<span class="_3 blank"> </span>el volumen sanguíneo <span class="_3 blank"> </span>es </div><div class="t m0 xa h8 ycc ff6 fs1 fc0 sc0 lse wsa3">captado <span class="_3 blank"> </span>por receptores de presión o de </div><div class="t m0 xa h8 ycd ff6 fs1 fc0 sc0 lsd wsa4">volumen llamados ba<span class="_3 blank"> </span>ror<span class="_2 blank"></span>receptores o </div><div class="t m0 xa h8 yce ff6 fs1 fc0 sc0 lsa wsa5">presorreceptores que son receptores de </div><div class="t m0 xa h8 ycf ff6 fs1 fc0 sc0 ls9 wsa6">distensión <span class="_3 blank"> </span> ubicados en va<span class="_3 blank"> </span>sos sanguíneos de<span class="_3 blank"> </span> </div><div class="t m0 xa h8 yd0 ff6 fs1 fc0 sc0 lsf wsa7">alta y baja presión, así tam<span class="_3 blank"> </span>bién como en las </div><div class="t m0 xa h8 yd1 ff6 fs1 fc0 sc0 ls8 wsa8">aurículas; las va<span class="_3 blank"> </span>ri<span class="_2 blank"></span>aciones de la osmolaridad </div><div class="t m0 xa h8 yd2 ff6 fs1 fc0 sc0 ls8 wsa9">son captadas<span class="_3 blank"> </span> por osmorreceptores ubicados </div><div class="t m0 xa h8 yd3 ff6 fs1 fc0 sc0 ls49 wsaa">en hipotálamo. </div><div class="t m0 xa h8 yd4 ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 xa h7 yd5 ff5 fs1 fc1 sc0 ls4a wsab">CONTRO<span class="_2 blank"></span>L NERVIOSO DEL </div><div class="t m0 xa h7 yd6 ff5 fs1 fc1 sc0 ls53 wsac">VO<span class="_3 blank"> </span>LUM<span class="_3 blank"> </span>EN S<span class="_3 blank"> </span>ANG<span class="_3 blank"> </span>UÍ<span class="_3 blank"> </span>NEO:<span class="ff6 fc0 ls48 wsad v0"> e<span class="_3 blank"> </span>l medio por </span></div><div class="t m0 xa h8 yd7 ff6 fs1 fc0 sc0 ls54 wsae">el cual el sistema nervioso contr<span class="_2 blank"></span>ola el </div><div class="t m0 xa h8 yd8 ff6 fs1 fc0 sc0 lsb wsa9">volumen sang<span class="_3 blank"> </span>uíneo es a travé<span class="_3 blank"> </span>s del si<span class="_2 blank"></span>stema </div><div class="t m0 xa h8 yd9 ff6 fs1 fc0 sc0 ls13 wsaf">nervioso autónomo<span class="_3 blank"> </span> (SNA) y de ésta la ma<span class="_3 blank"> </span>yor </div><div class="t m0 xa h8 yda ff6 fs1 fc0 sc0 ls9 wsb0">parte está<span class="_3 blank"> </span> dado por el sistema nervioso </div><div class="t m0 xa h8 ydb ff6 fs1 fc0 sc0 ls13 wsb1">simpático (SNS). La inervación de <span class="_2 blank"></span>las </div><div class="t m0 xa h8 ydc ff6 fs1 fc0 sc0 ls6 wsb2">pequeñas <span class="_3 blank"> </span>arterias y de las arteriolas permite </div><div class="t m0 xa h8 ydd ff6 fs1 fc0 sc0 ls47 wsb3">que la estimulación<span class="_3 blank"> </span> s<span class="_2 blank"></span>impática aumente la </div><div class="t m0 xa h8 yde ff6 fs1 fc0 sc0 ls8 wsb4">resistencia y <span class="_3 blank"> </span>disminuya el flujo<span class="_3 blank"> </span> sanguíneo a<span class="_3 blank"> </span> </div><div class="t m0 xa h8 ydf ff6 fs1 fc0 sc0 ls49 wsb5">los tejidos. La inervación de gran<span class="_3 blank"> </span>des vasos, </div><div class="t m0 xa h8 ye0 ff6 fs1 fc0 sc0 ls8 wsb6">hace po<span class="_3 blank"> </span>sible que la estimulación simpática </div><div class="t m0 xa h8 ye1 ff6 fs1 fc0 sc0 ls47 wsb7">disminuya el volumen de estos vasos <span class="_2 blank"></span>y </div><div class="t m0 xa h8 ye2 ff6 fs1 fc0 sc0 lsf wsb8">modifique el volumen de<span class="_3 blank"> </span>l sistema circulatorio </div><div class="t m0 xa h8 ye3 ff6 fs1 fc0 sc0 ls55 wsb9">periférico. Los nervios simpáticos llevan </div><div class="t m0 xa h8 ye4 ff6 fs1 fc0 sc0 ls6 wsba">gran cantidad de fibras vasoconstrictoras y </div><div class="t m0 xa h8 ye5 ff6 fs1 fc0 sc0 ls7 wsbb">unas pocas fibras vasodilatad<span class="_3 blank"> </span>oras. La </div><div class="t m0 xa h8 ye6 ff6 fs1 fc0 sc0 lsb wsbc">sustancia segregad<span class="_3 blank"> </span>a en las terminaciones de </div><div class="t m0 xa h8 ye7 ff6 fs1 fc0 sc0 ls4e wsbd">los ner<span class="_2 blank"></span>vios s<span class="_2 blank"></span>impático<span class="_2 blank"></span>s vasoco<span class="_2 blank"></span>nstr<span class="_2 blank"></span>ictor<span class="_2 blank"></span>es es </div><div class="t m0 xa h8 ye8 ff6 fs1 fc0 sc0 ls7 wsbe">la norepinefrina, que actúa sob<span class="_3 blank"> </span>re <span class="_2 blank"></span>los </div><div class="t m0 xa h8 ye9 ff6 fs1 fc0 sc0 lsd wsbf">receptores alfa del <span class="_3 blank"> </span>músculo liso vascular </div><div class="t m0 xa h8 yea ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 yeb ff6 fs1 fc0 sc0 ls6 wsc0">Los impulsos simpáticos<span class="_3 blank"> </span> se trasmiten a <span class="_2 blank"></span>la </div><div class="t m0 xa h8 yec ff6 fs1 fc0 sc0 lsb wsc1">médula suprarrenal, ésta segrega tanto </div><div class="t m0 xa h8 yed ff6 fs1 fc0 sc0 lsb wsc2">epinefrina como norepinefrina<span class="_3 blank"> </span>; la <span class="_2 blank"></span>epinefrina </div><div class="t m0 xa h8 yee ff6 fs1 fc0 sc0 ls7 wsc3">causa a <span class="_3 blank"> </span>veces <span class="_3 blank"> </span>vasodilatación debido a<span class="_3 blank"> </span> que </div><div class="t m0 xa h8 yef ff6 fs1 fc0 sc0 ls6 wsc4">tiene efec<span class="_3 blank"> </span>tos estimuladores de los </div><div class="t m0 xa h8 yf0 ff6 fs1 fc0 sc0 lsa wsc5">receptores bet<span class="_3 blank"> </span>a que con frecuencia dilatan<span class="_3 blank"> </span> </div><div class="t m0 xa h8 yf1 ff6 fs1 fc0 sc0 ls56 wsc6">los vasos en<span class="_3 blank"> </span> ciertos tejidos<span class="_3 blank"> </span>. </div><div class="t m0 xa h8 yf2 ff6 fs1 fc0 sc0 lse ws92"> Cu<span class="_3 blank"> </span>ando <span class="_1c blank"> </span>se <span class="_1c blank"> </span>producen <span class="_1c blank"> </span>modificaciones <span class="_1c blank"> </span>en <span class="_3 blank"> </span>la<span class="_3 blank"> </span> </div><div class="t m0 xa h8 yf3 ff6 fs1 fc0 sc0 lsb wsc7">ingesta de líquidos y Na+ se producen </div><div class="t m0 xa h8 yf4 ff6 fs1 fc0 sc0 ls13 wsc8">simultáneamente<span class="_3 blank"> </span> modificaciones del volumen </div><div class="t m0 xa h8 yf5 ff6 fs1 fc0 sc0 lsd wsc9">del LEC, del v<span class="_3 blank"> </span>olumen sanguíneo <span class="_3 blank"> </span>y de la </div><div class="t m0 xa h8 yf6 ff6 fs1 fc0 sc0 ls9 wsca">presión arterial; son justamente estas<span class="_3 blank"> </span> </div><div class="t m0 xa h8 yf7 ff6 fs1 fc0 sc0 ls13 wscb">alteraciones de la presión arterial <span class="_2 blank"></span>los </div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y84 w2 hd" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg3.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">3 </span></div><div class="t m0 x1 h8 y85 ff6 fs1 fc0 sc0 lsa wsce">estímulo<span class="_3 blank"> </span>s que son captados por los </div><div class="t m0 x1 h8 y86 ff6 fs1 fc0 sc0 ls8 wscf">receptores de presión que por último </div><div class="t m0 x1 h8 y87 ff6 fs1 fc0 sc0 lsf wsd0">producen <span class="_3 blank"> </span>modificaciones en la e<span class="_3 blank"> </span>xcreción </div><div class="t m0 x1 h8 y88 ff6 fs1 fc0 sc0 ls34 wsd1">renal de agua <span class="_3 blank"> </span>y Na+ para eq<span class="_3 blank"> </span>uilibrar así la </div><div class="t m0 x1 h8 y89 ff6 fs1 fc0 sc0 lsa ws34">ingesta tanto de agua<span class="_3 blank"> </span> como de Na+. </div><div class="t m0 x1 h8 y8a ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 hc yf8 ff6 fs1 fc0 sc0 ls10 ws7"> <span class="ff5 fc1 ls59 wsd2 v0">RECEPTORES DE VOLUMEN:</span><span class="ls5a"> s<span class="_16 blank"></span>o<span class="_1d blank"></span>n<span class="_1e blank"></span> </span></div><div class="t m0 x1 h8 yf9 ff6 fs1 fc0 sc0 ls6 wsd3">receptores que cens<span class="_3 blank"> </span>an modificaciones tanto </div><div class="t m0 x1 h8 yfa ff6 fs1 fc0 sc0 lsd wsd4">del volumen sanguín<span class="_3 blank"> </span>eo como de la presión </div><div class="t m0 x1 h8 yfb ff6 fs1 fc0 sc0 lsb wsd5">arterial. Se los pu<span class="_3 blank"> </span>ede dividir en </div><div class="t m0 x1 h8 yfc ff6 fs1 fc0 sc0 ls5b wsd6">RECEP<span class="_2 blank"></span>TORES D<span class="_2 blank"></span>E ALTA PR<span class="_2 blank"></span>ESIÓN<span class="_2 blank"></span> y </div><div class="t m0 x1 h8 yfd ff6 fs1 fc0 sc0 ls1 wsd7">RECEP<span class="_2 blank"></span>TOR<span class="_2 blank"></span>ES DE BAJ<span class="_2 blank"></span>A PRESI<span class="_2 blank"></span>ÓN<span class="_2 blank"></span>. Pa<span class="_2 blank"></span>ra <span class="_2 blank"></span>qu<span class="_2 blank"></span>e </div><div class="t m0 x1 h8 yfe ff6 fs1 fc0 sc0 ls5c wsd8">est<span class="_2 blank"></span>os rec<span class="_2 blank"></span>ept<span class="_2 blank"></span>or<span class="_2 blank"></span>es<span class="_2 blank"></span> <span class="_3 blank"> </span>se<span class="_2 blank"></span>an es<span class="_2 blank"></span>ti<span class="_2 blank"></span>mula<span class="_2 blank"></span>dos<span class="_2 blank"></span>, las<span class="_2 blank"></span> </div><div class="t m0 x1 h8 yff ff6 fs1 fc0 sc0 ls8 wsd9">variaciones del volumen sanguíneo deben<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y100 ff6 fs1 fc0 sc0 ls6 wsda">ser del 10%,<span class="_3 blank"> </span> es por ello, que<span class="_3 blank"> </span> se los </div><div class="t m0 x1 h8 y101 ff6 fs1 fc0 sc0 lsd wsdb">considera receptores de baja sensibilidad, </div><div class="t m0 x1 h8 y102 ff6 fs1 fc0 sc0 ls8 wsdc">pero cuando son estimulad<span class="_3 blank"> </span>os, responden </div><div class="t m0 x1 h8 y103 ff6 fs1 fc0 sc0 ls9 wsdd">enérgicamente deb<span class="_3 blank"> </span>ido a su alta <span class="_3 blank"> </span>potencia. </div><div class="t m0 x1 h8 y104 ff6 fs1 fc0 sc0 ls10 ws7"> <span class="_3 blank"> </span> </div><div class="t m0 x1 h7 y105 ff5 fs1 fc1 sc0 ls57 wsde">SISTEMA DE CO<span class="_2 blank"></span>NTROL </div><div class="t m0 x1 h7 y106 ff5 fs1 fc1 sc0 ls5d wsdf">BARO<span class="_2 blank"></span>RRECEPTOR<span class="_2 blank"></span> ARTERIAL:<span class="ff6 fc0 ls28 ws7 v0"> </span></div><div class="t m0 x1 h8 y107 ff6 fs1 fc0 sc0 ls5e wse0">REFLEJOS BARORRE<span class="_2 blank"></span>CEPTORES: es<span class="_2 blank"></span>te </div><div class="t m0 x1 h8 y108 ff6 fs1 fc0 sc0 ls48 wse1">reflejo se inicia por receptores de distensión </div><div class="t m0 x1 h8 y109 ff6 fs1 fc0 sc0 lsb wse2">denominados ba<span class="_3 blank"> </span>rorrec<span class="_2 blank"></span>eptores o </div><div class="t m0 x1 h8 y10a ff6 fs1 fc0 sc0 lsb ws36">presorreceptores, localizados en las par<span class="_2 blank"></span>edes </div><div class="t m0 x1 h8 y10b ff6 fs1 fc0 sc0 ls7 wse3">de varias de las<span class="_3 blank"> </span> grandes arterias sistémicas. </div><div class="t m0 x1 h8 y10c ff6 fs1 fc0 sc0 lsd wse4">Un aumento de<span class="_3 blank"> </span> la pr<span class="_2 blank"></span>esión arterial distiende </div><div class="t m0 x1 h8 y10d ff6 fs1 fc0 sc0 lsa wse5">a los barorreceptores que t<span class="_3 blank"> </span>ransmiten <span class="_1f blank"></span> </div><div class="t m0 x1 h8 y10e ff6 fs1 fc0 sc0 lsd wse6">señales al interior del sistema nervioso </div><div class="t m0 x1 h8 y10f ff6 fs1 fc0 sc0 lse wse7">central (SNC) que en<span class="_3 blank"> </span>vían señales de </div><div class="t m0 x1 h8 y110 ff6 fs1 fc0 sc0 ls6 wse8">retroacción de n<span class="_3 blank"> </span>uevo a la circulación a </div><div class="t m0 x1 h8 y111 ff6 fs1 fc0 sc0 lsf wse9">través del SNA <span class="_3 blank"> </span>para reducir la presión </div><div class="t m0 x1 h8 y112 ff6 fs1 fc0 sc0 ls8 wsea">arterial hacia el nivel no<span class="_3 blank"> </span>rmal. </div><div class="t m0 x1 h8 y113 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y114 ff5 fs1 fc1 sc0 ls20 wseb">ANATOMÍA FISIOLÓGICA DE <span class="_2 blank"></span>LOS </div><div class="t m0 x1 h7 y115 ff5 fs1 fc1 sc0 ls30 wsec">BARORRECEP<span class="_3 blank"> </span>TORES Y DE SU </div><div class="t m0 x1 h7 y116 ff5 fs1 fc1 sc0 ls5f wscc">INER<span class="_2 blank"></span>VAC<span class="_2 blank"></span>IÓN</div><div class="t m0 x17 h7 y117 ff9 fs1 fc0 sc0 ls1b">:<span class="ff6 lsa wsed"> los barorr<span class="_2 blank"></span>eceptores son </span></div><div class="t m0 x1 h8 y118 ff6 fs1 fc0 sc0 lsa wsee">terminaciones nerviosas<span class="_3 blank"> </span> situadas en las <span class="_20 blank"></span> </div><div class="t m0 x1 h8 y119 ff6 fs1 fc0 sc0 ls9 wsef">paredes de las a<span class="_3 blank"> </span>rterias. Se ubican en </div><div class="t m0 x1 h8 y11a ff6 fs1 fc0 sc0 ls7 wsf0">grandes arterias <span class="_3 blank"> </span>del tórax y cuello en </div><div class="t m0 x1 h8 y11b ff6 fs1 fc0 sc0 ls7 wsf1">especial en: 1- la pared de la carótida </div><div class="t m0 x1 h8 y11c ff6 fs1 fc0 sc0 lsf wsf2">interna, inmediatamente por encima de la </div><div class="t m0 x1 h8 y11d ff6 fs1 fc0 sc0 lsf wsf3">bifurcación de la carótida primitiva, una z<span class="_3 blank"> </span>ona </div><div class="t m0 x1 h8 y11e ff6 fs1 fc0 sc0 ls47 wsf4">conocida como S<span class="_3 blank"> </span>ENO CAROTÍDEO; 2- la </div><div class="t m0 x1 h8 y11f ff6 fs1 fc0 sc0 ls6 wsf5">pared del cayado de la arteria aort<span class="_2 blank"></span>a </div><div class="t m0 x1 h8 y120 ff6 fs1 fc0 sc0 ls60 wsf6">conocido com<span class="_3 blank"> </span>o BARORRECEP<span class="_3 blank"> </span>TORES </div><div class="t m0 x1 h8 y121 ff6 fs1 fc0 sc0 lsa wsf7">AÓRTICOS<span class="_3 blank"> </span>; también<span class="_3 blank"> </span> se ubican en otras </div><div class="t m0 x1 h8 y122 ff6 fs1 fc0 sc0 ls7 wsf8">arterias como la <span class="_3 blank"> </span>arteria renal aferente, entre </div><div class="t m0 x1 h8 y123 ff6 fs1 fc0 sc0 lsa ws7">otras. </div><div class="t m0 x1 h8 y124 ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 x1 h8 y125 ff6 fs1 fc0 sc0 ls9 wsf9"> <span class="_21 blank"></span>Las s<span class="_3 blank"> </span>eñales se transmite<span class="_3 blank"> </span>n desde el seno </div><div class="t m0 x1 h8 y126 ff6 fs1 fc0 sc0 ls8 ws1d">carotídeo a través del nervio de<span class="_3 blank"> </span> H<span class="_2 blank"></span>ering al </div><div class="t m0 x1 h8 y127 ff6 fs1 fc0 sc0 ls9 wsfa">nervio glosofaríng<span class="_3 blank"> </span>eo y desde allí al fascíc<span class="_3 blank"> </span>ulo </div><div class="t m0 x1 h8 y128 ff6 fs1 fc0 sc0 ls49 wsfb">solitario del <span class="_3 blank"> </span>bulbo. Las señales proceden<span class="_3 blank"> </span>tes </div><div class="t m0 x1 h8 y129 ff6 fs1 fc0 sc0 lsd wsfc">del cayado aórtico s<span class="_3 blank"> </span>e transmiten por medio </div><div class="t m0 x1 h8 y12a ff6 fs1 fc0 sc0 lsf wsfd">de los nervios vagos a <span class="_3 blank"> </span>la mi<span class="_2 blank"></span>sma zona del </div><div class="t m0 x1 h8 y12b ff6 fs1 fc0 sc0 lsa wsfe">bulbo. Los barorreceptores responden de </div><div class="t m0 xa h8 y12c ff6 fs1 fc0 sc0 lsb wsff">forma extremadamente rápida a las </div><div class="t m0 xa h8 y12d ff6 fs1 fc0 sc0 lsa wsc5">variaciones de presión, además<span class="_3 blank"> </span>, r<span class="_2 blank"></span>esponden<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y12e ff6 fs1 fc0 sc0 lsd ws100">más a un<span class="_3 blank"> </span>a presión que cambia rápidamente<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y12f ff6 fs1 fc0 sc0 lse ws60">que a una presión estacionaria. </div><div class="t m0 xa h8 y130 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y131 ff5 fs1 fc1 sc0 ls45 ws101">FUNC<span class="_2 blank"></span>IÓN DE AMO<span class="_2 blank"></span>RTIGUACIÓN </div><div class="t m0 xa h7 y132 ff5 fs1 fc1 sc0 ls58 ws102">DEL SISTEMA DE CONTRO<span class="_2 blank"></span>L DE </div><div class="t m0 xa he y133 ff5 fs1 fc1 sc0 ls10 ws103">LOS BAR<span class="_3 blank"> </span>ORRECEPTOR<span class="_3 blank"> </span>ES<span class="ff9 fc0 ls1b v0">:<span class="ff6 lsa ws104"> dado<span class="_3 blank"> </span> que el </span></span></div><div class="t m0 xa h8 y134 ff6 fs1 fc0 sc0 ls8 ws105">sistema de los barorreceptores se opone </div><div class="t m0 xa h8 y135 ff6 fs1 fc0 sc0 lse ws106">tanto al aume<span class="_3 blank"> </span>nto como a la disminución de la </div><div class="t m0 xa h8 y136 ff6 fs1 fc0 sc0 ls8 ws107">presión arterial, se los <span class="_3 blank"> </span>denominan sistemas<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y137 ff6 fs1 fc0 sc0 ls8 wsbc">amortiguadores de presión. E<span class="_3 blank"> </span>n resumen una </div><div class="t m0 xa h8 y138 ff6 fs1 fc0 sc0 ls4 ws108">finalidad primaria <span class="_2 blank"></span>del sistema barorrec<span class="_2 blank"></span>eptor </div><div class="t m0 xa h8 y139 ff6 fs1 fc0 sc0 ls4 ws109">arterial es r<span class="_2 blank"></span>educir las variaciones diarias<span class="_2 blank"></span> de </div><div class="t m0 xa h8 y13a ff6 fs1 fc0 sc0 ls7 ws10a">la presión arterial, actúa n a co<span class="_3 blank"> </span>rto pl<span class="_2 blank"></span>azo, ya </div><div class="t m0 xa h8 y13b ff6 fs1 fc0 sc0 ls9 ws10b">que tien<span class="_3 blank"> </span>e poca o ninguna importancia en la </div><div class="t m0 xa h8 y13c ff6 fs1 fc0 sc0 lsd ws10c">regulación a largo plazo de<span class="_3 blank"> </span> la <span class="_2 blank"></span>presión </div><div class="t m0 xa h8 y13d ff6 fs1 fc0 sc0 lsb ws10d">arterial ya qu<span class="_3 blank"> </span>e los barorreceptores se </div><div class="t m0 xa h8 y13e ff6 fs1 fc0 sc0 ls7 wse3">reajustan en 1<span class="_3 blank"> </span> ó 2 días a cualq<span class="_3 blank"> </span>uier nivel de </div><div class="t m0 xa h8 y13f ff6 fs1 fc0 sc0 ls49 ws10e">presión al que es<span class="_3 blank"> </span>tán expuestos<span class="_3 blank"> </span>. </div><div class="t m0 xa h8 y140 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y141 ff5 fs1 fc1 sc0 ls61 ws10f">RECEPTORES DE BAJA PRESIÓN:<span class="ff6 fc0 ls28 ws7 v0"> </span></div><div class="t m0 xa h8 y142 ff6 fs1 fc0 sc0 lsa ws110">tanto las au<span class="_3 blank"> </span>rículas como las arterias </div><div class="t m0 xa h8 y143 ff6 fs1 fc0 sc0 ls8 ws111">pulmonares tienen receptore<span class="_3 blank"> </span>s <span class="_2 blank"></span>de distensión </div><div class="t m0 xa h8 y144 ff6 fs1 fc0 sc0 ls8 ws112">en sus paredes. Estos<span class="_3 blank"> </span> rec<span class="_2 blank"></span>eptores de baja </div><div class="t m0 xa h8 y145 ff6 fs1 fc0 sc0 ls6 ws6c">presión desempeñan un importante<span class="_3 blank"> </span> papel </div><div class="t m0 xa h8 y146 ff6 fs1 fc0 sc0 ls3 ws113">para minimizar las alteraciones de <span class="_2 blank"></span>la presión </div><div class="t m0 xa h8 y147 ff6 fs1 fc0 sc0 ls7 ws114">arterial en respuesta a las variaciones de </div><div class="t m0 xa h8 y148 ff6 fs1 fc0 sc0 ls13 ws115">volumen. La<span class="_3 blank"> </span> distensión de <span class="_3 blank"> </span>las aurículas </div><div class="t m0 xa h8 y149 ff6 fs1 fc0 sc0 ls7 ws116">también c<span class="_3 blank"> </span>ausa dilatació<span class="_3 blank"> </span>n refleja de las </div><div class="t m0 xa h8 y14a ff6 fs1 fc0 sc0 ls9 ws117">arteriolas aferentes de los riñones. También </div><div class="t m0 xa h8 y14b ff6 fs1 fc0 sc0 lsd ws118">se transmiten seña<span class="_3 blank"> </span>les simultaneas al </div><div class="t m0 xa h8 y14c ff6 fs1 fc0 sc0 ls34 ws119">hipotálamo para dism<span class="_3 blank"> </span>inuir la secreción de </div><div class="t m0 xa h8 y14d ff6 fs1 fc0 sc0 ls34 ws11a">ADH. La disminución de la resistencia de <span class="_2 blank"></span>la </div><div class="t m0 xa h8 y14e ff6 fs1 fc0 sc0 lsa ws11b">arteriola aferente hac<span class="_3 blank"> </span>e que aumente<span class="_3 blank"> </span> la </div><div class="t m0 xa h8 y14f ff6 fs1 fc0 sc0 lsf ws11c">presión capilar glomerular, con aument<span class="_3 blank"> </span>o de </div><div class="t m0 xa h8 y150 ff6 fs1 fc0 sc0 lsd ws11d">la filtración de líquidos a los túbulos </div><div class="t m0 xa h8 y151 ff6 fs1 fc0 sc0 ls47 ws11e">renales. La disminución de la A<span class="_3 blank"> </span>DH disminuye </div><div class="t m0 xa h8 y152 ff6 fs1 fc0 sc0 lsb ws11f">la reabsorción de <span class="_3 blank"> </span>H2O por los túbulos; la </div><div class="t m0 xa h8 y153 ff6 fs1 fc0 sc0 lse ws120">combinación de <span class="_3 blank"> </span>estos dos factores causa <span class="_22 blank"></span> </div><div class="t m0 xa h8 y154 ff6 fs1 fc0 sc0 lsb ws121">una rápida pérdida de líquidos por la orina </div><div class="t m0 xa h8 y155 ff6 fs1 fc0 sc0 lsb ws122">que sirve como <span class="_3 blank"> </span>poderoso medio para </div><div class="t m0 xa h8 y156 ff6 fs1 fc0 sc0 ls52 ws123">devolver hacia la normali<span class="_2 blank"></span>dad el volumen </div><div class="t m0 xa h8 y157 ff6 fs1 fc0 sc0 lsb ws124">sanguíneo<span class="_3 blank"> </span>. La distensión auricular </div><div class="t m0 xa h8 y158 ff6 fs1 fc0 sc0 ls9 ws55">desencaden<span class="_3 blank"> </span>a un e<span class="_3 blank"> </span>fecto hormonal sobre los </div><div class="t m0 xa h8 y159 ff6 fs1 fc0 sc0 lsd ws125">riñones (la liberación del péptido natriurético </div><div class="t m0 xa h8 y15a ff6 fs1 fc0 sc0 ls8 ws105">auricular) que contribuyen aún mas a la </div><div class="t m0 xa h8 y15b ff6 fs1 fc0 sc0 ls8 ws121">rápida pérdida de líqu<span class="_3 blank"> </span>idos por la orina y a </div><div class="t m0 xa h8 y15c ff6 fs1 fc0 sc0 ls13 ws126">normalizar el v<span class="_2 blank"></span>olumen sanguíne<span class="_3 blank"> </span>o. </div><div class="t m0 xa h8 y15d ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y15e ff5 fs1 fc1 sc0 ls25 wscd">OSMOR RECEP TO RES:<span class="ff6 fc0 lsa ws127 v0"> son <span class="_3 blank"> </span>receptores </span></div><div class="t m0 xa h8 y15f ff6 fs1 fc0 sc0 lsd ws128">que se hallan ubicad<span class="_3 blank"> </span>os a nivel del </div><div class="t m0 xa h8 y160 ff6 fs1 fc0 sc0 ls6 ws22">hipotálamo y censan sobre todo variaciones </div><div class="t m0 xa h8 y161 ff6 fs1 fc0 sc0 ls4 ws129">de la osmolaridad plasmática y en menor </div><div class="t m0 xa h8 y162 ff6 fs1 fc0 sc0 lsd wsd4">medida <span class="_3 blank"> </span>variaciones del volumen sanguíneo.<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y163 ff6 fs1 fc0 sc0 ls62 ws12a">Su sensibilidad es mayor ya <span class="_2 blank"></span>que una </div><div class="t m0 xa h8 y164 ff6 fs1 fc0 sc0 ls13 ws12b">variación del <span class="_3 blank"> </span>1% de lo osmolaridad <span class="_3 blank"> </span>ya son </div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y165 w2 hf" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg4.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">4 </span></div><div class="t m0 x1 h8 y85 ff6 fs1 fc0 sc0 lse ws12c">suficientes para excitarlos, pero su pot<span class="_3 blank"> </span>encia </div><div class="t m0 x1 h8 y86 ff6 fs1 fc0 sc0 lsb ws12d">es menor que los receptores de v<span class="_2 blank"></span>olúmenes. </div><div class="t m0 x1 h8 y87 ff6 fs1 fc0 sc0 ls11 ws29"> Cu<span class="_3 blank"> </span>ando <span class="_23 blank"> </span>su <span class="_23 blank"> </span>produce <span class="_23 blank"> </span>un <span class="_23 blank"> </span>aumen<span class="_3 blank"> </span>to <span class="_23 blank"> </span>de <span class="_23 blank"> </span>la </div><div class="t m0 x1 h8 y88 ff6 fs1 fc0 sc0 ls34 ws12e">osmolaridad plasmática, la<span class="_3 blank"> </span>s células </div><div class="t m0 x1 h8 y89 ff6 fs1 fc0 sc0 ls9 ws12f">osmorreceptoras pierden agua y se </div><div class="t m0 x1 h8 y8a ff6 fs1 fc0 sc0 ls7 ws130">deshidratan y esto es un estí<span class="_3 blank"> </span>mulo para <span class="_2 blank"></span>la </div><div class="t m0 x1 h8 y8b ff6 fs1 fc0 sc0 ls47 ws131">liberación de ADH y para el estímulo de la </div><div class="t m0 x1 h8 y8c ff6 fs1 fc0 sc0 lsf ws132">sed, lo <span class="_3 blank"> </span>que lleva a u<span class="_3 blank"> </span>na mayor ingesta de </div><div class="t m0 x1 h8 y8d ff6 fs1 fc0 sc0 lsf ws133">líquidos y una <span class="_3 blank"> </span>disminución en la excreción </div><div class="t m0 x1 h8 y8e ff6 fs1 fc0 sc0 ls13 ws134">renal de líquidos. Por el contrario cuando se </div><div class="t m0 x1 h8 y8f ff6 fs1 fc0 sc0 ls13 ws12b">produce un<span class="_3 blank"> </span>a disminución en la os<span class="_3 blank"> </span>molaridad </div><div class="t m0 x1 h8 y90 ff6 fs1 fc0 sc0 ls13 ws135">plasmática, las células o<span class="_3 blank"> </span>smorreceptoras </div><div class="t m0 x1 h8 y91 ff6 fs1 fc0 sc0 ls49 ws136">incorporan agua, a<span class="_3 blank"> </span>umentan de tamaño<span class="_3 blank"> </span> y<span class="_2 blank"></span> esto </div><div class="t m0 x1 h8 y166 ff6 fs1 fc0 sc0 lsb ws137">es un estímulo p<span class="_3 blank"> </span>ara disminuir la secreción </div><div class="t m0 x1 h8 y167 ff6 fs1 fc0 sc0 lsb ws138">de AD<span class="_3 blank"> </span>H y d<span class="_3 blank"> </span>isminuir el estímulo de la s<span class="_3 blank"> </span>ed con </div><div class="t m0 x1 h8 y168 ff6 fs1 fc0 sc0 lsd ws20">la consiguiente disminución en la ingesta de </div><div class="t m0 x1 h8 y169 ff6 fs1 fc0 sc0 ls47 ws139">líquidos y mayor eliminación <span class="_3 blank"> </span>renal de agua. </div><div class="t m0 x1 h8 y16a ff6 fs1 fc0 sc0 ls10 ws7"> </div><div class="t m0 x1 h7 y16b ff5 fs1 fc1 sc0 ls63 ws13a">REG<span class="_3 blank"> </span>ULACI<span class="_3 blank"> </span>ÓN RENA<span class="_3 blank"> </span>L DE L<span class="_3 blank"> </span>OS </div><div class="t m0 x1 h7 y16c ff5 fs1 fc1 sc0 ls45 ws13b">LÍQUIDOS Y ELECTRÓLITOS </div><div class="t m0 x1 h8 y16d ff6 fs1 fc0 sc0 ls34 ws13c">El mantenimiento <span class="_3 blank"> </span>del volumen y de la </div><div class="t m0 x1 h8 y16e ff6 fs1 fc0 sc0 ls34 ws13d">osmolaridad normales de<span class="_3 blank"> </span> los líquidos </div><div class="t m0 x1 h8 y16f ff6 fs1 fc0 sc0 ls6 wsba">corporales d<span class="_3 blank"> </span>epende del equilibrio entre<span class="_3 blank"> </span> la </div><div class="t m0 x1 h8 y170 ff6 fs1 fc0 sc0 ls13 ws13e">entrada y salida del agua<span class="_3 blank"> </span> (solvente) y del </div><div class="t m0 x1 h8 y9d ff6 fs1 fc0 sc0 ls47 ws13f">sodio (principal soluto del líquido </div><div class="t m0 x1 h8 y171 ff6 fs1 fc0 sc0 ls7 ws7">extracelular). </div><div class="t m0 x1 h8 y172 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y173 ff5 fs1 fc1 sc0 ls64 ws140">Re<span class="_3 blank"> </span>gula<span class="_3 blank"> </span>ci<span class="_3 blank"> </span>ón<span class="_3 blank"> </span> del eq<span class="_3 blank"> </span>u<span class="_3 blank"> </span>ili<span class="_3 blank"> </span>bri<span class="_3 blank"> </span>o d<span class="_3 blank"> </span>el agu<span class="_3 blank"> </span>a </div><div class="t m0 x1 h8 y10e ff6 fs1 fc0 sc0 ls62 ws141">En la salud el volumen líquido normal del </div><div class="t m0 x1 h8 y10f ff6 fs1 fc0 sc0 lsf ws142">plasma se mantiene dentro de límites </div><div class="t m0 x1 h8 y110 ff6 fs1 fc0 sc0 ls6 ws143">relativamente estrechos. Si se produce </div><div class="t m0 x1 h8 y111 ff6 fs1 fc0 sc0 ls34 ws144">deshidratación o <span class="_3 blank"> </span>hemorragia, el volumen <span class="_3 blank"> </span>se </div><div class="t m0 x1 h8 y112 ff6 fs1 fc0 sc0 ls9 ws145">reducirá y el s<span class="_2 blank"></span>hock será evidente. Si <span class="_2 blank"></span>se </div><div class="t m0 x1 h8 y113 ff6 fs1 fc0 sc0 lsb ws36">produce sob<span class="_3 blank"> </span>rehidr<span class="_2 blank"></span>atación, la acci<span class="_3 blank"> </span>ón cardiaca </div><div class="t m0 x1 h8 y174 ff6 fs1 fc0 sc0 lsb ws146">puede est<span class="_3 blank"> </span>ar dificultada y el líquido se<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y175 ff6 fs1 fc0 sc0 lsf ws147">perderá de los vasos <span class="_3 blank"> </span>para producir edema de </div><div class="t m0 x1 h8 y176 ff6 fs1 fc0 sc0 lsf ws148">los tejidos subcutáne<span class="_3 blank"> </span>os o de los pulmon<span class="_3 blank"> </span>es. </div><div class="t m0 x1 h8 y177 ff6 fs1 fc0 sc0 ls6 ws149">El equilibrio de agua en el cuerpo está </div><div class="t m0 x1 h8 y178 ff6 fs1 fc0 sc0 ls8 ws105">controlado a través de la regulación del </div><div class="t m0 x1 h8 y179 ff6 fs1 fc0 sc0 ls6 ws14a">ingreso y excreción corporal. </div><div class="t m0 x1 h8 y17a ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y17b ff5 fs1 fc1 sc0 ls65 ws64">Ingre<span class="_2 blank"></span>sos </div><div class="t m0 x1 h8 y17c ff6 fs1 fc0 sc0 ls9 ws14b">La regulación de la entrada de<span class="_3 blank"> </span> <span class="_2 blank"></span>agua está </div><div class="t m0 x1 h8 y17d ff6 fs1 fc0 sc0 ls8 ws1d">dada principalmente<span class="_3 blank"> </span> por los c<span class="_2 blank"></span>ambios en el </div><div class="t m0 x1 h8 y17e ff6 fs1 fc0 sc0 ls8 ws4a">volumen de agua c<span class="_3 blank"> </span>onsumida como líquido, </div><div class="t m0 x1 h8 y17f ff6 fs1 fc0 sc0 ls8 ws9b">en promedio 1<span class="_3 blank"> </span> a 2 l / día (puede variar <span class="_2 blank"></span>de </div><div class="t m0 x1 h8 y180 ff6 fs1 fc0 sc0 ls13 ws71">menos de 1l a 20 l/día). Habitualment<span class="_3 blank"> </span>e el </div><div class="t m0 x1 h8 y181 ff6 fs1 fc0 sc0 lsb wsc7">ingreso de agua<span class="_3 blank"> </span> es promovido por una </div><div class="t m0 x1 h8 y182 ff6 fs1 fc0 sc0 ls47 ws14c">sensación de sed, como se <span class="_2 blank"></span>ha visto </div><div class="t m0 x1 h8 y183 ff6 fs1 fc0 sc0 ls56 ws7">anteriormente. </div><div class="t m0 x1 h8 y184 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y185 ff5 fs1 fc1 sc0 ls46 ws7">Egresos </div><div class="t m0 x1 h8 y186 ff6 fs1 fc0 sc0 ls9 ws14d">La exc<span class="_3 blank"> </span>reción del agua corporal está regulada </div><div class="t m0 x1 h8 y187 ff6 fs1 fc0 sc0 ls34 ws14e">principalmente p<span class="_3 blank"> </span>or la variación del ritm<span class="_3 blank"> </span>o del </div><div class="t m0 x1 h8 y188 ff6 fs1 fc0 sc0 ls8 ws14f">flujo urinario (<span class="_2 blank"></span>volumen de orina). Una caída </div><div class="t m0 x1 h8 y189 ff6 fs1 fc0 sc0 ls4 ws150">en la osmolalidad plasmática <span class="_2 blank"></span>indica un </div><div class="t m0 x1 h8 y18a ff6 fs1 fc0 sc0 ls8 ws151">exceso de <span class="_3 blank"> </span>agua y produce u<span class="_3 blank"> </span>n volumen </div><div class="t m0 xa h8 y18b ff6 fs1 fc0 sc0 lse ws28">aumenta<span class="_3 blank"> </span>do de orina con una<span class="_3 blank"> </span> os<span class="_2 blank"></span>molalidad<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y18c ff6 fs1 fc0 sc0 lsf ws152">menor que la del plasma, restableciendo así </div><div class="t m0 xa h8 y18d ff6 fs1 fc0 sc0 lsd ws153">la osmolalidad plasmática ha<span class="_3 blank"> </span>cia l<span class="_2 blank"></span>o normal. </div><div class="t m0 xa h8 y18e ff6 fs1 fc0 sc0 lsd ws154">Cuando la osm<span class="_3 blank"> </span>olalidad plasmática está por </div><div class="t m0 xa h8 y18f ff6 fs1 fc0 sc0 ls4 ws155">encima de la normal, el volumen urinario cae </div><div class="t m0 xa h8 y190 ff6 fs1 fc0 sc0 ls34 ws156">y su osmolalidad <span class="_3 blank"> </span>se eleva por encima de la </div><div class="t m0 xa h8 y191 ff6 fs1 fc0 sc0 lsd ws157">del plasma. El flujo <span class="_2 blank"></span>urinario también <span class="_2 blank"></span>está </div><div class="t m0 xa h8 y192 ff6 fs1 fc0 sc0 ls34 ws158">bajo la influencia del F<span class="_3 blank"> </span>iltrado Glomerular </div><div class="t m0 xa h8 y193 ff6 fs1 fc0 sc0 lsf wsb8">(FG), la condición del epitelio tubular renal y </div><div class="t m0 xa h8 y194 ff6 fs1 fc0 sc0 lsb ws159">las concentraciones plasmáticas de </div><div class="t m0 xa h8 y195 ff6 fs1 fc0 sc0 ls9 ws15a">esteroides suprarrenales. </div><div class="t m0 xa h8 y196 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y197 ff6 fs1 fc0 sc0 lsd ws10c">Estudios en conejos han demostrado el </div><div class="t m0 xa h8 y198 ff6 fs1 fc0 sc0 lse ws15b">papel del <span class="_3 blank"> </span>cotransportador Na+-dicarboxilasa, </div><div class="t m0 xa h8 y199 ff6 fs1 fc0 sc0 ls7 ws15c">presente en <span class="_3 blank"> </span>membrana apical de túbulo </div><div class="t m0 xa h8 y19a ff6 fs1 fc0 sc0 ls6 ws15d">proximal, en la reabsorción de a<span class="_3 blank"> </span>gua (9). Este </div><div class="t m0 xa h8 y19b ff6 fs1 fc0 sc0 lse ws12c">cotransportador fo<span class="_3 blank"> </span>rma parte de la familia de </div><div class="t m0 xa h8 y19c ff6 fs1 fc0 sc0 ls7 ws15e">transportadores de aniones dependient<span class="_3 blank"> </span>es de </div><div class="t m0 xa h8 y19d ff6 fs1 fc0 sc0 lsf ws15f">Na+, y normalmen<span class="_3 blank"> </span>te reabsorbe los </div><div class="t m0 xa h8 y19e ff6 fs1 fc0 sc0 ls4 ws160">intermediarios del ciclo del ácido </div><div class="t m0 xa h8 y19f ff6 fs1 fc0 sc0 ls48 ws7">tricarboxílico.(8)<span class="_2 blank"></span> </div><div class="t m0 xa h8 y1a0 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y1a1 ff6 fs1 fc0 sc0 lsa ws161">La sed es u<span class="_3 blank"> </span>na defensa m<span class="_3 blank"> </span>ayor contra la </div><div class="t m0 xa h8 y1a2 ff6 fs1 fc0 sc0 lsd ws100">depleción de líquido y la <span class="_2 blank"></span>hipertonicidad, los </div><div class="t m0 xa h8 y1a3 ff6 fs1 fc0 sc0 ls7 ws114">riñones también pue<span class="_3 blank"> </span>den estar involucrados </div><div class="t m0 xa h8 y1a4 ff6 fs1 fc0 sc0 lsc ws162">en la<span class="_3 blank"> </span> regulación <span class="_3 blank"> </span>del ing<span class="_3 blank"> </span>reso de agua a <span class="_3 blank"> </span>través </div><div class="t m0 xa h8 y1a5 ff6 fs1 fc0 sc0 ls6 ws163">del sistema renina-angio<span class="_3 blank"> </span>tensina.. Se debe </div><div class="t m0 xa h8 y1a6 ff6 fs1 fc0 sc0 lse ws164">recordar que algunos de los ce<span class="_3 blank"> </span>ntros de l<span class="_2 blank"></span>a </div><div class="t m0 xa h8 y1a7 ff6 fs1 fc0 sc0 ls6 ws165">sed no<span class="_3 blank"> </span> están conectados<span class="_3 blank"> </span> funcional y </div><div class="t m0 xa h8 y1a8 ff6 fs1 fc0 sc0 lse ws21">físicamente c<span class="_3 blank"> </span>on aquellos involucrados en la </div><div class="t m0 xa h8 y1a9 ff6 fs1 fc0 sc0 lse ws92">liberación de A<span class="_3 blank"> </span>DH. </div><div class="t m0 xa h8 y1aa ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y1ab ff6 fs1 fc0 sc0 ls6 ws98">Tanto <span class="_3 blank"> </span>la ADH como la sed están co<span class="_3 blank"> </span>ntroladas </div><div class="t m0 xa h8 y1ac ff6 fs1 fc0 sc0 ls62 ws166">por centros localizados en hipotálamo </div><div class="t m0 xa h8 y1ad ff6 fs1 fc0 sc0 lse ws167">posterior, y son estimulados principalmente<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y1ae ff6 fs1 fc0 sc0 ls66 ws168">por do<span class="_3 blank"> </span>s situaci<span class="_3 blank"> </span>ones fi<span class="_3 blank"> </span>siológi<span class="_3 blank"> </span>cas:<span class="_3 blank"> </span> los </div><div class="t m0 xa h8 y1af ff6 fs1 fc0 sc0 ls7 ws169">aumento<span class="_3 blank"> </span>s de la osmolaridad y <span class="_2 blank"></span>las </div><div class="t m0 xa h8 y1b0 ff6 fs1 fc0 sc0 ls4 ws16a">disminuciones del volumen. </div><div class="t m0 x18 h8 y1b1 ff6 fs1 fc0 sc0 lsd ws16b"> <span class="_24 blank"></span>Los aument<span class="_3 blank"> </span>os de la <span class="_2 blank"></span>osmolaridad </div><div class="t m0 x19 h8 y1b2 ff6 fs1 fc0 sc0 ls47 ws16c">plasmática so<span class="_3 blank"> </span>n percibidos por </div><div class="t m0 x19 h8 y1b3 ff6 fs1 fc0 sc0 lsb ws16d">osmorreceptores y se dan por depleción </div><div class="t m0 x19 h8 y1b4 ff6 fs1 fc0 sc0 lsf ws133">del agua c<span class="_3 blank"> </span>orporal total o por descenso </div><div class="t m0 x19 h8 y1b5 ff6 fs1 fc0 sc0 lse ws60">de la concentración del sodio. </div><div class="t m0 x18 h8 y1b6 ff6 fs1 fc0 sc0 ls47 ws16e"> <span class="_5 blank"></span>Las disminuciones de<span class="_3 blank"> </span>l volumen </div><div class="t m0 x19 h8 y1b7 ff6 fs1 fc0 sc0 lsf ws16f">plasmático so<span class="_3 blank"> </span>n percibidas por </div><div class="t m0 x19 h8 y1b8 ff6 fs1 fc0 sc0 lsf ws170">barorreceptores (receptores de v<span class="_3 blank"> </span>olumen) </div><div class="t m0 x19 h8 y1b9 ff6 fs1 fc0 sc0 lsb ws27">localizados en zona<span class="_3 blank"> </span>s de baja presión </div><div class="t m0 x19 h8 y1ba ff6 fs1 fc0 sc0 lsb ws171">(aurículas y vena<span class="_3 blank"> </span>s pulmonares) y en </div><div class="t m0 x19 h8 y1bb ff6 fs1 fc0 sc0 ls49 ws136">regiones de alta<span class="_3 blank"> </span> presión (seno carotídeo, </div><div class="t m0 x19 h8 y1bc ff6 fs1 fc0 sc0 lsf wsd0">cayado a<span class="_3 blank"> </span>órtico y arteriolas aferentes </div><div class="t m0 x19 h8 y1bd ff6 fs1 fc0 sc0 ls67 ws172">re<span class="_2 blank"></span>nale<span class="_2 blank"></span>s)<span class="_2 blank"></span> de<span class="_2 blank"></span> la c<span class="_2 blank"></span>ir<span class="_2 blank"></span>cul<span class="_2 blank"></span>ac<span class="_2 blank"></span>ión<span class="_2 blank"></span>. U<span class="_2 blank"></span>na </div><div class="t m0 x19 h8 y1be ff6 fs1 fc0 sc0 ls3 ws173">disminución del volumen plasmático hace </div><div class="t m0 x19 h8 y1bf ff6 fs1 fc0 sc0 lsa ws174">que disminuya la<span class="_3 blank"> </span> frecuencia de descarga </div><div class="t m0 x19 h8 y1c0 ff6 fs1 fc0 sc0 ls60 ws175">en estos receptores, que a su <span class="_2 blank"></span>vez </div><div class="t m0 x19 h8 y1c1 ff6 fs1 fc0 sc0 lsf ws176">provoca estimulación de<span class="_3 blank"> </span> la sed y </div><div class="t m0 x19 h8 y1c2 ff6 fs1 fc0 sc0 lsf ws177">secreción de ADH. </div><div class="t m0 xa h8 y1c3 ff6 fs1 fc0 sc0 ls28 ws7"> </div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y1c4 w2 h10" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg5.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">5 </span></div><div class="t m0 x1 h8 y85 ff6 fs1 fc0 sc0 ls72 ws179">En condiciones <span class="_3 blank"> </span>fisiológicas, la se<span class="_2 blank"></span>d y la </div><div class="t m0 x1 h8 y86 ff6 fs1 fc0 sc0 ls8 wsa8">secreción de A<span class="_3 blank"> </span>DH están bajo<span class="_3 blank"> </span> control de los </div><div class="t m0 x1 h8 y87 ff6 fs1 fc0 sc0 ls9 ws145">osmorreceptores, debido<span class="_3 blank"> </span> a que estos son </div><div class="t m0 x1 h8 y88 ff6 fs1 fc0 sc0 ls34 ws17a">muy sensibles a cambios de la osmolaridad. </div><div class="t m0 x1 h8 y89 ff6 fs1 fc0 sc0 ls68 ws17b">En cambio, los cambios del volumen </div><div class="t m0 x1 h8 y8a ff6 fs1 fc0 sc0 lsf ws9c">plasmático afectan a la sed y a la ADH en </div><div class="t m0 x1 h8 y8b ff6 fs1 fc0 sc0 lsb ws17c">circunstancias extremas (deshidratación </div><div class="t m0 x1 h8 y8c ff6 fs1 fc0 sc0 ls4c ws7e">grave, hemorragia, e<span class="_3 blank"> </span>tc). </div><div class="t m0 x1 h8 y8d ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y1c5 ff5 fs1 fc1 sc0 ls4e ws17d">HORMO<span class="_2 blank"></span>NA ANTIDIURÉ<span class="_2 blank"></span>TICA (ADH) </div><div class="t m0 x1 h8 yfc ff6 fs1 fc0 sc0 ls7 wsbe">Esta ho<span class="_3 blank"> </span>rmona, también conoc<span class="_3 blank"> </span>ida como </div><div class="t m0 x1 h8 yfd ff6 fs1 fc0 sc0 ls9 ws17e">vasopresina, tiene efec<span class="_3 blank"> </span>tos vasculares y </div><div class="t m0 x1 h8 yfe ff6 fs1 fc0 sc0 lsd ws17f">sobre la porción final del túbulo c<span class="_2 blank"></span>ontorneado </div><div class="t m0 x1 h8 yff ff6 fs1 fc0 sc0 ls4 ws180">distal (TCD) y el túbu<span class="_3 blank"> </span>lo colector, en los que </div><div class="t m0 x1 h8 y100 ff6 fs1 fc0 sc0 ls7 ws181">modifica la permeab<span class="_3 blank"> </span>ilidad del agua, y<span class="_3 blank"> </span> el </div><div class="t m0 x1 h8 y101 ff6 fs1 fc0 sc0 lsb ws112">transporte del sodio. También actúa s<span class="_3 blank"> </span>obre </div><div class="t m0 x1 h8 y102 ff6 fs1 fc0 sc0 ls52 ws182">las células contráctiles del mesangio </div><div class="t m0 x1 h8 y103 ff6 fs1 fc0 sc0 ls72 ws183">(disminuye el co<span class="_2 blank"></span>eficiente de permeabilidad </div><div class="t m0 x1 h8 y104 ff6 fs1 fc0 sc0 ls48 ws184">glomerular) y sobre los vasos r<span class="_2 blank"></span>ectos, </div><div class="t m0 x1 h8 y1c6 ff6 fs1 fc0 sc0 lsf ws185">regulando la permeabilidad med<span class="_3 blank"> </span>ular; además </div><div class="t m0 x1 h8 y1c7 ff6 fs1 fc0 sc0 ls47 ws186">estimula la síntesis de prostagland<span class="_3 blank"> </span>inas e </div><div class="t m0 x1 h8 y1c8 ff6 fs1 fc0 sc0 ls13 ws187">inhibe la secreción de renina<span class="_3 blank"> </span>. A nivel del </div><div class="t m0 x1 h8 y1c9 ff6 fs1 fc0 sc0 ls13 ws188">túbulo colector también modifica la </div><div class="t m0 x1 h8 y1ca ff6 fs1 fc0 sc0 lsd wsbf">permeabilidad para la u<span class="_3 blank"> </span>rea. </div><div class="t m0 x1 h8 y1cb ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y1cc ff6 fs1 fc0 sc0 ls9 ws189">Los receptores para la <span class="_3 blank"> </span>ADH son de dos </div><div class="t m0 x1 h8 y1cd ff6 fs1 fc0 sc0 ls4f ws18a">tipos: </div><div class="t m0 x1 h8 y1ce ff6 fs1 fc0 sc0 ls69 ws7"> <span class="ls73 v2"> V</span></div><div class="t m0 x1a h11 y1cf ff6 fs4 fc0 sc0 ls6f ws18b">1 </div><div class="t m0 x1b h8 y1d0 ff6 fs1 fc0 sc0 lsf ws24">se encuentra en músculo liso de </div><div class="t m0 x1c h8 y1d1 ff6 fs1 fc0 sc0 ls2 ws18c">vasos r<span class="_2 blank"></span>ectos<span class="_2 blank"></span> y en cé<span class="_2 blank"></span>lulas<span class="_2 blank"></span> del me<span class="_2 blank"></span>sangio<span class="_2 blank"></span> y </div><div class="t m0 x1c h8 y1d2 ff6 fs1 fc0 sc0 lsb ws18d">actúa por medio de<span class="_3 blank"> </span>l Inositol-1,4,5- </div><div class="t m0 x1c h12 y1d3 ff6 fs1 fc0 sc0 ls10 ws7">trifosfa<span class="_3 blank"> </span>to (IP<span class="fs4 ls6a v3">3</span><span class="ls74 ws18e v0">) <span class="_3 blank"> </span>y del<span class="_3 blank"> </span> Ca <span class="ffb fs4 ls6b v4">++</span></span><span class="fs4 ls6c v5"> </span><span class="ls6 v0">intracelular. </span></div><div class="t m0 x1d h13 y1d4 ff8 fs5 fc0 sc0 ls6d ws7"> <span class="ff6 fs1 ls6e v6">V<span class="fs4 ls6f v3">2 </span><span class="ls6 ws18f">se ubican en la región <span class="_3 blank"> </span>basal de </span></span></div><div class="t m0 x1c h8 y1d5 ff6 fs1 fc0 sc0 ls9 ws190">las células del túbulo colecto<span class="_3 blank"> </span>r y <span class="_2 blank"></span>están </div><div class="t m0 x1c h8 y1d6 ff6 fs1 fc0 sc0 ls49 ws191">acoplados <span class="_3 blank"> </span>a una proteína<span class="_3 blank"> </span> G, que activa a<span class="_3 blank"> </span> </div><div class="t m0 x1c h8 y1d7 ff6 fs1 fc0 sc0 lse ws92">la Adenilat<span class="_3 blank"> </span>o Ciclasa que produc<span class="_3 blank"> </span>e AMPc. </div><div class="t m0 x1 h8 y1d8 ff6 fs1 fc0 sc0 ls75 ws192">Éste<span class="_2 blank"></span>, al uni<span class="_2 blank"></span>rs<span class="_2 blank"></span>e a la<span class="_2 blank"></span> pro<span class="_2 blank"></span>te<span class="_2 blank"></span>ína qu<span class="_2 blank"></span>ina<span class="_2 blank"></span>sa A (<span class="_2 blank"></span>PKA)<span class="_2 blank"></span> </div><div class="t m0 x1 h8 y1d9 ff6 fs1 fc0 sc0 lsa ws193">se obse<span class="_3 blank"> </span>rvó en ratones que induce la </div><div class="t m0 x1 h8 y1da ff6 fs1 fc0 sc0 ls8 ws194">fosforilación de proteínas<span class="_3 blank"> </span> de membrana, </div><div class="t m0 x1 h8 y1db ff6 fs1 fc0 sc0 ls7 wsf1">entre ellas la AQP<span class="_3 blank"> </span>2 en su sitio Ser<span class="fs4 ls6f ws178 v5">256</span><span class="ls10 ws7 v0">, </span></div><div class="t m0 x1 h8 y1dc ff6 fs1 fc0 sc0 lsb ws6b">provocando la inserción de \u201c<span class="_3 blank"> </span>agregóforos\u201d a </div><div class="t m0 x1 h8 y1dd ff6 fs1 fc0 sc0 ls3 ws195">la membrana luminal por exocitosis, </div><div class="t m0 x1 h8 y1de ff6 fs1 fc0 sc0 lsd ws157">generando <span class="_3 blank"> </span>un cambio en la permeabilidad<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y1df ff6 fs1 fc0 sc0 ls8 ws196">del agua gracias a<span class="_3 blank"> </span> los canales proteicos </div><div class="t m0 x1 h8 y1e0 ff6 fs1 fc0 sc0 ls8 ws197">(acuaporinas) presentes en las vesículas.<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y1e1 ff6 fs1 fc0 sc0 ls8 ws198">Existen ot<span class="_3 blank"> </span>ros pasos involucrados en este </div><div class="t m0 x1 h8 y1e2 ff6 fs1 fc0 sc0 lsa ws34">proceso aún no reconocidos (1). </div><div class="t m0 x1 h8 y1e3 ff6 fs1 fc0 sc0 ls9 ws69">Se ha<span class="_3 blank"> </span> demostrado,<span class="_3 blank"> </span> en ratones, que el uso<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y1e4 ff6 fs1 fc0 sc0 ls8 wsb4">crónico de un antagonista de la Aldosterona </div><div class="t m0 x1 h8 y1e5 ff6 fs1 fc0 sc0 ls8 ws76">influencia la acción de la A<span class="_3 blank"> </span>DH en r<span class="_2 blank"></span>eceptores </div><div class="t m0 x1 h8 y1e6 ff6 fs1 fc0 sc0 ls7 ws199">tipo V<span class="fs4 ls6f ws7 v3">2 <span class="_3 blank"> </span></span><span class="lsb ws19a v0"> lo que provocó una disminución de la </span></div><div class="t m0 x1 h8 y1e7 ff6 fs1 fc0 sc0 lsf ws19b">reabsorción renal de a<span class="_3 blank"> </span>gua mediada por la </div><div class="t m0 x1 h8 y1e8 ff6 fs1 fc0 sc0 ls13 ws7b">vasopresina, disminución de la expresión de </div><div class="t m0 x1 h8 y1e9 ff6 fs1 fc0 sc0 lsf ws19c">AQP2 en el túbu<span class="_3 blank"> </span>lo colector y un aumento el </div><div class="t m0 x1 h8 y1ea ff6 fs1 fc0 sc0 lsf wsf3">flujo de orina libre de solutos, lo q<span class="_3 blank"> </span>ue sugiere </div><div class="t m0 x1 h8 y1eb ff6 fs1 fc0 sc0 ls4 ws109">que los mineralocorticoides tienen influencia </div><div class="t m0 x1 h8 y1ec ff6 fs1 fc0 sc0 ls56 ws19d">sobre los receptores V<span class="fs4 ls6f v3">2<span class="ls70 ws7 v7"> </span></span><span class="ls4b ws19e v0">(2)<span class="_3 blank"> </span>. </span></div><div class="t m0 x1 h8 y1ed ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y1ee ff6 fs1 fc0 sc0 ls8 wsc2">También se ha v<span class="_3 blank"> </span>isto que el ayuno daña la </div><div class="t m0 xa h8 y1ef ff6 fs1 fc0 sc0 ls13 ws19f">habilidad de conc<span class="_3 blank"> </span>entrar <span class="_2 blank"></span>la orina y, c<span class="_2 blank"></span>omo </div><div class="t m0 xa h8 y1f0 ff6 fs1 fc0 sc0 ls6 ws1a0">resultado, causa poliuria. E<span class="_3 blank"> </span>ste efecto es </div><div class="t m0 xa h8 y1f1 ff6 fs1 fc0 sc0 lsb ws4a">mediado <span class="_3 blank"> </span>vía la supresión de expresión de </div><div class="t m0 xa h8 y1f2 ff6 fs1 fc0 sc0 lsc ws1a1">AQP2 <span class="_3 blank"> </span>en el conducto c<span class="_3 blank"> </span>olector. La </div><div class="t m0 xa h8 y1f3 ff6 fs1 fc0 sc0 lsb ws1a2">incapacidad para concen<span class="_3 blank"> </span>trar la orina <span class="_2 blank"></span>en el </div><div class="t m0 xa h8 y1f4 ff6 fs1 fc0 sc0 lsd wse6">ayuno es ráp<span class="_3 blank"> </span>idamente reversibl<span class="_2 blank"></span>e con la </div><div class="t m0 xa h8 y1f5 ff6 fs1 fc0 sc0 ls6 wse">realimentación y es asociado co<span class="_3 blank"> </span>n un r<span class="_2 blank"></span>etorno </div><div class="t m0 xa h8 y1f6 ff6 fs1 fc0 sc0 ls8 ws1a3">de expresión d<span class="_3 blank"> </span>e AQP2 a los niveles </div><div class="t m0 xa h8 y1f7 ff6 fs1 fc0 sc0 ls4 ws7">normales.(11) </div><div class="t m0 xa h8 y1f8 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y1f9 ff6 fs1 fc0 sc0 lsa ws1a4">Efectos <span class="_3 blank"> </span>de la <span class="_3 blank"> </span>ADH: Cuando el volum<span class="_3 blank"> </span>en de </div><div class="t m0 xa h8 y1fa ff6 fs1 fc0 sc0 ls34 ws144">los líquidos corporales está diluido, la ADH </div><div class="t m0 xa h8 y1fb ff6 fs1 fc0 sc0 ls9 ws1a5">está ausente, ento<span class="_3 blank"> </span>nces se elimina gr<span class="_2 blank"></span>an </div><div class="t m0 xa h8 y1fc ff6 fs1 fc0 sc0 lsb ws19a">cantidad de <span class="_3 blank"> </span>orina con una densidad muy baja </div><div class="t m0 xa h8 y1fd ff6 fs1 fc0 sc0 ls47 ws14c">(poliuria), mientras que el ing<span class="_3 blank"> </span>reso de </div><div class="t m0 xa h8 y1fe ff6 fs1 fc0 sc0 ls8 ws1a6">líquidos está aumen<span class="_3 blank"> </span>tado (polidipsia). Cuando </div><div class="t m0 xa h8 y1ff ff6 fs1 fc0 sc0 lsf wsf3">la presión osmótica se eleva, la secreción de </div><div class="t m0 xa h8 y200 ff6 fs1 fc0 sc0 ls35 ws31">ADH está<span class="_3 blank"> </span> aumentada. </div><div class="t m0 xa h8 y201 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y202 ff6 fs1 fc0 sc0 ls7 ws181">Distintos t<span class="_3 blank"> </span>rastornos pueden afectar o ser </div><div class="t m0 xa h8 y203 ff6 fs1 fc0 sc0 lsf ws1a7">afectados por la liberación y acción de la </div><div class="t m0 xa h8 y204 ff6 fs1 fc0 sc0 ls5f ws7">ADH:<span class="_2 blank"></span> <span class="ls13 ws1a8 v2"> Est<span class="_3 blank"> </span>ímulos <span class="_25 blank"> </span>tensionantes <span class="_25 blank"> </span>(dolor, </span></div><div class="t m0 x19 h8 y205 ff6 fs1 fc0 sc0 ls9 ws1a9">debido a<span class="_3 blank"> </span> cirugía, quemaduras, </div><div class="t m0 x19 h8 y206 ff6 fs1 fc0 sc0 ls34 ws1aa">traumatismo) - aument<span class="_3 blank"> </span>a la secreción de </div><div class="t m0 x19 h8 y207 ff6 fs1 fc0 sc0 lsc ws1ab">ADH. E<span class="_3 blank"> </span>ste fact<span class="_3 blank"> </span>or debe considerarse en </div><div class="t m0 x19 h8 y208 ff6 fs1 fc0 sc0 ls7 ws4f">la terapia con líqu<span class="_3 blank"> </span>idos. </div><div class="t m0 x14 h8 y209 ff6 fs1 fc0 sc0 ls47 ws1ac"> <span class="_21 blank"></span>B<span class="_3 blank"> </span>arbitúricos, demerol y morfina: </div><div class="t m0 x19 h8 y20a ff6 fs1 fc0 sc0 lsb ws1ad">estimulan su secreción. La<span class="_3 blank"> </span> reducción del </div><div class="t m0 x19 h8 y20b ff6 fs1 fc0 sc0 ls47 ws1ae">filtrado glomerular también puede </div><div class="t m0 x19 h8 y20c ff6 fs1 fc0 sc0 ls47 ws1af">disminuir la excr<span class="_2 blank"></span>eción urinaria. </div><div class="t m0 x14 h8 y20d ff6 fs1 fc0 sc0 ls76 ws1b0"> <span class="_1f blank"></span>Drogas colinérgic<span class="_2 blank"></span>as y beta-</div><div class="t m0 x19 h8 y20e ff6 fs1 fc0 sc0 lsf ws54">adrenérgicas, nicotina y prostaglandinas: </div><div class="t m0 x19 h8 y20f ff6 fs1 fc0 sc0 ls11 ws29">fuertes est<span class="_3 blank"> </span>imuladores de su s<span class="_3 blank"> </span>ecreción. </div><div class="t m0 x14 h8 y210 ff6 fs1 fc0 sc0 lsd ws1b1"> <span class="_2 blank"></span>Alcohol - fuerte inhibidor de su </div><div class="t m0 x19 h8 y211 ff6 fs1 fc0 sc0 ls8 wsc2">excreción. La excreción urinaria excede </div><div class="t m0 x19 h8 y212 ff6 fs1 fc0 sc0 ls7 ws1b2">al ingreso, produciendo cierto grado de </div><div class="t m0 x19 h8 y213 ff6 fs1 fc0 sc0 ls13 ws1b3">deshidratación hipernatrémica </div><div class="t m0 x14 h8 y214 ff6 fs1 fc0 sc0 lse ws1b4"> <span class="_4 blank"> </span>Glucocorticoides y fenitoína<span class="_3 blank"> </span>: <span class="_2 blank"></span>inhibe </div><div class="t m0 x19 h8 y215 ff6 fs1 fc0 sc0 ls49 ws10e">su secreción. </div><div class="t m0 x14 h8 y216 ff6 fs1 fc0 sc0 ls34 ws1b5"> <span class="_26 blank"> </span>Glucosa en <span class="_3 blank"> </span>la luz del túbulo renal </div><div class="t m0 x19 h8 y217 ff6 fs1 fc0 sc0 ls77 ws1b6">(diabetes mellit<span class="_2 blank"></span>us): limita la capac<span class="_2 blank"></span>idad </div><div class="t m0 x19 h8 y218 ff6 fs1 fc0 sc0 ls9 wsdd">de la A<span class="_3 blank"> </span>DH para conservar agua. </div><div class="t m0 x14 h8 y219 ff6 fs1 fc0 sc0 ls49 ws1b7"> Diabetes <span class="_27 blank"></span>insípida <span class="_8 blank"></span>ne<span class="_3 blank"> </span>frogénica: <span class="_8 blank"></span>falla </div><div class="t m0 x19 h8 y21a ff6 fs1 fc0 sc0 ls8 ws1b8">de los t<span class="_3 blank"> </span>úbulos colectores renales para </div><div class="t m0 x19 h8 y21b ff6 fs1 fc0 sc0 ls9 ws15a">responder a la ADH </div><div class="t m0 x1e h8 y21c ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1e h8 y21d ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y21e ff5 fs1 fc1 sc0 ls78 ws1b9">Regul<span class="_2 blank"></span>ación del equil<span class="_2 blank"></span>ibrio de<span class="_2 blank"></span>l </div><div class="t m0 xa h7 y21f ff5 fs1 fc1 sc0 ls71 ws7">sodio </div><div class="t m0 x1e h8 y220 ff6 fs1 fc0 sc0 ls9 wsfa">Debido a que la e<span class="_3 blank"> </span>ntrada de sodio no </div><div class="t m0 xa h8 y221 ff6 fs1 fc0 sc0 ls13 ws1ba">es significativa en el hombre, el equilibro </div><div class="t m0 xa h8 y222 ff6 fs1 fc0 sc0 ls8 ws111">debe alca<span class="_3 blank"> </span>nzarse procurando que la s<span class="_3 blank"> </span>alida </div><div class="t m0 xa h8 y223 ff6 fs1 fc0 sc0 lsd ws1bb">de sodio iguale a la entrada del <span class="_2 blank"></span>mismo. </div><div class="t m0 x1e h8 y224 ff6 fs1 fc0 sc0 ls28 ws7"> </div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf6" class="pf w0 h0" data-page-no="6"><div class="pc pc6 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y225 w2 h14" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg6.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">6 </span></div><div class="t m0 x3 h8 y85 ff6 fs1 fc0 sc0 ls8 ws14f">En condiciones normales el riñón es </div><div class="t m0 x1 h8 y86 ff6 fs1 fc0 sc0 ls34 ws1bd">el principal órgano que regula la excreció<span class="_2 blank"></span>n </div><div class="t m0 x1 h8 y87 ff6 fs1 fc0 sc0 lsd ws100">del sodio, principalmente por cambios en la </div><div class="t m0 x1 h8 y88 ff6 fs1 fc0 sc0 ls49 ws1be">cantidad excretada por la orina. El aumento<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y89 ff6 fs1 fc0 sc0 ls8 wsdc">de la <span class="_3 blank"> </span>excreción del <span class="_3 blank"> </span>sodio se denom<span class="_3 blank"> </span>ina </div><div class="t m0 x1 h8 y8a ff6 fs1 fc0 sc0 ls8 wsea">natriuresis y la disminución<span class="_3 blank"> </span> antinatriuresis. </div><div class="t m0 x3 h8 y8b ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h8 y8c ff6 fs1 fc0 sc0 lse ws1bf">La pérdida de s<span class="_3 blank"> </span>odio a través de la </div><div class="t m0 x1 h8 y8d ff6 fs1 fc0 sc0 lsf ws1c0">piel no interviene en la regulación; es </div><div class="t m0 x1 h8 y8e ff6 fs1 fc0 sc0 lsd ws1c1">simplemente un s<span class="_3 blank"> </span>ubproducto de la regulación </div><div class="t m0 x1 h8 y8f ff6 fs1 fc0 sc0 lsa ws1c2">de la te<span class="_3 blank"> </span>mperatura del cuerpo. </div><div class="t m0 x3 h8 y226 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h8 y227 ff6 fs1 fc0 sc0 ls13 ws1c3">Los mecanismos descriptos muestran </div><div class="t m0 x1 h8 y228 ff6 fs1 fc0 sc0 lse ws1bf">dos tipos de<span class="_3 blank"> </span> regulación: uno proximal, que </div><div class="t m0 x1 h8 y229 ff6 fs1 fc0 sc0 ls7 wsf8">es dond<span class="_3 blank"> </span>e se p<span class="_3 blank"> </span>roduce la mayor proporción de </div><div class="t m0 x1 h8 y22a ff6 fs1 fc0 sc0 ls4 ws1c4">la reabsorción del so<span class="_3 blank"> </span>dio filtrado (balance </div><div class="t m0 x1 h8 y22b ff6 fs1 fc0 sc0 ls7 ws1c5">glomérulotubular), y otro <span class="_2 blank"></span>fino, que se </div><div class="t m0 x1 h8 y22c ff6 fs1 fc0 sc0 lsb wsa9">produce en el n<span class="_3 blank"> </span>efrón distal y está sujeto a </div><div class="t m0 x1 h8 y22d ff6 fs1 fc0 sc0 ls6 ws14a">regulación hormonal. </div><div class="t m0 x3 h8 y22e ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h8 y22f ff6 fs1 fc0 sc0 ls9 ws1c6">La regulación de<span class="_3 blank"> </span> la excreción del </div><div class="t m0 x1 h8 y230 ff6 fs1 fc0 sc0 ls8 ws73">sodio va a depender de la <span class="_2 blank"></span>interacción de </div><div class="t m0 x1 h8 y231 ff6 fs1 fc0 sc0 ls8 wsa8">mecanismos físicos, hormonales<span class="_3 blank"> </span> y <span class="_2 blank"></span>nerviosos </div><div class="t m0 x1 h8 y232 ff6 fs1 fc0 sc0 lsf ws1c0">con receptores de sodio y de <span class="_2 blank"></span>volumen </div><div class="t m0 x1 h8 y233 ff6 fs1 fc0 sc0 ls7d ws1c7">intra<span class="_3 blank"> </span>rren<span class="_3 blank"> </span>ales y e<span class="_3 blank"> </span>xtrarre<span class="_3 blank"> </span>nal<span class="_3 blank"> </span>es. </div><div class="t m0 x3 h8 y234 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h8 y235 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y236 ff5 fs1 fc1 sc0 ls7e ws1c8">Ca<span class="_2 blank"></span>mbios en el Volumen de </div><div class="t m0 x1 h7 y237 ff5 fs1 fc1 sc0 ls7f ws1c9">Filtración Gl<span class="_2 blank"></span>omerula<span class="_2 blank"></span>r (VFG) </div><div class="t m0 x3 h8 ya2 ff6 fs1 fc0 sc0 ls13 ws1ca">Cuando cambia la ing<span class="_3 blank"> </span>esta de sodio, </div><div class="t m0 x1 h8 y238 ff6 fs1 fc0 sc0 ls13 ws1cb">se producen c<span class="_3 blank"> </span>ambios compensatorios del </div><div class="t m0 x1 h8 ya4 ff6 fs1 fc0 sc0 ls7 ws1cc">VFG q<span class="_3 blank"> </span>ue pueden af<span class="_3 blank"> </span>ectar la excreción <span class="_2 blank"></span>renal </div><div class="t m0 x1 h8 y239 ff6 fs1 fc0 sc0 lsd ws154">del sodio. El regulador más i<span class="_2 blank"></span>mportante del </div><div class="t m0 x1 h8 y23a ff6 fs1 fc0 sc0 ls49 ws1cd">VFG es el Flujo Plasmát<span class="_3 blank"> </span>ico Renal (FPR), y </div><div class="t m0 x1 h8 y23b ff6 fs1 fc0 sc0 ls49 ws1ce">también puede v<span class="_3 blank"> </span>erse afectado por la presión </div><div class="t m0 x1 h8 y23c ff6 fs1 fc0 sc0 lsd ws17f">neta de <span class="_3 blank"> </span>filtración. Los <span class="_3 blank"> </span>cambios en la ingesta </div><div class="t m0 x1 h8 y23d ff6 fs1 fc0 sc0 lsd ws1c1">de sod<span class="_3 blank"> </span>io pueden <span class="_3 blank"> </span>cambiar el FPR y la presión </div><div class="t m0 x1 h8 y23e ff6 fs1 fc0 sc0 lsa wsa5">neta de filtración<span class="_3 blank"> </span>, de esta manera se </div><div class="t m0 x1 h8 y23f ff6 fs1 fc0 sc0 ls7a ws1cf">modifi<span class="_2 blank"></span>cará<span class="_2 blank"></span> <span class="_3 blank"> </span>el VFG<span class="_2 blank"></span>. El papel de los camb<span class="_2 blank"></span>ios </div><div class="t m0 x1 h8 y240 ff6 fs1 fc0 sc0 ls8 ws1d0">del VFG n<span class="_3 blank"> </span>o es muy importante en la </div><div class="t m0 x1 h8 y241 ff6 fs1 fc0 sc0 lsd ws1d1">regulación de la excreción del sodio en </div><div class="t m0 x1 h8 y242 ff6 fs1 fc0 sc0 lsf ws1d2">condiciones fisiológicas, debido<span class="_3 blank"> </span> a la </div><div class="t m0 x1 h8 y243 ff6 fs1 fc0 sc0 ls8 ws14f">existencia de mecanismos que mant<span class="_3 blank"> </span>ienen la </div><div class="t m0 x1 h8 y244 ff6 fs1 fc0 sc0 lsf ws1d3">llegada de u<span class="_3 blank"> </span>na fracción constante del total </div><div class="t m0 x1 h8 y245 ff6 fs1 fc0 sc0 lsd ws154">filtrado de s<span class="_3 blank"> </span>odio al comienzo del condu<span class="_3 blank"> </span>cto </div><div class="t m0 x1 h8 y246 ff6 fs1 fc0 sc0 ls9 ws1d4">colector, dichos mecanismos son la </div><div class="t m0 x1 h8 y247 ff6 fs1 fc0 sc0 lsf ws1d5">autorregulación de la velocidad del filtrado </div><div class="t m0 x1 h8 y248 ff6 fs1 fc0 sc0 ls4 ws1d6">glomerular, el equilibri<span class="_2 blank"></span>o glomerulotubular y </div><div class="t m0 x1 h8 y249 ff6 fs1 fc0 sc0 lsb ws1d7">la dependencia d<span class="_3 blank"> </span>el filtrado par<span class="_2 blank"></span>a la </div><div class="t m0 x1 h8 y24a ff6 fs1 fc0 sc0 lsd ws1d8">reabsorción del sodio en el <span class="_2 blank"></span>asa de <span class="_2 blank"></span>Henle y </div><div class="t m0 x1 h8 y24b ff6 fs1 fc0 sc0 lsb ws1d9">en el túbulo distal (reabsorción dependiente </div><div class="t m0 x1 h8 y24c ff6 fs1 fc0 sc0 ls30 ws1da">de la carga). </div><div class="t m0 x3 h8 y24d ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y24e ff5 fs1 fc2 sc0 ls79 ws1db">FACTORES HU<span class="_2 blank"></span>MORALES </div><div class="t m0 xa h7 y24f ff5 fs1 fc2 sc0 ls80 ws7">ANTINATRIURÉ<span class="_2 blank"></span>TICOS </div><div class="t m0 x1e h7 y250 ff9 fs1 fc1 sc0 ls28 ws7"> </div><div class="t m0 x1e h7 y251 ff5 fs1 fc1 sc0 ls7a ws1dc">ALDOSTER<span class="_2 blank"></span>ONA </div><div class="t m0 x1e h8 y252 ff6 fs1 fc0 sc0 ls6 ws1dd">La Aldosterona es la principal </div><div class="t m0 xa h8 y253 ff6 fs1 fc0 sc0 lsb ws1de">hormona antinatriurética <span class="_3 blank"> </span>del organismo, que </div><div class="t m0 xa h8 y254 ff6 fs1 fc0 sc0 ls49 ws1df">actúa <span class="_3 blank"> </span>provocando un<span class="_3 blank"> </span>a reabsorción de sodio<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y255 ff6 fs1 fc0 sc0 lsd ws100">en la porción fina<span class="_3 blank"> </span>l del TCD y en la por<span class="_2 blank"></span>ción </div><div class="t m0 xa h8 y256 ff6 fs1 fc0 sc0 ls81 ws1e0">corti<span class="_3 blank"> </span>cal d<span class="_3 blank"> </span>el túb<span class="_3 blank"> </span>ulo co<span class="_3 blank"> </span>lect<span class="_3 blank"> </span>or. Tam<span class="_3 blank"> </span>bié<span class="_3 blank"> </span>n </div><div class="t m0 xa h8 y257 ff6 fs1 fc0 sc0 ls13 ws1e1">estimula la secreción de potasio y de </div><div class="t m0 xa h8 y258 ff6 fs1 fc0 sc0 lsa ws34">protones en el conducto colector. </div><div class="t m0 x1e h8 y259 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y25a ff5 fs1 fc1 sc0 ls46 ws1e2">Estímulos par<span class="_2 blank"></span>a la se<span class="_2 blank"></span>creción de </div><div class="t m0 xa he y25b ff5 fs1 fc1 sc0 ls82 ws1bc">Aldoste<span class="_2 blank"></span>rona<span class="ff9 fc0 ls1b v0">:<span class="ff6 ls7b ws1e3"> (*estímulos más </span></span></div><div class="t m0 xa h8 y25c ff6 fs1 fc0 sc0 lsd ws7">importantes) </div><div class="t m0 x1f h8 y25d ff6 fs1 fc0 sc0 lsd wsbf"> <span class="_28 blank"> </span>Aumento <span class="_3 blank"> </span>de Angiotensina ll* </div><div class="t m0 x1f h8 y25e ff6 fs1 fc0 sc0 ls8 ws1e4"> <span class="_28 blank"> </span>Aumento de la potasemia* </div><div class="t m0 x1f h8 y25f ff6 fs1 fc0 sc0 lsa ws1e5"> Disminución <span class="_29 blank"></span>del <span class="_29 blank"></span>FNA<span class="_3 blank"> </span> </div><div class="t m0 x1f h8 y260 ff6 fs1 fc0 sc0 ls8 ws1e4"> <span class="_28 blank"> </span>Aumento de la ACTH </div><div class="t m0 x1f h8 y261 ff6 fs1 fc0 sc0 ls8 ws1e4"> <span class="_28 blank"> </span>Disminución de la natremia <span class="_2 blank"></span> </div><div class="t m0 x1e h8 y262 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y263 ff5 fs1 fc1 sc0 ls7c ws1e6">Mecanismo de a<span class="_2 blank"></span>cción<span class="ff9 fc0 ls1b v0">:<span class="ff6 ls13 ws1e7"> al ser una </span></span></div><div class="t m0 xa h8 y264 ff6 fs1 fc0 sc0 ls3 ws1e8">hormona liposoluble, atraviesa la<span class="_3 blank"> </span> membrana </div><div class="t m0 xa h8 y265 ff6 fs1 fc0 sc0 lse wsa0">celular y s<span class="_3 blank"> </span>e una a una p<span class="_3 blank"> </span>roteína receptora en </div><div class="t m0 xa h8 y266 ff6 fs1 fc0 sc0 ls83 ws1e9">el cito<span class="_2 blank"></span>sol; est<span class="_2 blank"></span>e complejo<span class="_2 blank"></span> atravie<span class="_2 blank"></span>sa la </div><div class="t m0 xa h8 y267 ff6 fs1 fc0 sc0 ls7 ws10a">membrana <span class="_3 blank"> </span>nuclear y se un<span class="_3 blank"> </span>e a una proteína a<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y268 ff6 fs1 fc0 sc0 ls13 ws1ea">nivel de los cromosomas para inducir la </div><div class="t m0 xa h8 y269 ff6 fs1 fc0 sc0 ls47 ws1eb">síntesis de RNAm, <span class="_3 blank"> </span>el cual migra al </div><div class="t m0 xa h8 y26a ff6 fs1 fc0 sc0 lsb ws1de">citoplasma do<span class="_3 blank"> </span>nde se produce la s<span class="_3 blank"> </span>íntesis de </div><div class="t m0 xa h8 y26b ff6 fs1 fc0 sc0 lse ws28">una Prote<span class="_3 blank"> </span>ína inducida por la Aldoste<span class="_3 blank"> </span>rona </div><div class="t m0 xa h8 y26c ff6 fs1 fc0 sc0 lsc ws1ec">(AIP). E<span class="_3 blank"> </span>sta proteína aume<span class="_3 blank"> </span>nta la </div><div class="t m0 xa h8 y26d ff6 fs1 fc0 sc0 lsd wsfc">permeabilidad de la membrana lum<span class="_3 blank"> </span>inal para </div><div class="t m0 xa h8 y26e ff6 fs1 fc0 sc0 lsb ws1ed">el sodio (abriendo canales o gene<span class="_3 blank"> </span>rando l<span class="_2 blank"></span>a </div><div class="t m0 xa h8 y26f ff6 fs1 fc0 sc0 ls9 ws55">producción de nue<span class="_3 blank"> </span>vos canales), penetrando </div><div class="t m0 xa h8 y270 ff6 fs1 fc0 sc0 lsf ws24">pasivamente a la célula, estimulando este<span class="_3 blank"> </span> a </div><div class="t m0 xa h8 y271 ff6 fs1 fc0 sc0 ls8 ws1ee">la bomba de<span class="_3 blank"> </span> sodio pota<span class="_3 blank"> </span>sio ATPasa <span class="_3 blank"> </span>en la </div><div class="t m0 xa h8 y272 ff6 fs1 fc0 sc0 ls13 ws1ef">membrana basolate<span class="_3 blank"> </span>ral. Otros <span class="_2 blank"></span>mecanismos<span class="_3 blank"> </span> </div><div class="t m0 xa h8 y273 ff6 fs1 fc0 sc0 lsf ws49">involucrarían una estimulación <span class="_3 blank"> </span>directa de la </div><div class="t m0 xa h8 y274 ff6 fs1 fc0 sc0 ls7 ws1f0">bomba de sodio pot<span class="_3 blank"> </span>asio ATPasa o la </div><div class="t m0 xa h8 y275 ff6 fs1 fc0 sc0 ls7 ws1f1">producción de enzimas mitoco<span class="_3 blank"> </span>ndriales que </div><div class="t m0 xa h8 y276 ff6 fs1 fc0 sc0 ls56 ws1f2">aumenta<span class="_3 blank"> </span>n la producción de A<span class="_3 blank"> </span>TP. Este efe<span class="_3 blank"> </span>cto </div><div class="t m0 xa h8 y277 ff6 fs1 fc0 sc0 ls8 ws1f3">de la Aldosterona no es<span class="_3 blank"> </span> inmediato, sino <span class="_2 blank"></span>que </div><div class="t m0 xa h8 y278 ff6 fs1 fc0 sc0 lsa wsfe">tarda <span class="_3 blank"> </span>un tiempo<span class="_3 blank"> </span> en producirse (1 h<span class="_3 blank"> </span>ora, </div><div class="t m0 xa h8 y279 ff6 fs1 fc0 sc0 ls9 ws1f4">efecto retardado). Recientes est<span class="_3 blank"> </span>udios han </div><div class="t m0 xa h8 y27a ff6 fs1 fc0 sc0 lse ws1f5">identificado la <span class="_3 blank"> </span>proteína G K-Ras2 y la kinasa </div><div class="t m0 xa h8 y27b ff6 fs1 fc0 sc0 ls34 ws1f6">de serina-treonina (sgk) como los primeros </div><div class="t m0 xa h8 y27c ff6 fs1 fc0 sc0 ls7 ws1cc">productos <span class="_3 blank"> </span>del gen indu<span class="_3 blank"> </span>cido por aldosterona </div><div class="t m0 xa h8 y27d ff6 fs1 fc0 sc0 lse ws70">que regulan el transpo<span class="_3 blank"> </span>rte de Na+. Se espera </div><div class="t m0 xa h8 y27e ff6 fs1 fc0 sc0 ls9 ws1f7">que juntas, con otras proteín<span class="_3 blank"> </span>as reguladoras, </div><div class="t m0 xa h8 y27f ff6 fs1 fc0 sc0 lsf ws1f8">estimulen la <span class="_3 blank"> </span>actividad de lo<span class="_3 blank"> </span>s canales de </div><div class="t m0 xa h8 y280 ff6 fs1 fc0 sc0 ls34 ws144">Sodio epiteliale<span class="_3 blank"> </span>s y la Na-K ATPasa<span class="_3 blank"> </span> durante </div><div class="t m0 xa h8 y281 ff6 fs1 fc0 sc0 ls6 ws1f9">la fase <span class="_3 blank"> </span>temprana de la ac<span class="_3 blank"> </span>ción de la </div><div class="t m0 xa h8 y282 ff6 fs1 fc0 sc0 lsb ws12d">Aldosterona (2-3 hs post administración). </div><div class="t m0 x1 h8 y283 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y284 ff6 fs1 fc0 sc0 ls28 ws7"> </div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf7" class="pf w0 h0" data-page-no="7"><div class="pc pc7 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y285 w2 h15" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg7.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">7 </span></div><div class="t m0 x10 h3 y286 ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h3 y287 ff4 fs1 fc1 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y288 ff5 fs1 fc1 sc0 ls8e ws7">ANGIOT<span class="_3 blank"> </span>ENSINA </div><div class="t m0 x1 h8 y289 ff6 fs1 fc0 sc0 ls8d ws1fb">La renin<span class="_2 blank"></span>a es una <span class="_2 blank"></span>enzima pr<span class="_2 blank"></span>oteolít<span class="_2 blank"></span>ica que<span class="_2 blank"></span> se sint<span class="_2 blank"></span>etiza, </div><div class="t m0 x1 h8 y28a ff6 fs1 fc0 sc0 ls8c ws162">almacena<span class="_2 blank"></span> y excr<span class="_2 blank"></span>eta en l<span class="_2 blank"></span>as cél<span class="_2 blank"></span>ulas gr<span class="_2 blank"></span>anular<span class="_2 blank"></span>es del <span class="_2 blank"></span>apar<span class="_2 blank"></span>ato </div><div class="t m0 x1 h8 y28b ff6 fs1 fc0 sc0 ls8f wsc6">yuxtagl<span class="_2 blank"></span>omerul<span class="_2 blank"></span>ar. Su s<span class="_2 blank"></span>ecrec<span class="_2 blank"></span>ión está r<span class="_2 blank"></span>egula<span class="_2 blank"></span>da por: </div><div class="t m0 x1 h16 y28c ffc fs1 fc5 sc0 ls84 ws7">1. <span class="ff6 fc0 ls90 ws30">Dismi<span class="_2 blank"></span>nución del<span class="_2 blank"></span>a pres<span class="_2 blank"></span>ión d<span class="_2 blank"></span>e perfus<span class="_2 blank"></span>ión: d<span class="_2 blank"></span>etect<span class="_2 blank"></span>ada </span></div><div class="t m0 x1 h8 y28d ff6 fs1 fc0 sc0 ls85 ws1fc">por l<span class="_2 blank"></span>a arter<span class="_2 blank"></span>iola af<span class="_2 blank"></span>eren<span class="_2 blank"></span>te (bar<span class="_2 blank"></span>orre<span class="_2 blank"></span>ceptor<span class="_2 blank"></span> de alta <span class="_2 blank"></span>pres<span class="_2 blank"></span>ión). </div><div class="t m0 x1 h16 y28e ffc fs1 fc5 sc0 ls84 ws7">2. <span class="ff6 fc0 ls91 ws4f">Estimu<span class="_2 blank"></span>lación d<span class="_2 blank"></span>e los n<span class="_2 blank"></span>ervio<span class="_2 blank"></span>s si<span class="_2 blank"></span>mpáticos<span class="_2 blank"></span> renal<span class="_2 blank"></span>es </span></div><div class="t m0 x1 h16 y28f ffc fs1 fc5 sc0 ls84 ws7">3. <span class="ff6 fc0 ls92 ws156">Cambi<span class="_2 blank"></span>os en el vol<span class="_2 blank"></span>umen o co<span class="_2 blank"></span>mposi<span class="_2 blank"></span>ción de<span class="_2 blank"></span>l líq<span class="_2 blank"></span>uido </span></div><div class="t m0 x1 h8 y290 ff6 fs1 fc0 sc0 ls93 ws1fd">que ll<span class="_2 blank"></span>ega <span class="_2 blank"></span>a la má<span class="_2 blank"></span>cula d<span class="_2 blank"></span>ensa: l<span class="_2 blank"></span>a lle<span class="_2 blank"></span>gada de<span class="_2 blank"></span> un<span class="_2 blank"></span>a </div><div class="t m0 x1 h8 y291 ff6 fs1 fc0 sc0 ls89 ws1fe">concentr<span class="_2 blank"></span>ación <span class="_2 blank"></span>de ClN<span class="_2 blank"></span>a a la mác<span class="_2 blank"></span>ula <span class="_2 blank"></span>densa <span class="_2 blank"></span>estimul<span class="_2 blank"></span>a la </div><div class="t m0 x1 h8 y292 ff6 fs1 fc0 sc0 ls86 wsdd">produc<span class="_2 blank"></span>ción de<span class="_2 blank"></span> ren<span class="_2 blank"></span>ina por l<span class="_2 blank"></span>a mis<span class="_2 blank"></span>ma. </div><div class="t m0 x1 h8 y293 ff6 fs1 fc0 sc0 ls86 ws1ff">El angi<span class="_2 blank"></span>otensi<span class="_2 blank"></span>nógeno e<span class="_2 blank"></span>s un <span class="_2 blank"></span>péptido <span class="_2 blank"></span>sintet<span class="_2 blank"></span>izado <span class="_2 blank"></span>en<span class="_2 blank"></span> el </div><div class="t m0 x1 h8 y294 ff6 fs1 fc0 sc0 ls87 ws200">hígado, es<span class="_2 blank"></span>te es hidr<span class="_2 blank"></span>oli<span class="_2 blank"></span>zado por l<span class="_2 blank"></span>a r<span class="_2 blank"></span>enina <span class="_2 blank"></span>para<span class="_2 blank"></span> pro<span class="_2 blank"></span>ducir </div><div class="t m0 x1 h8 y295 ff6 fs1 fc0 sc0 ls87 ws201">angioten<span class="_2 blank"></span>sina I, que pos<span class="_2 blank"></span>teri<span class="_2 blank"></span>ormente<span class="_2 blank"></span> se degrada<span class="_2 blank"></span> par<span class="_2 blank"></span>a </div><div class="t m0 x1 h8 y296 ff6 fs1 fc0 sc0 ls88 ws174">produc<span class="_2 blank"></span>ir un oc<span class="_2 blank"></span>tapéptid<span class="_2 blank"></span>o denominad<span class="_2 blank"></span>o angio<span class="_2 blank"></span>tensina II <span class="_2 blank"></span>por </div><div class="t m0 x1 h8 y297 ff6 fs1 fc0 sc0 ls88 ws202">una enz<span class="_2 blank"></span>ima de <span class="_2 blank"></span>conver<span class="_2 blank"></span>sión <span class="_2 blank"></span>(ECA)<span class="_2 blank"></span> que se<span class="_2 blank"></span> encuentr<span class="_2 blank"></span>a en el </div><div class="t m0 x1 h8 y298 ff6 fs1 fc0 sc0 ls88 wsdd">endoteli<span class="_2 blank"></span>o vasc<span class="_2 blank"></span>ular<span class="_2 blank"></span> (pulmo<span class="_2 blank"></span>nar <span class="_2 blank"></span>y ren<span class="_2 blank"></span>al prin<span class="_2 blank"></span>cipal<span class="_2 blank"></span>mente)<span class="_2 blank"></span>. </div><div class="t m0 x1 h8 y299 ff6 fs1 fc0 sc0 ls88 ws203">La angiotensi<span class="_2 blank"></span>na disminu<span class="_2 blank"></span>ye la excre<span class="_2 blank"></span>ción del so<span class="_2 blank"></span>dio por </div><div class="t m0 x1 h8 y29a ff6 fs1 fc0 sc0 ls89 ws29">medio d<span class="_2 blank"></span>e difer<span class="_2 blank"></span>entes acci<span class="_2 blank"></span>ones: </div><div class="t m0 xa h17 y29b ffc fs6 fc6 sc0 ls8a ws7">1. </div><div class="t m0 x19 h8 y29c ff6 fs1 fc0 sc0 ls86 ws164">Estimula<span class="_2 blank"></span>ción de l<span class="_2 blank"></span>a produc<span class="_2 blank"></span>ción de<span class="_2 blank"></span> Aldos<span class="_2 blank"></span>terona <span class="_2 blank"></span>a </div><div class="t m0 x19 h8 y29d ff6 fs1 fc0 sc0 ls86 ws92">nivel <span class="_2 blank"></span>dela co<span class="_2 blank"></span>rtez<span class="_2 blank"></span>a suprar<span class="_2 blank"></span>rena<span class="_2 blank"></span>l. </div><div class="t m0 xa h17 y29e ffc fs6 fc6 sc0 ls8a ws7">2. </div><div class="t m0 x19 h8 y29f ff6 fs1 fc0 sc0 ls8b ws204">Vasoconstricción de la AEF. </div><div class="t m0 xa h17 y2a0 ffc fs6 fc6 sc0 ls8a ws7">3. </div><div class="t m0 x19 h8 y2a1 ff6 fs1 fc0 sc0 ls8d ws1c2">Estimula<span class="_2 blank"></span>ción d<span class="_2 blank"></span>e la se<span class="_2 blank"></span>creció<span class="_2 blank"></span>n de ADH y<span class="_2 blank"></span> de la<span class="_2 blank"></span> sed </div><div class="t m0 xa h17 y2a2 ffc fs6 fc6 sc0 ls8a ws7">4. </div><div class="t m0 x19 h8 y2a3 ff6 fs1 fc0 sc0 ls88 ws205">Aumento de l<span class="_2 blank"></span>a reabs<span class="_2 blank"></span>orci<span class="_2 blank"></span>ón de <span class="_2 blank"></span>ClNa <span class="_2 blank"></span>por <span class="_2 blank"></span>el <span class="_2 blank"></span>túbulo </div><div class="t m0 x19 h8 y2a4 ff6 fs1 fc0 sc0 ls94 ws7e">proxi<span class="_2 blank"></span>mal y de a<span class="_2 blank"></span>gua por<span class="_2 blank"></span> el túbul<span class="_2 blank"></span>o distal.<span class="_2 blank"></span> </div><div class="t m0 xa h8 y2a5 ff6 fs1 fc0 sc0 ls95 ws206">Además de l<span class="_2 blank"></span>a Angiote<span class="_2 blank"></span>nsina II s<span class="_2 blank"></span>istémic<span class="_2 blank"></span>a, el tú<span class="_2 blank"></span>bulo </div><div class="t m0 xa h8 y2a6 ff6 fs1 fc0 sc0 ls8c ws207">prox<span class="_2 blank"></span>imal cuenta <span class="_2 blank"></span> con un<span class="_2 blank"></span> sist<span class="_2 blank"></span>ema reni<span class="_2 blank"></span>na an<span class="_2 blank"></span>giotensi<span class="_2 blank"></span>na </div><div class="t m0 xa h8 y2a7 ff6 fs1 fc0 sc0 ls88 ws208">propi<span class="_2 blank"></span>o que regul<span class="_2 blank"></span>a la re<span class="_2 blank"></span>absorc<span class="_2 blank"></span>ión de <span class="_2 blank"></span>sodio<span class="_2 blank"></span>, la </div><div class="t m0 xa h8 y2a8 ff6 fs1 fc0 sc0 ls8c ws209">angioten<span class="_2 blank"></span>sina I<span class="_2 blank"></span>I intr<span class="_2 blank"></span>alumin<span class="_2 blank"></span>al puede<span class="_2 blank"></span> alcanz<span class="_2 blank"></span>ar </div><div class="t m0 xa h8 y2a9 ff6 fs1 fc0 sc0 ls88 ws34">concentr<span class="_2 blank"></span>aci<span class="_2 blank"></span>ones 100 veces<span class="_2 blank"></span> más alta<span class="_2 blank"></span>s que en <span class="_2 blank"></span>el plas<span class="_2 blank"></span>ma y </div><div class="t m0 xa h8 y2aa ff6 fs1 fc0 sc0 ls8c ws20a">su activ<span class="_2 blank"></span>idad es i<span class="_2 blank"></span>ndependi<span class="_2 blank"></span>ente de l<span class="_2 blank"></span>a angi<span class="_2 blank"></span>otensi<span class="_2 blank"></span>na </div><div class="t m0 xa h8 y2ab ff6 fs1 fc0 sc0 ls88 ws34">sistém<span class="_2 blank"></span>ica cir<span class="_2 blank"></span>cul<span class="_2 blank"></span>ante; a <span class="_2 blank"></span>su vez s<span class="_2 blank"></span>e pudo co<span class="_2 blank"></span>mproba<span class="_2 blank"></span>r que l<span class="_2 blank"></span>os </div><div class="t m0 xa h8 y2ac ff6 fs1 fc0 sc0 ls8c ws20b">nerv<span class="_2 blank"></span>ios simpátic<span class="_2 blank"></span>os re<span class="_2 blank"></span>nales j<span class="_2 blank"></span>uegan un<span class="_2 blank"></span> rol e<span class="_2 blank"></span>n la </div><div class="t m0 xa h8 y2ad ff6 fs1 fc0 sc0 ls96 ws20c">modulac<span class="_2 blank"></span>ión en la pr<span class="_2 blank"></span>oducc<span class="_2 blank"></span>ión i<span class="_2 blank"></span>ntralumi<span class="_2 blank"></span>nal de </div><div class="t m0 xa h8 y2ae ff6 fs1 fc0 sc0 ls89 ws29">angioten<span class="_2 blank"></span>sina II<span class="_2 blank"></span> a nivel<span class="_2 blank"></span> del túbul<span class="_2 blank"></span>o pro<span class="_2 blank"></span>ximal. <span class="_2 blank"></span> </div><div class="t m0 xa h8 y2af ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x20 h3 y2b0 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h3 y2b1 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h3 y2b2 ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y2b3 ff6 fs1 fc0 sc0 ls97 ws68">Tambié<span class="_2 blank"></span>n se ha a<span class="_2 blank"></span>cumula<span class="_2 blank"></span>do evidenc<span class="_2 blank"></span>ia s<span class="_2 blank"></span>obre l<span class="_2 blank"></span>as funci<span class="_2 blank"></span>ones </div><div class="t m0 x1 h18 y2b4 ff6 fs1 fc0 sc0 ls8d ws1c2">del r<span class="_2 blank"></span>eceptor<span class="_2 blank"></span> de Angi<span class="_2 blank"></span>otensi<span class="_2 blank"></span>na AT<span class="fs4 ls28 ws1fa v3">2</span><span class="ls95 ws20d v0"> en los últ<span class="_2 blank"></span>imos años<span class="_2 blank"></span> y <span class="_2a blank"> </span><span class="ls8d ws1c2 v8">finalm<span class="_2 blank"></span>ente se v<span class="_2 blank"></span>io que<span class="_2 blank"></span> es res<span class="_2 blank"></span>ponsable<span class="_2 blank"></span> de vas<span class="_2 blank"></span>odilat<span class="_2 blank"></span>ación y </span></span></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf8" class="pf w0 h0" data-page-no="8"><div class="pc pc8 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y2b5 w2 h19" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg8.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">8 </span></div><div class="t m0 x1 h8 y85 ff6 fs1 fc0 sc0 ls95 ws20d">natri<span class="_2 blank"></span>uresi<span class="_2 blank"></span>s, lo que e<span class="_2 blank"></span>s totalmen<span class="_2 blank"></span>te opuesto<span class="_2 blank"></span> a las func<span class="_2 blank"></span>iones <span class="_2b blank"> </span>del r<span class="_2 blank"></span>eceptor<span class="_2 blank"></span> de AT<span class="fs4 ls98 v3">1</span><span class="lsa1 ws7 v0">. </span></div><div class="t m0 x1 h3 y2b6 ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x21 h3 y2b7 ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h1a y2b8 ff3 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h1a y2b9 ff3 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h1a y2ba ff3 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y2bb ff5 fs1 fc1 sc0 lsa2 ws20e">NE<span class="_2 blank"></span>RV<span class="_2 blank"></span>IOS<span class="_2 blank"></span> S<span class="_2 blank"></span>IMPÁ<span class="_2 blank"></span>TIC<span class="_2 blank"></span>O<span class="_2 blank"></span>S R<span class="_2 blank"></span>EN<span class="_2 blank"></span>A<span class="_2 blank"></span>LE<span class="_2 blank"></span>S </div><div class="t m0 x1 h8 y2bc ff6 fs1 fc0 sc0 ls89 ws20f">Las fibr<span class="_2 blank"></span>as si<span class="_2 blank"></span>mpátic<span class="_2 blank"></span>as iner<span class="_2 blank"></span>van las<span class="_2 blank"></span> arte<span class="_2 blank"></span>riol<span class="_2 blank"></span>as af<span class="_2 blank"></span>erentes <span class="_2 blank"></span>y </div><div class="t m0 x1 h8 y2bd ff6 fs1 fc0 sc0 ls96 ws210">eferen<span class="_2 blank"></span>tes, cé<span class="_2 blank"></span>lulas de<span class="_2 blank"></span>l glom<span class="_2 blank"></span>érulo<span class="_2 blank"></span> y <span class="_2 blank"></span>del <span class="_2 blank"></span>túbulo<span class="_2 blank"></span> pro<span class="_2 blank"></span>ximal. <span class="_7 blank"></span> </div><div class="t m0 x1 h8 y2be ff6 fs1 fc0 sc0 ls89 ws211">Este sistema<span class="_2 blank"></span> se activa por<span class="_2 blank"></span> acción d<span class="_2 blank"></span>e los <span class="_2 blank"></span>baror<span class="_2 blank"></span>recepto<span class="_2 blank"></span>res </div><div class="t m0 x1 h8 y2bf ff6 fs1 fc0 sc0 ls8f wsc6">de alta y <span class="_2 blank"></span>de baja pr<span class="_2 blank"></span>esión<span class="_2 blank"></span>, pro<span class="_2 blank"></span>vocando: </div><div class="t m0 x1 h17 y2c0 ffc fs6 fc6 sc0 ls8a ws7">1. </div><div class="t m0 x1c h8 y2c1 ff6 fs1 fc0 sc0 ls89 ws212">Vasocons<span class="_2 blank"></span>tricci<span class="_2 blank"></span>ón de las <span class="_2 blank"></span>art<span class="_2 blank"></span>eriolas<span class="_2 blank"></span> afer<span class="_2 blank"></span>entes <span class="_2 blank"></span>y </div><div class="t m0 x1c h8 y2c2 ff6 fs1 fc0 sc0 ls99 ws7">eferen<span class="_2 blank"></span>tes </div><div class="t m0 x1 h17 y2c3 ffc fs6 fc6 sc0 ls9a ws7">2. </div><div class="t m0 x1c h8 y2c4 ff6 fs1 fc0 sc0 ls96 ws33">Estimu<span class="_2 blank"></span>la la sec<span class="_2 blank"></span>reci<span class="_2 blank"></span>ón de r<span class="_2 blank"></span>enin<span class="_2 blank"></span>a </div><div class="t m0 x1 h17 y2c5 ffc fs6 fc6 sc0 ls8a ws7">3. </div><div class="t m0 x1c h8 y2c6 ff6 fs1 fc0 sc0 ls93 ws1c1">Estimu<span class="_2 blank"></span>la dir<span class="_2 blank"></span>ectament<span class="_2 blank"></span>e la r<span class="_2 blank"></span>eabsor<span class="_2 blank"></span>ció<span class="_2 blank"></span>n de C<span class="_2 blank"></span>lNa <span class="_2 blank"></span>en el </div><div class="t m0 x1c h8 y2c7 ff6 fs1 fc0 sc0 lsa3 ws59">túbulo pr<span class="_2 blank"></span>oximal. </div><div class="t m0 x1 h17 y2c8 ffc fs6 fc6 sc0 ls8a ws7">4. </div><div class="t m0 x1c h8 y2c9 ff6 fs1 fc0 sc0 ls8c ws213">Modulan<span class="_2 blank"></span> el efec<span class="_2 blank"></span>to de <span class="_2 blank"></span>Angi<span class="_2 blank"></span>otensina <span class="_2 blank"></span>II <span class="_2 blank"></span>intr<span class="_2 blank"></span>aluminal<span class="_2 blank"></span> </div><div class="t m0 x1c h8 y2ca ff6 fs1 fc0 sc0 ls85 ws1fc">genera<span class="_2 blank"></span>da en túbul<span class="_2 blank"></span>o prox<span class="_2 blank"></span>imal </div><div class="t m0 x1 h8 y2cb ff6 fs1 fc0 sc0 ls88 ws214">El aumento de<span class="_2 blank"></span> la activid<span class="_2 blank"></span>ad simpá<span class="_2 blank"></span>tica r<span class="_2 blank"></span>enal dis<span class="_2 blank"></span>minuye la<span class="_2 blank"></span> </div><div class="t m0 x1 h8 y2cc ff6 fs1 fc0 sc0 ls8c ws213">excr<span class="_2 blank"></span>eción ren<span class="_2 blank"></span>al de C<span class="_2 blank"></span>lNa, e<span class="_2 blank"></span>n respue<span class="_2 blank"></span>sta de a<span class="_2 blank"></span>daptac<span class="_2 blank"></span>ión </div><div class="t m0 x1 h8 y2cd ff6 fs1 fc0 sc0 ls9b ws65">para r<span class="_2 blank"></span>eestablecer<span class="_2 blank"></span> la volemia. <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> <span class="_2 blank"></span> </div><div class="t m0 x1 h8 y2ce ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h1b y2cf ff8 fs6 fc1 sc0 ls9c ws215">FACTORES HUMORALES NATRIURÉTICOS </div><div class="t m0 x1 h8 y2d0 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y2d1 ff5 fs1 fc1 sc0 lsa4 ws216">HORMONAS NA<span class="_3 blank"> </span>TRIURÉTICAS<span class="_3 blank"> </span> </div><div class="t m0 x1 h7 y2d2 ff5 fs1 fc1 sc0 lsa5 ws217">CARDIACAS<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y2d3 ff6 fs1 fc0 sc0 ls89 ws218">Son de naturale<span class="_2 blank"></span>za peptídic<span class="_2 blank"></span>a y se si<span class="_2 blank"></span>ntetiza<span class="_2 blank"></span>n y secre<span class="_2 blank"></span>tan </div><div class="t m0 x1 h8 y2d4 ff6 fs1 fc0 sc0 ls89 ws219">por l<span class="_2 blank"></span>os car<span class="_2 blank"></span>diomioci<span class="_2 blank"></span>tos en r<span class="_2 blank"></span>espuesta<span class="_2 blank"></span> al aumento<span class="_2 blank"></span> de la </div><div class="t m0 x1 h8 y2d5 ff6 fs1 fc0 sc0 lsa6 ws21a">volemia.<span class="_3 blank"> </span> Son mie<span class="_3 blank"> </span>mbros de u<span class="_3 blank"> </span>na familia, a<span class="_3 blank"> </span>ún en </div><div class="t m0 x1 h8 y2d6 ff6 fs1 fc0 sc0 ls8c ws21b">cre<span class="_2 blank"></span>cimient<span class="_2 blank"></span>o, denominados<span class="_2 blank"></span> Péptid<span class="_2 blank"></span>os Natr<span class="_2 blank"></span>iuré<span class="_2 blank"></span>ticos. <span class="_2 blank"></span>Ellas </div><div class="t m0 x1 h8 y2d7 ff6 fs1 fc0 sc0 lsa7 ws7">son: </div><div class="t m0 x1 h8 y2d8 ff6 fs1 fc0 sc0 ls9d ws7"> <span class="lsa8 ws57 v2"> <span class="_2c blank"> </span>Péptido na<span class="_2 blank"></span>triur<span class="_2 blank"></span>ético atr<span class="_2 blank"></span>ial (<span class="_2 blank"></span>ANP), </span></div><div class="t m0 x22 h8 y2d9 ff6 fs1 fc0 sc0 lsa0 ws21c"> <span class="_2c blank"> </span>Péptido n<span class="_2 blank"></span>atriur<span class="_2 blank"></span>ético de l<span class="_2 blank"></span>arga a<span class="_2 blank"></span>ctividad<span class="_2 blank"></span>, </div><div class="t m0 x22 h8 y2da ff6 fs1 fc0 sc0 ls8f ws21d"> Péptido <span class="_2d blank"></span>vasodi<span class="_2 blank"></span>latador, <span class="_2d blank"></span> </div><div class="t m0 x22 h8 y2db ff6 fs1 fc0 sc0 lsa9 ws66"> <span class="_2c blank"> </span>Péptido kal<span class="_2 blank"></span>iuréti<span class="_2 blank"></span>co, </div><div class="t m0 x22 h8 y2dc ff6 fs1 fc0 sc0 lsaa ws66"> <span class="_2c blank"> </span>Péptido na<span class="_2 blank"></span>triur<span class="_2 blank"></span>ético cer<span class="_2 blank"></span>ebral<span class="_2 blank"></span> (BNP), <span class="_2 blank"></span> </div><div class="t m0 x1 h8 y2dd ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y2de ff6 fs1 fc0 sc0 ls87 ws21e">Además de estos pé<span class="_2 blank"></span>ptidos <span class="_2 blank"></span>de ori<span class="_2 blank"></span>gen card<span class="_2 blank"></span>iaco e<span class="_2 blank"></span>xisten </div><div class="t m0 x1 h8 y2df ff6 fs1 fc0 sc0 ls9e ws21f">otros estructu<span class="_2 blank"></span>ralmente relacio<span class="_2 blank"></span>nados con la familia </div><div class="t m0 x1 h8 y2e0 ff6 fs1 fc0 sc0 lsab ws220">AN<span class="_2 blank"></span>P/<span class="_2 blank"></span>BNP<span class="_2 blank"></span>, e<span class="_2 blank"></span>ll<span class="_2 blank"></span>os<span class="_2 blank"></span> s<span class="_2 blank"></span>on:<span class="_2 blank"></span> </div><div class="t m0 x22 h8 y2e1 ff6 fs1 fc0 sc0 ls8f ws221"> <span class="_2e blank"> </span>CNP (péptid<span class="_2 blank"></span>o natriur<span class="_2 blank"></span>ético tipo C<span class="_2 blank"></span>) que no posee </div><div class="t m0 x1 h8 y2e2 ff6 fs1 fc0 sc0 ls9f ws7">efectos natri<span class="_2 blank"></span>uréticos<span class="_2 blank"></span>. </div><div class="t m0 x1f h8 y2e3 ff6 fs1 fc0 sc0 ls87 ws222"> <span class="_2f blank"> </span>Uro<span class="_2 blank"></span>dilatina:<span class="_2 blank"></span> es idéntic<span class="_2 blank"></span>a al ANP, sa<span class="_2 blank"></span>lvo po<span class="_2 blank"></span>r posee<span class="_2 blank"></span>r 4<span class="_2 blank"></span> </div><div class="t m0 xa h8 y2e4 ff6 fs1 fc0 sc0 ls8f ws223">Aa más en su extr<span class="_2 blank"></span>emo N<span class="_2 blank"></span>t. Es si<span class="_2 blank"></span>ntetizada <span class="_2 blank"></span>por l<span class="_2 blank"></span>as cél<span class="_2 blank"></span>ulas </div><div class="t m0 xa h8 y2e5 ff6 fs1 fc0 sc0 ls8d ws224">del túb<span class="_2 blank"></span>ulo d<span class="_2 blank"></span>istal d<span class="_2 blank"></span>e la ne<span class="_2 blank"></span>frona y<span class="_2 blank"></span> secr<span class="_2 blank"></span>etada a<span class="_2 blank"></span> su <span class="_2 blank"></span>luz <span class="_2 blank"></span>en <span class="_2 blank"></span>la </div><div class="t m0 xa h8 y2e6 ff6 fs1 fc0 sc0 ls8c ws225">orin<span class="_2 blank"></span>a. Actúa a ni<span class="_2 blank"></span>vel <span class="_2 blank"></span>local <span class="_2 blank"></span>y tiene i<span class="_2 blank"></span>dénticas<span class="_2 blank"></span> acci<span class="_2 blank"></span>ones a<span class="_2 blank"></span> las </div><div class="t m0 xa h8 y2e7 ff6 fs1 fc0 sc0 lsac ws226">del ANP a nivel re<span class="_2 blank"></span>nal. </div><div class="t m0 x1f h8 y2e8 ff6 fs1 fc0 sc0 ls8d ws227"> DNP (dendr<span class="_2 blank"></span>oaspi<span class="_2 blank"></span>s natri<span class="_2 blank"></span>uretic<span class="_2 blank"></span> pepti<span class="_2 blank"></span>de): e<span class="_2 blank"></span>s un </div><div class="t m0 xa h8 y2e9 ff6 fs1 fc0 sc0 lsad ws228">miem<span class="_3 blank"> </span>bro de<span class="_3 blank"> </span> la fa<span class="_3 blank"> </span>milia re<span class="_3 blank"> </span>cienteme<span class="_3 blank"> </span>nte d<span class="_3 blank"> </span>escrito, e<span class="_3 blank"> </span>stá </div><div class="t m0 xa h8 y2ea ff6 fs1 fc0 sc0 ls97 ws229">pres<span class="_2 blank"></span>ente en el <span class="_3 blank"> </span>pla<span class="_2 blank"></span>sma humano<span class="_2 blank"></span> y en miocardi<span class="_2 blank"></span>o auric<span class="_2 blank"></span>ular<span class="_2 blank"></span>, </div><div class="t m0 xa h8 y2eb ff6 fs1 fc0 sc0 ls8f wsc6">y su conc<span class="_2 blank"></span>entra<span class="_2 blank"></span>ción se<span class="_2 blank"></span> aumenta en p<span class="_2 blank"></span>acientes<span class="_2 blank"></span> con ICC<span class="_2 blank"></span>. </div><div class="t m0 xa h8 y2ec ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y2ed ff6 fs1 fc0 sc0 ls87 ws22a">Poseen algu<span class="_2 blank"></span>nas o toda<span class="_2 blank"></span>s estas a<span class="_2 blank"></span>ccione<span class="_2 blank"></span>s en los </div><div class="t m0 xa h8 y2ee ff6 fs1 fc0 sc0 ls84 ws22b">mamíferos: <span class="_2 blank"></span> </div><div class="t m0 xa h8 y2ef ff6 fs1 fc0 sc0 ls9f ws7"> </div><div class="t m0 xa h9 y2f0 ff8 fs1 fc1 sc0 ls89 ws29">A nivel <span class="_2 blank"></span>vascular:<span class="_2 blank"></span> </div><div class="t m0 x1f h8 y2f1 ff6 fs1 fc0 sc0 lsa0 ws21c"> <span class="_30 blank"> </span> R<span class="_2 blank"></span>elajan <span class="_3 blank"> </span>o <span class="_3 blank"> </span>disminuyen <span class="_3 blank"> </span>la <span class="_3 blank"> </span>vasoconstr<span class="_2 blank"></span>icció<span class="_2 blank"></span>n <span class="_3 blank"> </span>del </div><div class="t m0 x19 h8 y2f2 ff6 fs1 fc0 sc0 ls93 ws22c">múscul<span class="_2 blank"></span>o liso<span class="_2 blank"></span>, tanto las de or<span class="_2 blank"></span>igen <span class="_2 blank"></span>hormona<span class="_2 blank"></span>l como l<span class="_2 blank"></span>as </div><div class="t m0 x19 h8 y2f3 ff6 fs1 fc0 sc0 ls89 ws29">debidas a<span class="_2 blank"></span>l si<span class="_2 blank"></span>stema ner<span class="_2 blank"></span>vioso.<span class="_2 blank"></span> </div><div class="t m0 x1f h8 y2f4 ff6 fs1 fc0 sc0 ls95 ws20d"> <span class="_30 blank"> </span> <span class="_1c blank"> </span>Aumentan <span class="_1c blank"> </span>la <span class="_1c blank"> </span>permeabil<span class="_2 blank"></span>idad <span class="_1c blank"> </span>capil<span class="_2 blank"></span>ar, <span class="_1c blank"> </span>y <span class="_1c blank"> </span>por <span class="_1c blank"> </span>lo </div><div class="t m0 x19 h8 y2f5 ff6 fs1 fc0 sc0 ls85 ws22d">tanto prov<span class="_2 blank"></span>ocan el paso de fl<span class="_2 blank"></span>uido intra<span class="_2 blank"></span>vascul<span class="_2 blank"></span>ar al </div><div class="t m0 x19 h8 y2f6 ff6 fs1 fc0 sc0 ls87 ws22e">espaci<span class="_2 blank"></span>o intersti<span class="_2 blank"></span>cial en r<span class="_2 blank"></span>espues<span class="_2 blank"></span>ta al aumen<span class="_2 blank"></span>to de </div><div class="t m0 x19 h8 y2f7 ff6 fs1 fc0 sc0 ls96 ws22f">pres<span class="_2 blank"></span>ión hidr<span class="_2 blank"></span>ostáti<span class="_2 blank"></span>ca de l<span class="_2 blank"></span>a sangr<span class="_2 blank"></span>e en <span class="_2 blank"></span>los <span class="_2 blank"></span>capi<span class="_2 blank"></span>lares.<span class="_2 blank"></span> </div><div class="t m0 x19 h8 y2f8 ff6 fs1 fc0 sc0 ls87 ws230">Son edematóg<span class="_2 blank"></span>enos. </div><div class="t m0 xa h8 y2f9 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h9 y2fa ff8 fs1 fc1 sc0 lsa7 ws231">A nivel renal: </div><div class="t m0 x1f h8 y2fb ff6 fs1 fc0 sc0 ls87 ws230"> <span class="_30 blank"> </span>Aumento de l<span class="_2 blank"></span>a natr<span class="_2 blank"></span>iures<span class="_2 blank"></span>is, di<span class="_2 blank"></span>ures<span class="_2 blank"></span>is y de l<span class="_2 blank"></span>a filtr<span class="_2 blank"></span>ación </div><div class="t m0 x19 h8 y2fc ff6 fs1 fc0 sc0 ls87 ws230">glomeru<span class="_2 blank"></span>lar (<span class="_2 blank"></span>hiper<span class="_2 blank"></span>filt<span class="_2 blank"></span>ració<span class="_2 blank"></span>n). </div><div class="t m0 x19 h8 y2fd ff6 fs1 fc0 sc0 ls86 wsdd">Inhiben <span class="_2 blank"></span>la sec<span class="_2 blank"></span>reci<span class="_2 blank"></span>ón de Ren<span class="_2 blank"></span>ina por<span class="_2 blank"></span> las<span class="_2 blank"></span> células </div><div class="t m0 x19 h8 y2fe ff6 fs1 fc0 sc0 ls8d ws1c2">yuxtagl<span class="_2 blank"></span>omeru<span class="_2 blank"></span>lares<span class="_2 blank"></span>, además<span class="_2 blank"></span> de antago<span class="_2 blank"></span>nizar <span class="_2 blank"></span>todos </div><div class="t m0 x19 h8 y2ff ff6 fs1 fc0 sc0 ls87 ws230">los ef<span class="_2 blank"></span>ectos con<span class="_2 blank"></span>ocido<span class="_2 blank"></span>s que pos<span class="_2 blank"></span>ee la Angi<span class="_2 blank"></span>otensina I<span class="_2 blank"></span>I. </div><div class="t m0 x1f h8 y300 ff6 fs1 fc0 sc0 ls85 ws1fc"> <span class="_30 blank"> </span>Inhiben <span class="_2 blank"></span>los efe<span class="_2 blank"></span>ctos de l<span class="_2 blank"></span>a ADH </div><div class="t m0 x1f h8 y301 ff6 fs1 fc0 sc0 lsa0 ws21c"> <span class="_30 blank"> </span>Antagoniza<span class="_2 blank"></span> los efec<span class="_2 blank"></span>tos de la a<span class="_2 blank"></span>ngiotensi<span class="_2 blank"></span>na II </div><div class="t m0 x1f h8 y302 ff6 fs1 fc0 sc0 ls94 ws232"> <span class="_7 blank"></span>Aumenta <span class="_3 blank"> </span>el fluj<span class="_2 blank"></span>o sanguíneo<span class="_2 blank"></span> medular (<span class="_2 blank"></span>redu<span class="_2 blank"></span>ce la </div><div class="t m0 x19 h8 y303 ff6 fs1 fc0 sc0 ls90 ws233">hiper<span class="_2 blank"></span>tonic<span class="_2 blank"></span>idad de la misma<span class="_2 blank"></span>) </div><div class="t m0 x1f h8 y304 ff6 fs1 fc0 sc0 ls88 ws1ff"> <span class="_31 blank"> </span>Contr<span class="_2 blank"></span>ibuye<span class="_2 blank"></span> al e<span class="_2 blank"></span>scape de<span class="_2 blank"></span>l so<span class="_2 blank"></span>dio <span class="_2 blank"></span> a<span class="_2 blank"></span>l d<span class="_2 blank"></span>isminuir<span class="_2 blank"></span> <span class="_2 blank"></span>la </div><div class="t m0 x19 h8 y305 ff6 fs1 fc0 sc0 ls88 ws92">res<span class="_2 blank"></span>puesta de<span class="_2 blank"></span> retr<span class="_2 blank"></span>oalimenta<span class="_2 blank"></span>ción tu<span class="_2 blank"></span>buloglo<span class="_2 blank"></span>mer<span class="_2 blank"></span>ular.<span class="_2 blank"></span> </div><div class="t m0 xa h8 y306 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y307 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y308 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y309 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y30a ff6 fs1 fc0 sc0 ls28 ws7"> </div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pf9" class="pf w0 h0" data-page-no="9"><div class="pc pc9 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y30b w3 h1c" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bg9.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_2 blank"></span> <span class="ff3 ls2c ws0">CHALLIOL <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>il<span class="_3 blank"> </span>a </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 ls0 ws7"> <span class="ff1 ls2d v1">9 </span></div><div class="t m0 x1 h9 y85 ff8 fs1 fc1 sc0 lsa8 ws57">A nivel de <span class="_2 blank"></span>la glándula suprarrenal: </div><div class="t m0 x22 h8 y30c ff6 fs1 fc0 sc0 ls8d ws236"> <span class="_26 blank"> </span>Inhiben l<span class="_2 blank"></span>a síntesi<span class="_2 blank"></span>s de Ald<span class="_2 blank"></span>oster<span class="_2 blank"></span>ona en la <span class="_2 blank"></span>zona </div><div class="t m0 x1c h8 y30d ff6 fs1 fc0 sc0 ls87 ws7">glomeru<span class="_2 blank"></span>losa. </div><div class="t m0 x1c h8 y30e ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y30f ff6 fs1 fc0 sc0 ls87 ws22a">En cuanto a<span class="_2 blank"></span>l modo de a<span class="_2 blank"></span>cción <span class="_2 blank"></span>de l<span class="_2 blank"></span>os pép<span class="_2 blank"></span>tidos </div><div class="t m0 x1 h8 y310 ff6 fs1 fc0 sc0 ls94 ws237">natri<span class="_2 blank"></span>urétic<span class="_2 blank"></span>os activo<span class="_2 blank"></span>s card<span class="_2 blank"></span>iacos (<span class="_2 blank"></span>horm<span class="_2 blank"></span>onas ANP y BNP)<span class="_2 blank"></span>, </div><div class="t m0 x1 h8 y311 ff6 fs1 fc0 sc0 ls87 ws238">éstos s<span class="_2 blank"></span>e unen <span class="_2 blank"></span>a rec<span class="_2 blank"></span>eptor<span class="_2 blank"></span>es NPR-<span class="_2 blank"></span>A que <span class="_2 blank"></span>provoc<span class="_2 blank"></span>an el<span class="_2 blank"></span> </div><div class="t m0 x1 h8 y312 ff6 fs1 fc0 sc0 ls91 ws4d">aument<span class="_2 blank"></span>o de cGMP intr<span class="_2 blank"></span>acitop<span class="_2 blank"></span>lasmát<span class="_2 blank"></span>ico en las<span class="_2 blank"></span> cél<span class="_2 blank"></span>ulas </div><div class="t m0 x1 h8 y313 ff6 fs1 fc0 sc0 ls88 ws1ff">efector<span class="_2 blank"></span>as como 2º<span class="_2 blank"></span> mens<span class="_2 blank"></span>ajero<span class="_2 blank"></span>, que media tod<span class="_2 blank"></span>os sus<span class="_2 blank"></span> </div><div class="t m0 x1 h8 y314 ff6 fs1 fc0 sc0 ls94 ws239">efectos. En un estu<span class="_2 blank"></span>dio ameri<span class="_2 blank"></span>cano se<span class="_2 blank"></span> encontró<span class="_2 blank"></span> que la </div><div class="t m0 x1 h8 y315 ff6 fs1 fc0 sc0 ls91 wsd3">unión d<span class="_2 blank"></span>e ANF a s<span class="_2 blank"></span>u r<span class="_2 blank"></span>eceptor<span class="_2 blank"></span> <span class="_2 blank"></span>requi<span class="_2 blank"></span>ere <span class="_2 blank"></span>la pr<span class="_2 blank"></span>esenci<span class="_2 blank"></span>a <span class="_2 blank"></span>de </div><div class="t m0 x1 h8 y316 ff6 fs1 fc0 sc0 ls88 ws23a">clor<span class="_2 blank"></span>uro y ocur<span class="_2 blank"></span>re de maner<span class="_2 blank"></span>a dependie<span class="_2 blank"></span>nte de la </div><div class="t m0 x1 h8 y317 ff6 fs1 fc0 sc0 ls87 ws21e">concentr<span class="_2 blank"></span>ación de c<span class="_2 blank"></span>lor<span class="_2 blank"></span>uro. Lo<span class="_2 blank"></span>s recep<span class="_2 blank"></span>tores<span class="_2 blank"></span> ANF clor<span class="_2 blank"></span>uro-</div><div class="t m0 x1 h8 y318 ff6 fs1 fc0 sc0 ls96 ws23b">dependi<span class="_2 blank"></span>entes pu<span class="_2 blank"></span>eden f<span class="_2 blank"></span>uncion<span class="_2 blank"></span>ar como<span class="_2 blank"></span> un <span class="_2 blank"></span>mecan<span class="_2 blank"></span>ismo <span class="_2 blank"></span>de </div><div class="t m0 x1 h8 y319 ff6 fs1 fc0 sc0 ls8d ws23c">feedbac<span class="_2 blank"></span>k que r<span class="_2 blank"></span>egula<span class="_2 blank"></span> la acc<span class="_2 blank"></span>ión del <span class="_2 blank"></span>ANF y <span class="_2 blank"></span>de la<span class="_2 blank"></span> excr<span class="_2 blank"></span>eci<span class="_2 blank"></span>ón </div><div class="t m0 x1 h8 y31a ff6 fs1 fc0 sc0 ls87 ws230">de sodio <span class="_2 blank"></span>rena<span class="_2 blank"></span>l. </div><div class="t m0 x1 h8 y31b ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y31c ff5 fs1 fc1 sc0 lsb1 ws23d">ADRENOM<span class="_3 blank"> </span>EDULINA </div><div class="t m0 x1 h8 y31d ff6 fs1 fc0 sc0 ls88 ws23a">La adreno<span class="_2 blank"></span>meduli<span class="_2 blank"></span>na (ADM<span class="_2 blank"></span>) es un <span class="_2 blank"></span>nuevo pé<span class="_2 blank"></span>ptido </div><div class="t m0 x1 h8 y31e ff6 fs1 fc0 sc0 ls88 ws23e">vasoac<span class="_2 blank"></span>tivo ai<span class="_2 blank"></span>slado<span class="_2 blank"></span> origi<span class="_2 blank"></span>nalmente <span class="_2 blank"></span>a par<span class="_2 blank"></span>tir<span class="_2 blank"></span> de </div><div class="t m0 x1 h8 y31f ff6 fs1 fc0 sc0 ls88 ws23f">feocr<span class="_2 blank"></span>omocitom<span class="_2 blank"></span>a humano este pépt<span class="_2 blank"></span>ido <span class="_2 blank"></span>pert<span class="_2 blank"></span>enece a<span class="_2 blank"></span> la </div><div class="t m0 x1 h8 y320 ff6 fs1 fc0 sc0 lsb2 ws240">superfam<span class="_3 blank"> </span>ilia de CG<span class="_3 blank"> </span>RP Fisiol<span class="_3 blank"> </span>ógicament<span class="_3 blank"> </span>e, la </div><div class="t m0 x1 h8 y321 ff6 fs1 fc0 sc0 ls89 ws241">adre<span class="_2 blank"></span>nomedulina<span class="_2 blank"></span> tien<span class="_2 blank"></span>e un poten<span class="_2 blank"></span>te y <span class="_2 blank"></span>prol<span class="_2 blank"></span>ongado <span class="_2 blank"></span>efect<span class="_2 blank"></span>o </div><div class="t m0 x1 h8 y322 ff6 fs1 fc0 sc0 ls85 ws242">vasodi<span class="_2 blank"></span>latador.<span class="_2 blank"></span> Además<span class="_2 blank"></span>, posee ef<span class="_2 blank"></span>ectos diur<span class="_2 blank"></span>étic<span class="_2 blank"></span>o y </div><div class="t m0 x1 h8 y323 ff6 fs1 fc0 sc0 ls8f ws243">natri<span class="_2 blank"></span>urétic<span class="_2 blank"></span>o, que están media<span class="_2 blank"></span>dos por un <span class="_2 blank"></span>aumento del<span class="_2 blank"></span> </div><div class="t m0 x1 h8 y324 ff6 fs1 fc0 sc0 ls96 ws244">filtr<span class="_2 blank"></span>ado glomerul<span class="_2 blank"></span>ar y dis<span class="_2 blank"></span>minuci<span class="_2 blank"></span>ón de la reabs<span class="_2 blank"></span>orci<span class="_2 blank"></span>ón </div><div class="t m0 x1 h8 y325 ff6 fs1 fc0 sc0 ls8c ws10e">tubular<span class="_2 blank"></span> de so<span class="_2 blank"></span>dio a niv<span class="_2 blank"></span>el dist<span class="_2 blank"></span>al </div><div class="t m0 x1 h8 y326 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y327 ff6 fs1 fc0 sc0 ls8d ws19">La distri<span class="_2 blank"></span>bució<span class="_2 blank"></span>n tisular y ex<span class="_2 blank"></span>presi<span class="_2 blank"></span>ón génic<span class="_2 blank"></span>a de este fact<span class="_2 blank"></span>or </div><div class="t m0 x1 h8 y328 ff6 fs1 fc0 sc0 ls8c ws245">es ubicu<span class="_2 blank"></span>a, y está espe<span class="_2 blank"></span>cialmen<span class="_2 blank"></span>te pres<span class="_2 blank"></span>ente en el siste<span class="_2 blank"></span>ma </div><div class="t m0 x1 h8 y329 ff6 fs1 fc0 sc0 ls89 ws246">cardi<span class="_2 blank"></span>ovascu<span class="_2 blank"></span>lar, r<span class="_2 blank"></span>iñón, pul<span class="_2 blank"></span>món y glándu<span class="_2 blank"></span>la supr<span class="_2 blank"></span>arr<span class="_2 blank"></span>enal. </div><div class="t m0 x1 h8 y32a ff6 fs1 fc0 sc0 ls90 ws247">Asimismo<span class="_2 blank"></span>, la <span class="_2 blank"></span>ADM se en<span class="_2 blank"></span>cuent<span class="_2 blank"></span>ra en <span class="_2 blank"></span>plasma<span class="_2 blank"></span> a </div><div class="t m0 x1 h8 y32b ff6 fs1 fc0 sc0 ls2d ws248">concentraciones <span class="_3 blank"> </span>en <span class="_3 blank"> </span>el rango picom<span class="_3 blank"> </span>olar, y sus nivele<span class="_3 blank"> </span>s </div><div class="t m0 x1 h8 y32c ff6 fs1 fc0 sc0 ls91 ws249">plasmáti<span class="_2 blank"></span>cos se ha<span class="_2 blank"></span>llan au<span class="_2 blank"></span>mentado<span class="_2 blank"></span>s en dive<span class="_2 blank"></span>rsas </div><div class="t m0 x1 h8 y32d ff6 fs1 fc0 sc0 ls91 ws24a">enferm<span class="_2 blank"></span>edades tale<span class="_2 blank"></span>s como la<span class="_2 blank"></span> hipertens<span class="_2 blank"></span>ión ar<span class="_2 blank"></span>teri<span class="_2 blank"></span>al, la </div><div class="t m0 x1 h8 y32e ff6 fs1 fc0 sc0 lsa5 ws24b">insuficiencia cardíaca o la<span class="_3 blank"> </span> insuficiencia renal. Todo ello </div><div class="t m0 x1 h8 y32f ff6 fs1 fc0 sc0 ls86 wsdd">sugie<span class="_2 blank"></span>re que la ADM juega un papel en l<span class="_2 blank"></span>a regu<span class="_2 blank"></span>laci<span class="_2 blank"></span>ón de la </div><div class="t m0 x1 h8 y330 ff6 fs1 fc0 sc0 ls99 ws31">presi<span class="_2 blank"></span>ón arte<span class="_2 blank"></span>rial y<span class="_2 blank"></span> del equ<span class="_2 blank"></span>ilibr<span class="_2 blank"></span>io hidr<span class="_2 blank"></span>oelectr<span class="_2 blank"></span>olíti<span class="_2 blank"></span>co. </div><div class="t m0 x1 h8 y331 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y332 ff6 fs1 fc0 sc0 ls86 ws14d">ADM está ampl<span class="_2 blank"></span>iament<span class="_2 blank"></span>e distr<span class="_2 blank"></span>ibui<span class="_2 blank"></span>da en t<span class="_2 blank"></span>ejidos, <span class="_2 blank"></span>incluy<span class="_2 blank"></span>endo </div><div class="t m0 x1 h8 y333 ff6 fs1 fc0 sc0 ls87 ws24c">la médul<span class="_2 blank"></span>a y cór<span class="_2 blank"></span>tex supr<span class="_2 blank"></span>arr<span class="_2 blank"></span>enal, r<span class="_2 blank"></span>iñón, p<span class="_2 blank"></span>ulmón, <span class="_2 blank"></span>coraz<span class="_2 blank"></span>ón, </div><div class="t m0 x1 h8 y334 ff6 fs1 fc0 sc0 ls86 ws24d">hipófi<span class="_2 blank"></span>sis ante<span class="_2 blank"></span>rior,<span class="_2 blank"></span> tálamo<span class="_2 blank"></span> e hipotál<span class="_2 blank"></span>amo. A nive<span class="_2 blank"></span>l renal<span class="_2 blank"></span> se </div><div class="t m0 x1 h8 y335 ff6 fs1 fc0 sc0 ls97 ws24e">ha demo<span class="_2 blank"></span>strad<span class="_2 blank"></span>o la pr<span class="_2 blank"></span>esencia<span class="_2 blank"></span> de ADM en <span class="_2 blank"></span>glomér<span class="_2 blank"></span>ulo, </div><div class="t m0 x1 h8 y336 ff6 fs1 fc0 sc0 ls94 ws24f">túbulo dis<span class="_2 blank"></span>tal cor<span class="_2 blank"></span>tical y tú<span class="_2 blank"></span>bulo colect<span class="_2 blank"></span>or<span class="_2 blank"></span> medular<span class="_2 blank"></span>. Ademá<span class="_2 blank"></span>s, </div><div class="t m0 x1 h8 y337 ff6 fs1 fc0 sc0 lsb3 ws250">la ADM se sintet<span class="_3 blank"> </span>iza y secreta por células endoteliales, </div><div class="t m0 x1 h8 y338 ff6 fs1 fc0 sc0 lsb3 ws251">fibra muscular lisa vascular, cardiomiocitos, fibroblastos, </div><div class="t m0 x1 h8 y339 ff6 fs1 fc0 sc0 ls90 ws1c">macr<span class="_2 blank"></span>ófagos y c<span class="_2 blank"></span>élul<span class="_2 blank"></span>as mes<span class="_2 blank"></span>angiales<span class="_2 blank"></span>, entr<span class="_2 blank"></span>e otras<span class="_2 blank"></span> estir<span class="_2 blank"></span>pes </div><div class="t m0 x1 h8 y33a ff6 fs1 fc0 sc0 lsb4 ws252">celulares.<span class="_3 blank"> </span> </div><div class="t m0 x1 h8 y33b ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h8 y33c ff6 fs1 fc0 sc0 ls96 ws22">Estudio<span class="_2 blank"></span>s en animales y<span class="_2 blank"></span> en el ho<span class="_2 blank"></span>mbre i<span class="_2 blank"></span>ndic<span class="_2 blank"></span>an que la </div><div class="t m0 x1 h8 y33d ff6 fs1 fc0 sc0 ls90 ws253">circ<span class="_2 blank"></span>ulac<span class="_2 blank"></span>ión pulmona<span class="_2 blank"></span>r es el lugar<span class="_2 blank"></span> de aclar<span class="_2 blank"></span>amien<span class="_2 blank"></span>to de </div><div class="t m0 x1 h8 y33e ff6 fs1 fc0 sc0 ls8c ws136">ADM. La ADM s<span class="_2 blank"></span>e detec<span class="_2 blank"></span>ta en pl<span class="_2 blank"></span>asma <span class="_2 blank"></span>y en or<span class="_2 blank"></span>ina hum<span class="_2 blank"></span>ana </div><div class="t m0 x1 h8 y33f ff6 fs1 fc0 sc0 lsb5 ws254">y los <span class="_3 blank"> </span>niveles urinarios de este péptid<span class="_3 blank"> </span>o son seis veces </div><div class="t m0 x1 h8 y340 ff6 fs1 fc0 sc0 ls86 wsdd">super<span class="_2 blank"></span>ior<span class="_2 blank"></span>es a lo<span class="_2 blank"></span>s nivele<span class="_2 blank"></span>s plasm<span class="_2 blank"></span>áticos </div><div class="t m0 x1 h8 y341 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x1 h7 y342 ff5 fs1 fc1 sc0 lsb6 ws255">OTROS :<span class="ff6 fc0 lsaa ws256 v0"> <span class="_3 blank"> </span>PGE2, Oxido Nítri<span class="_2 blank"></span>co, Endoteli<span class="_2 blank"></span>na, factor </span></div><div class="t m0 x1 h8 y343 ff6 fs1 fc0 sc0 ls99 ws31">neuron<span class="_2 blank"></span>al re<span class="_2 blank"></span>flejo. </div><div class="t m0 x1 h8 y344 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h7 y345 ff5 fs1 fc1 sc0 lsb6 ws257">INTEG<span class="_3 blank"> </span>RACIÓN DE <span class="_3 blank"> </span>LOS MECA<span class="_3 blank"> </span>NISMOS<span class="_3 blank"> </span> </div><div class="t m0 xa h7 y346 ff5 fs1 fc1 sc0 lsb7 ws7">REGULADORES: </div><div class="t m0 xa h8 y347 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y348 ff6 fs1 fc0 sc0 lsb8 ws258">Como h<span class="_2 blank"></span>emos v<span class="_2 blank"></span>isto,<span class="_2 blank"></span> el <span class="_2 blank"></span>volume<span class="_2 blank"></span>n de LEC <span class="_2 blank"></span>dete<span class="_2 blank"></span>rmin<span class="_2 blank"></span>a el<span class="_2 blank"></span> </div><div class="t m0 xa h8 y349 ff6 fs1 fc0 sc0 ls8f ws259">volumen <span class="_2 blank"></span>plasmáti<span class="_2 blank"></span>co, y <span class="_2 blank"></span>el pr<span class="_2 blank"></span>incipa<span class="_2 blank"></span>l determ<span class="_2 blank"></span>inante d<span class="_2 blank"></span>el LEC </div><div class="t m0 xa h8 y34a ff6 fs1 fc0 sc0 ls88 ws214">es el Clorur<span class="_2 blank"></span>o de Sodio. Tambien s<span class="_2 blank"></span>e vio que el vol<span class="_2 blank"></span>umen </div><div class="t m0 xa h8 y34b ff6 fs1 fc0 sc0 ls97 ws198">de agua determina<span class="_2 blank"></span> la osmolal<span class="_2 blank"></span>idad de los líq<span class="_2 blank"></span>uido<span class="_2 blank"></span>s </div><div class="t m0 xa h8 y34c ff6 fs1 fc0 sc0 ls94 ws25a">corpor<span class="_2 blank"></span>ales<span class="_2 blank"></span>. </div><div class="t m0 xa h8 y34d ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y34e ff6 fs1 fc0 sc0 ls8d ws25b">Entonces tene<span class="_2 blank"></span>mos que la r<span class="_2 blank"></span>egulaci<span class="_2 blank"></span>ón de la <span class="_2 blank"></span>excr<span class="_2 blank"></span>eción </div><div class="t m0 xa h8 y34f ff6 fs1 fc0 sc0 ls8d ws23c">tanto de Clo<span class="_2 blank"></span>rur<span class="_2 blank"></span>o de Sodio como de Agua va a<span class="_2 blank"></span> mantener<span class="_2 blank"></span> </div><div class="t m0 xa h8 y350 ff6 fs1 fc0 sc0 ls8c ws1f">la volemi<span class="_2 blank"></span>a dentro de lími<span class="_2 blank"></span>tes nor<span class="_2 blank"></span>males. <span class="_2 blank"></span>Esta re<span class="_2 blank"></span>gulació<span class="_2 blank"></span>n se </div><div class="t m0 xa h8 y351 ff6 fs1 fc0 sc0 ls96 ws25c">lleva a c<span class="_2 blank"></span>abo a nivel r<span class="_2 blank"></span>enal, f<span class="_2 blank"></span>undamen<span class="_2 blank"></span>talmente, <span class="_2 blank"></span>por<span class="_2 blank"></span> medio </div><div class="t m0 xa h8 y352 ff6 fs1 fc0 sc0 lsb9 ws25d">de la interacción entre los me<span class="_3 blank"> </span>canismos hormonales y </div><div class="t m0 xa h8 y353 ff6 fs1 fc0 sc0 lsba ws25e">nerviosos de<span class="_3 blank"> </span>scriptos. Lo que vamo<span class="_3 blank"> </span>s a hacer es </div><div class="t m0 xa h8 y354 ff6 fs1 fc0 sc0 ls87 ws25f">integr<span class="_2 blank"></span>arl<span class="_2 blank"></span>os para v<span class="_2 blank"></span>er cómo actúa<span class="_2 blank"></span>n especí<span class="_2 blank"></span>ficame<span class="_2 blank"></span>nte en la </div><div class="t m0 xa h8 y355 ff6 fs1 fc0 sc0 ls94 ws7e">regul<span class="_2 blank"></span>ación de<span class="_2 blank"></span> la volem<span class="_2 blank"></span>ia. </div><div class="t m0 xa h8 y356 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y357 ff6 fs1 fc0 sc0 ls91 ws14a">Para ello<span class="_2 blank"></span> vamos a tomar<span class="_2 blank"></span> las 2<span class="_2 blank"></span> situac<span class="_2 blank"></span>iones<span class="_2 blank"></span> fundamen<span class="_2 blank"></span>tales </div><div class="t m0 xa h8 y358 ff6 fs1 fc0 sc0 ls91 ws11">en que s<span class="_2 blank"></span>e requi<span class="_2 blank"></span>ere r<span class="_2 blank"></span>egulac<span class="_2 blank"></span>ión del<span class="_2 blank"></span> volu<span class="_2 blank"></span>men: <span class="_2 blank"></span>expansi<span class="_2 blank"></span>ón </div><div class="t m0 xa h8 y359 ff6 fs1 fc0 sc0 ls90 ws260">del LEC y cont<span class="_2 blank"></span>racc<span class="_2 blank"></span>ión del<span class="_2 blank"></span> LEC. Y más <span class="_2 blank"></span>adela<span class="_2 blank"></span>nte, cua<span class="_2 blank"></span>ndo </div><div class="t m0 xa h8 y35a ff6 fs1 fc0 sc0 ls8c ws261">hablemo<span class="_2 blank"></span>s un poco de l<span class="_2 blank"></span>as patol<span class="_2 blank"></span>ogías, vam<span class="_2 blank"></span>os a <span class="_2 blank"></span>ver <span class="_2 blank"></span>que </div><div class="t m0 xa h8 y35b ff6 fs1 fc0 sc0 ls85 ws262">éstas dos<span class="_2 blank"></span> situaci<span class="_2 blank"></span>ones se <span class="_2 blank"></span>repite<span class="_2 blank"></span>n en <span class="_2 blank"></span>cada una<span class="_2 blank"></span> de <span class="_2 blank"></span>ellas, </div><div class="t m0 xa h8 y35c ff6 fs1 fc0 sc0 ls28 ws263">pero con características propias. </div><div class="t m0 xa h8 y35d ff6 fs1 fc0 sc0 ls87 ws264">Entonces, v<span class="_2 blank"></span>eamos qu<span class="_2 blank"></span>é suc<span class="_2 blank"></span>ede en c<span class="_2 blank"></span>aso de <span class="_2 blank"></span>expans<span class="_2 blank"></span>ión <span class="_2 blank"></span>del </div><div class="t m0 xa h8 y35e ff6 fs1 fc0 sc0 ls85 ws234">LEC<span class="ws265">, por eje<span class="_2 blank"></span>mplo en un<span class="_2 blank"></span>a situac<span class="_2 blank"></span>ión fisi<span class="_2 blank"></span>ológic<span class="_2 blank"></span>a como el </span></div><div class="t m0 xa h8 y35f ff6 fs1 fc0 sc0 ls97 ws181">embar<span class="_2 blank"></span>azo o po<span class="_2 blank"></span>r el<span class="_2 blank"></span> simp<span class="_2 blank"></span>le hec<span class="_2 blank"></span>ho de aum<span class="_2 blank"></span>entar el<span class="_2 blank"></span> </div><div class="t m0 xa h8 y360 ff6 fs1 fc0 sc0 ls96 ws33">consumo<span class="_2 blank"></span> de sal<span class="_2 blank"></span>. </div><div class="t m0 xa h8 y361 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h8 y362 ff6 fs1 fc0 sc0 lsae ws63">Para ell<span class="_2 blank"></span>o vamos a tomar la<span class="_2 blank"></span> figura N°<span class="_2 blank"></span> 1 </div><div class="t m0 xa h8 y363 ff6 fs1 fc0 sc0 ls86 ws266">El aume<span class="_2 blank"></span>nto del <span class="_2 blank"></span>LEC va<span class="_2 blank"></span> a dar<span class="_2 blank"></span>se <span class="_2 blank"></span>junt<span class="_2 blank"></span>o co<span class="_2 blank"></span>n una </div><div class="t m0 xa h8 y364 ff6 fs1 fc0 sc0 ls8f ws267">dismi<span class="_2 blank"></span>nución de l<span class="_2 blank"></span>a Osmolar<span class="_2 blank"></span>idad Pl<span class="_2 blank"></span>asmática. <span class="_2 blank"></span>Ambos <span class="_2 blank"></span>van <span class="_27 blank"></span> </div><div class="t m0 xa h8 y365 ff6 fs1 fc0 sc0 ls8d wsaa">a estimu<span class="_2 blank"></span>lar<span class="_2 blank"></span> a los di<span class="_2 blank"></span>feren<span class="_2 blank"></span>tes r<span class="_2 blank"></span>eceptor<span class="_2 blank"></span>es que<span class="_2 blank"></span> inter<span class="_2 blank"></span>vienen<span class="_2 blank"></span> en </div><div class="t m0 xa h8 y366 ff6 fs1 fc0 sc0 ls87 ws230">la r<span class="_2 blank"></span>egulaci<span class="_2 blank"></span>ón de la vo<span class="_2 blank"></span>lemia <span class="_2 blank"></span>de la s<span class="_2 blank"></span>iguiente m<span class="_2 blank"></span>anera: <span class="_2 blank"></span> </div><div class="t m0 xa h8 y367 ff6 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 xa h1d y368 ffd fs1 fc6 sc0 ls28">!</div><div class="t m0 xa h1d y369 ffd fs1 fc6 sc0 ls28 ws59">!<span class="_32 blank"></span>!</div><div class="t m0 xa h1d y368 ffd fs1 fc6 sc0 lsbb">!"</div><div class="t m0 x1f h1d y369 ffd fs1 fc6 sc0 ls28 ws59">"<span class="_33 blank"></span>"</div><div class="t m0 x1f h1e y368 ffd fs1 fc6 sc0 lsaf">"<span class="ff6 fc0 ls8c ws268 v0">Los Bar<span class="_2 blank"></span>orr<span class="_2 blank"></span>eceptore<span class="_2 blank"></span>s de Baja<span class="_2 blank"></span> Presi<span class="_2 blank"></span>ón </span></div><div class="t m0 xa h8 y36a ff6 fs1 fc0 sc0 ls8d ws269">(pr<span class="_2 blank"></span>esentes en <span class="_2 blank"></span>aurí<span class="_2 blank"></span>cula izq<span class="_2 blank"></span>uierd<span class="_2 blank"></span>a y v<span class="_2 blank"></span>asos pul<span class="_2 blank"></span>monar<span class="_2 blank"></span>es) </div><div class="t m0 xa h8 y36b ff6 fs1 fc0 sc0 ls89 ws26a">van a res<span class="_2 blank"></span>ponder<span class="_2 blank"></span> de 2 for<span class="_2 blank"></span>mas: li<span class="_2 blank"></span>beran<span class="_2 blank"></span>do FNA <span class="_2 blank"></span>a la </div><div class="t m0 xa h8 y36c ff6 fs1 fc0 sc0 ls89 ws26b">circu<span class="_2 blank"></span>laci<span class="_2 blank"></span>ón y dismi<span class="_2 blank"></span>nuyendo la a<span class="_2 blank"></span>ctivi<span class="_2 blank"></span>dad sim<span class="_2 blank"></span>pática <span class="_2 blank"></span>renal<span class="_2 blank"></span>. </div><div class="t m0 xa h9 y36d ff6 fs1 fc0 sc0 lsa0 ws7">El <span class="_26 blank"> </span><span class="ff8 lsbc">FN<span class="_3 blank"> </span>A <span class="_26 blank"> </span></span><span class="ls89 ws26c">produce e<span class="_2 blank"></span>ntonces <span class="_2 blank"></span>vasodila<span class="_2 blank"></span>tación<span class="_2 blank"></span> de a<span class="_2 blank"></span>rter<span class="_2 blank"></span>iola </span></div><div class="t m0 xa h8 y36e ff6 fs1 fc0 sc0 ls85 ws262">aferen<span class="_2 blank"></span>te y vasoconstr<span class="_2 blank"></span>icció<span class="_2 blank"></span>n de arter<span class="_2 blank"></span>iola efe<span class="_2 blank"></span>rent<span class="_2 blank"></span>e con el </div><div class="t m0 xa h8 y36f ff6 fs1 fc0 sc0 ls8d ws26d">consi<span class="_2 blank"></span>guiente aum<span class="_2 blank"></span>ento del fi<span class="_2 blank"></span>ltrad<span class="_2 blank"></span>o glome<span class="_2 blank"></span>rular<span class="_2 blank"></span>, y<span class="_2 blank"></span> al </div><div class="t m0 xa h8 y370 ff6 fs1 fc0 sc0 ls8c ws26e">aument<span class="_2 blank"></span>ar éste <span class="ff7 ls96 ws99">au<span class="_2 blank"></span>menta l<span class="_2 blank"></span>a filt<span class="_2 blank"></span>ración<span class="_2 blank"></span> de Sodi<span class="_2 blank"></span>o<span class="ff6 lsb0 ws26f">. Al mismo </span></span></div><div class="t m0 xa h9 y371 ff6 fs1 fc0 sc0 ls8f ws270">tiempo, la di<span class="_2 blank"></span>sminuci<span class="_2 blank"></span>ón de l<span class="_2 blank"></span>a <span class="ff8 lsa9 ws271">act<span class="_2 blank"></span>ividad simpát<span class="_2 blank"></span>ica renal<span class="ff6 ls28 ws7"> </span></span></div><div class="t m0 xa h9 y372 ff6 fs1 fc0 sc0 ls88 ws8d">inhib<span class="_2 blank"></span>e la sec<span class="_2 blank"></span>reci<span class="_2 blank"></span>ón <span class="_2 blank"></span>de <span class="ff8 lsb5 ws235">Renina</span><span class="ls8f ws272">.8(E12.4(a) 5 Tc\ue00a0)21.9r.4(A )]TJ\ue00a/c5 TT12 112.3(n.002.3(n.y)-0.5(12.4(a))5.1538 TD\ue00a0.0057 Tc\ue00a0.0Ang)0.2( S.5(l)8.ens4(a)0.2(c)5n3( d)a(i)8.(n)12.1I5(l)8.I)naónn<span class="_2 blank"></span>iamee3(t)15oi<span class="_2 blank"></span>en.4(a)0o3( d)2.72( So( d)13(t)1513( d)s4(a)096 Twl.5(l)8.ado7(a)-0.4(.0052 TD\ue00a-0.0006 T(mu-8)5.3())9.6( )]TJ\ue00a/T(12 1 Tf\ue00a5.6923 0 TD\ue00a0.03 1 T006 T1(s)51(n)122.7(7( )1uc(n)12.7(só[(c)5.3(o)-0.nto)12.7( )-12.8(d)12.( a)1.5(r)9. 1(p)12.ab(o)-0.1(n)12o0.1(i)8(e)-0c(n)12.7(só[(s)5.3)8.1(a)3(n..1(a)3(e)0. Sodi)8.3(o)]TJ\ue00a/TT5.935 Tf\ue00a2.2179 02TD\ue00a0.0051 Tc\ue00a0.5 )]3(r)8.12o 7( )12.9-17.1 T28( )]TJ\ue00a0 -1.051Tc\ue00a-0.0T(i)2(úbr)21.7(3( v)5.nto)12.76( )r)9(o)-0.1x( )12.8(s)5for)(egul)7. Tw5.nca)-0.3( v)5.mo5(e)125.2(ó)1úe<span class="_34 blank"></span>3 C21.3.3( v)5.1(o)12.5(l)7.ca v<span class="_35 blank"></span>oN21.3.A.3( al)8( )]4744 -1.1667 TD\ue00a0.0381 Tc\ue00a0.0tam(t)15b<span class="_36 blank"></span> n <span class="_1a blank"></span>r12.9 .7()15n313-0.h.7()15b.7()158(e)5egu3-0.7s( )7513( )5c( )758(e)5 <span class="_37 blank"></span>ónes <span class="_1a blank"></span>n.002. </span></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div> <div id="pfa" class="pf w0 h0" data-page-no="a"><div class="pc pca w0 h0"><img fetchpriority="low" loading="lazy" class="bi x15 y373 w2 h1f" alt="" src="https://files.passeidireto.com/3b3592b3-07ad-49c2-bee1-da90d316ca79/bga.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls27 ws6"> <span class="_0 blank"> </span> <span class="_1 blank"> </span>Cátedra Nº 1 de Fisi<span class="_2 blank"></span>ología Human<span class="_2 blank"></span>a \u2013 Facult<span class="_2 blank"></span>ad de Medicina \u2013 Un<span class="_2 blank"></span>iversidad Nacional del No<span class="_2 blank"></span>rdeste </div><div class="t m0 x1 h3 y2 ff2 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2 h4 y3 ff3 fs0 fc1 sc0 ls29 ws8">Diser<span class="_3 blank"> </span>tantes: ALE<span class="_3 blank"> </span>GRE<span class="ff4 ls2a ws9"> M<span class="_3 blank"> </span>aría Cecilia \u2013 </span><span class="ws7">ALERICH <span class="_3 blank"> </span><span class="ff4 ls2b">José<span class="_2 blank"></span> María \u2013<span class="_37 blank"></span> <span class="ff3 ls2c ws0">CHAL LI O L <span class="ff4 ws8"> Cam<span class="_3 blank"> </span>ila </span></span></span></span></div><div class="t m0 x1 h5 y4 ff2 fs1 fc0 sc0 lsbd ws7"> <span class="ff1 ls2d v1">11 </span></div><div class="t m0 x23 h3 y374 ff4 fs1 fc0 sc0 lsbe ws7"> <span class="ff9 fs7 fc1 lsd1 ws273 v9">SPSC</span><span class="ff9 fc1 lsbf v9"> <span class="fs7 lsd2 ws274 v0">SIADH</span><span class="ls28"> </span></span></div><div class="t m0 x24 h20 y375 ffe fs1 fc0 sc0 lsd3 ws275">\ue001\ue002\ue003 \ue004\ue005\ue003\ue001\ue006 \ue007\ue008\ue009 \ue00a\ue00b\ue00c \ue005\ue00d \ue003<span class="ff4 lsc0 ws7 v0"> </span><span class="fff lsc1 ws276">\ue001\ue002\ue003 \ue004 \ue002\ue005\ue006\ue002\ue007\ue008 <span class="ff4 lsc2 ws7 v0"> </span>\ue001\ue002\ue003<span class="_3 blank"> </span>\ue004\ue002\ue005\ue006\ue002\ue007\ue008<span class="ff4 ls28 ws7 v0"> </span></span></div><div class="t m0 x8 h20 y376 ffe fs1 fc0 sc0 lsb7 ws277">\ue00e\ue009 \ue00a\ue003 \ue007\ue008\ue007\ue005\ue004\ue008\ue004\ue001<span class="_3 blank"> </span>\ue006\ue007\ue008\ue009\ue00a \ue00b\ue00c<span class="_3 blank"> </span>\ue005\ue00d\ue008<span class="fff lsc3 ws278">\ue009\ue009 <span class="lsc1 ws276">\ue001\ue002\ue003 \ue004 \ue002\ue005\ue006\ue002\ue007\ue00a <span class="ff4 lsc2 ws7 v0"> </span>\ue001\ue002\ue003<span class="_3 blank"> </span>\ue004\ue002\ue005\ue006\ue002\ue007\ue00a<span class="ff4 ls28 ws7 v0"> </span></span></span></div><div class="t m0 x8 h21 y377 ffe fs1 fc0 sc0 ls8b ws1af">\ue002\ue003\ue004\ue005\ue003\ue001\ue00f\ue010<span class="_3 blank"> </span>\ue005\ue011\ue008\ue010\ue005\ue003<span class="fff lsc3 ws279">\ue009\ue009\ue009</span></div><div class="t m0 x25 h3 y378 ff4 fs1 fc0 sc0 lsc4 ws7"> <span class="fff lsc5 ws27a v0">\ue00b\ue006\ue004\ue00c\ue005\ue00d \ue00a\ue007\ue008</span><span class="lsc6"> <span class="fff lsc5 ws27b v0">\ue00b\ue006\ue004 \ue00c\ue005\ue00d \ue00a\ue007\ue008 </span><span class="ls28"> </span></span></div><div class="t m0 x24 h20 y379 ffe fs1 fc0 sc0 lsc7 ws15a">\ue00e\ue009 \ue00a\ue003 \ue007\ue008\ue007\ue005\ue004\ue008\ue004\ue001<span class="_3 blank"> </span>\ue00f\ue010\ue005\ue011\ue008\ue010\ue005\ue008 <span class="fff lsc3 ws27c">\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009 <span class="lsc5 ws27a">\ue00b\ue006\ue004\ue00c\ue005\ue00d\ue00a\ue007\ue00a<span class="ff4 lsc6 ws7 v0"> </span><span class="ws27b">\ue00b\ue006\ue004 \ue00c\ue005\ue00d \ue00a\ue007\ue00a <span class="ff4 ls28 ws7 v0"> </span></span></span></span></div><div class="t m0 x24 h20 y37a ffe fs1 fc0 sc0 lsd4 ws27d">\ue012\ue013\ue014<span class="fff lsc3 ws279">\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009<span class="ff4 lsc8 ws7 v0"> </span><span class="lsc5 ws27a">\ue00b\ue006\ue004\ue00c\ue005\ue00d \ue00a\ue007\ue008<span class="ff4 lsc6 ws7 v0"> </span><span class="ws27b">\ue00b\ue006\ue004 \ue00c\ue005\ue00d \ue00a\ue007\ue008 <span class="ff4 ls28 ws7 v0"> </span></span></span></span></div><div class="t m0 x24 h20 y37b ffe fs1 fc0 sc0 ls91 ws27e">\ue014\ue015\ue016<span class="fff lsc3 ws279">\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009<span class="ff4 lsc9 ws7 v0"> </span><span class="ffe lsc5 ws27f">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008</span></span></div><div class="t m0 x26 h21 y37c ffe fs1 fc0 sc0 lsc5 ws27f">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008<span class="_38 blank"></span>\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008</div><div class="t m0 x26 h20 y37b ffe fs1 fc0 sc0 lsc5 ws27f">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008<span class="ff4 lsca ws7 v0"> </span>\ue014\ue017\ue00a \ue018\ue011\ue00c \ue008\ue004\ue008</div><div class="t m0 x1e h21 y37c ffe fs1 fc0 sc0 lsc5 ws27f">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008<span class="_38 blank"></span>\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008</div><div class="t m0 x1e h20 y37b ffe fs1 fc0 sc0 lsc5 ws14a">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008 <span class="ff4 ls28 ws7 v0"> </span></div><div class="t m0 x24 h21 y37d ffe fs1 fc0 sc0 lsd5 ws280">\ue006\ue003\ue00c\ue008\ue009\ue005\ue003\ue001\ue006\ue007\ue008\ue009\ue00a\ue00b\ue00c\ue005\ue00d\ue003<span class="fff lsc3 ws281">\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009 <span class="lsc5 ws27a">\ue00b\ue006\ue004\ue00c\ue005\ue00d \ue00a\ue007\ue008\ue009<span class="_39 blank"> </span>\ue00b\ue006\ue004\ue00c\ue005\ue00d \ue00a\ue007\ue008 \ue009</span></span></div><div class="t m0 x24 h21 y37e ffe fs1 fc0 sc0 lsd6 ws282">\ue019\ue003\ue007\ue018\ue00a\ue005<span class="_2 blank"></span>\ue008<span class="fff lsc3 ws279">\ue009\ue009</span><span class="lscb">\ue001<span class="lsc1 ws283">\ue015\ue005\ue009\ue00a\ue005\ue011\ue017\ue005\ue004\ue008</span></span></div><div class="t m0 x26 h21 y37f ffe fs1 fc0 sc0 lsc1 ws283">\ue015\ue005\ue009\ue00a \ue005\ue011\ue017\ue005\ue004\ue008<span class="_3a blank"></span>\ue015\ue005\ue009\ue00a \ue005\ue011\ue017\ue005\ue004\ue008</div><div class="t m0 x26 h21 y37e ffe fs1 fc0 sc0 lsc1 ws283">\ue015\ue005\ue009\ue00a \ue005\ue011\ue017\ue005\ue004\ue008 <span class="fff lscc">\ue009</span><span class="lsd7 ws284">\ue013\ue003 \ue010\ue00a\ue008\ue007\ue001<span class="_3 blank"> </span>\ue003\ue001</span></div><div class="t m0 x27 h21 y37f ffe fs1 fc0 sc0 lsd7 ws284">\ue013\ue003\ue010\ue00a\ue008\ue007\ue001 \ue003\ue001<span class="_3b blank"></span>\ue013\ue003\ue010\ue00a\ue008\ue007\ue001 \ue003\ue001</div><div class="t m0 x27 h21 y37e ffe fs1 fc0 sc0 lsd7 ws284">\ue013\ue003\ue010\ue00a\ue008\ue007\ue001 \ue003\ue001</div><div class="t m0 x1e h21 y380 ffe fs1 fc0 sc0 lsc5 ws27f">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008</div><div class="t m0 x1e h21 y381 ffe fs1 fc0 sc0 lsc5 ws27f">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008<span class="_38 blank"></span>\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008</div><div class="t m0 x1e h21 y380 ffe fs1 fc0 sc0 lsc5 ws14a">\ue014\ue017\ue00a\ue018\ue011\ue00c \ue008\ue004\ue008 <span class="fff ls28">\ue009</span></div><div class="t m0 x24 h21 y382 ffe fs1 fc0 sc0 lsd8 ws285">\ue006\ue018\ue009\ue003\ue001\ue01a \ue003\ue010\ue01b\ue003 \ue010\ue008\ue007\ue001<span class="_3c blank"> </span><span class="fff lsc1 ws276">\ue001\ue002\ue003\ue004 \ue002\ue005\ue006\ue002\ue007\ue008<span class="_3 blank"> </span></span><span class="ls28">\ue001</span></div><div class="t m0 x28 h21 y383 ffe fs1 fc0 sc0 lsd9">\ue001\ue001</div><div class="t m0 x28 h21 y382 ffe fs1 fc0 sc0 lscd">\ue001<span class="fff lsd7 ws286">\ue00e\ue008\ue00f\ue004\ue00a\ue010\ue009 \ue008\ue009</span></div><div class="t m0 x1e h21 y384 fff fs1 fc0 sc0 lsc5 ws27a">\ue00b\ue006\ue004\ue00c\ue005\ue00d \ue00a\ue007\ue008<span class="_3 blank"> </span><span class="ffe ls28">\ue001</span></div><div class="t m0 x29 h21 y385 ffe fs1 fc0 sc0 lsd9">\ue001\ue001</div><div class="t m0 x29 h21 y384 ffe fs1 fc0 sc0 ls28">\ue001</div><div class="t m0 x24 h21 y386 ffe fs1 fc0 sc0 ls99 ws287">\ue016\ue018\ue00a\ue008\ue00c\ue003\ue00d\ue010\ue005\ue00c \ue003\ue001<span class="_3d blank"> </span><span class="fff lsc5 ws27a">\ue00b\ue006\ue004\ue00c\ue005\ue00d \ue00a\ue007\ue008\ue009<span class="_3e blank"> </span><span class="lsa0 ws288">\ue00e\ue008\ue00f\ue004\ue00a\ue010\ue009\ue008\ue009\ue009</span></span></div><div class="t m0 x1e h21 y387 fff fs1 fc0 sc0 lsb7 ws289">\ue001\ue002\ue003\ue004 \ue002\ue005\ue006\ue002\ue007\ue008\ue009</div><div class="t m0 x3 h3 y388 ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h3 y389 ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x3 h8 y38a ff6 fs1 fc0 sc0 ls96 ws297">Los síndrom<span class="_2 blank"></span>es menc<span class="_2 blank"></span>ionados cur<span class="_2 blank"></span>san con </div><div class="t m0 x1 h8 y38b ff6 fs1 fc0 sc0 ls8c ws298">elevac<span class="_2 blank"></span>ión de ADH pero tam<span class="_2 blank"></span>bién hay si<span class="_2 blank"></span>tuacio<span class="_2 blank"></span>nes donde </div><div class="t m0 x1 h8 y38c ff6 fs1 fc0 sc0 ls86 ws106">ésta hor<span class="_2 blank"></span>mona se secr<span class="_2 blank"></span>eta en menor<span class="_37 blank"></span> cantidad o e<span class="_2 blank"></span>s nor<span class="_2 blank"></span>mal </div><div class="t m0 x1 h8 y38d ff6 fs1 fc0 sc0 ls8c ws1ab">pero no pue<span class="_2 blank"></span>de cumpl<span class="_2 blank"></span>ir su funci<span class="_2 blank"></span>ón. Así t<span class="_2 blank"></span>enemos <span class="_2 blank"></span>una </div><div class="t m0 x1 h9 y38e ff6 fs1 fc0 sc0 ls86 ws167">entidad l<span class="_2 blank"></span>lamada <span class="_2 blank"></span><span class="ff5 lsda ws299 v0">DIABETES INSÍPIDA<span class="ff8 lsce ws7 v0"> <span class="ff6 ls88 ws29a">que se </span></span></span></div><div class="t m0 x1 h8 y38f ff6 fs1 fc0 sc0 ls95 ws20d">divide<span class="_2 blank"></span> en 2: </div><div class="t m0 x1d h7 y390 ff9 fs1 fc0 sc0 lsdb ws29b"> NEFRÓGENA<span class="ff6 ls8c ws29c"> (por falt<span class="_2 blank"></span>a de r<span class="_2 blank"></span>espue<span class="_2 blank"></span>sta de <span class="_2 blank"></span>los </span></div><div class="t m0 x1c h8 y391 ff6 fs1 fc0 sc0 ls85 ws29d">conducto<span class="_2 blank"></span>s colecto<span class="_37 blank"></span>res a una secr<span class="_2 blank"></span>eción de<span class="_2 blank"></span> ADH </div><div class="t m0 x1c h8 y392 ff6 fs1 fc0 sc0 ls88 ws92">norma<span class="_2 blank"></span>l) y </div><div class="t m0 x1d h7 y393 ff9 fs1 fc0 sc0 lsdc ws29e"> NEURÓGE<span class="_3 blank"> </span>NA<span class="ff6 ls87 ws29f"> (p<span class="_2 blank"></span>or ins<span class="_2 blank"></span>uficient<span class="_2 blank"></span>e li<span class="_2 blank"></span>berac<span class="_2 blank"></span>ión </span></div><div class="t m0 x1c h8 y394 ff6 fs1 fc0 sc0 ls87 ws2a0">de la hormona)<span class="_37 blank"></span>. <span class="_3 blank"> </span>Ambas v<span class="_2 blank"></span>an a pr<span class="_2 blank"></span>esentar<span class="_2 blank"></span>se con<span class="lsdd ws7 v0"> -</span></div><div class="t m0 x19 h8 y395 ff6 fs1 fc0 sc0 ls97 ws11f">poliu<span class="_2 blank"></span>ria y -po<span class="_2 blank"></span>lidi<span class="_2 blank"></span>psia, ya que<span class="_2 blank"></span> el ri<span class="_2 blank"></span>ñón pier<span class="_2 blank"></span>de su </div><div class="t m0 x19 h8 y396 ff6 fs1 fc0 sc0 lsde ws2a1">capacidad <span class="_3 blank"> </span>para concent<span class="_3 blank"> </span>rar la orina y se activa<span class="_3 blank"> </span>n los </div><div class="t m0 x19 h8 y397 ff6 fs1 fc0 sc0 ls8d ws26d">mecanis<span class="_2 blank"></span>mos ya menci<span class="_2 blank"></span>onados, y por<span class="_37 blank"></span> <span class="_3 blank"> </span>lo tanto </div><div class="t m0 x19 h8 y398 ff6 fs1 fc0 sc0 ls96 ws2a2">pres<span class="_2 blank"></span>entan -<span class="_2 blank"></span>hipos<span class="_2 blank"></span>tenuri<span class="_2 blank"></span>a (di<span class="_2 blank"></span>sminució<span class="_37 blank"></span>n de la </div><div class="t m0 x19 h8 y399 ff6 fs1 fc0 sc0 lsdf ws2a3">osmola<span class="_3 blank"> </span>lidad <span class="_3 blank"> </span>urinaria). P<span class="_3 blank"> </span>odemo<span class="_3 blank"> </span>s ver en el c<span class="_3 blank"> </span>uadro la </div><div class="t m0 x19 h8 y39a ff6 fs1 fc0 sc0 ls96 ws18f">difer<span class="_2 blank"></span>encia<span class="_2 blank"></span> entre los sí<span class="_2 blank"></span>ndromes <span class="_2 blank"></span>donde <span class="_2 blank"></span>la ADH<span class="_2 blank"></span> es </div><div class="t m0 x19 h8 y39b ff6 fs1 fc0 sc0 ls87 ws97">insuf<span class="_2 blank"></span>iciente y d<span class="_2 blank"></span>onde la <span class="_2 blank"></span>ADH es e<span class="_2 blank"></span>xcesi<span class="_2 blank"></span>va y p<span class="_2 blank"></span>ara </div><div class="t m0 x19 h8 y39c ff6 fs1 fc0 sc0 ls8f ws2a4">recal<span class="_2 blank"></span>car está<span class="_2 blank"></span>n: la osmolali<span class="_2 blank"></span>dad ur<span class="_2 blank"></span>inaria<span class="_2 blank"></span>, la </div><div class="t m0 x19 h8 y39d ff6 fs1 fc0 sc0 ls89 ws2a5">osmolal<span class="_2 blank"></span>idad plas<span class="_2 blank"></span>mática, y<span class="_2 blank"></span> el sodio plas<span class="_2 blank"></span>mático</div><div class="t m0 x3 h3 y39e ff4 fs1 fc0 sc0 ls28">.</div><div class="t m0 x3 h3 y39f ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2a h22 y3a0 ff10 fs7 fc1 sc0 lse0 ws28a">\ue001\ue002\ue003\ue004\ue005\ue006\ue005\ue007\ue008<span class="_3 blank"> </span>\ue002\ue009\ue007\ue00a\ue00b\ue002<span class="_3 blank"> </span>\ue00c\ue003</div><div class="t m0 x2a h22 y3a1 ff10 fs7 fc1 sc0 lse0 ws28a">\ue001\ue002\ue003\ue004\ue005\ue006\ue005\ue007\ue008<span class="_3 blank"> </span>\ue002\ue009\ue007\ue00a\ue00b\ue002<span class="_3 blank"> </span>\ue00c\ue003<span class="_3f blank"></span>\ue001\ue002\ue003\ue004\ue005\ue006\ue005\ue007\ue008<span class="_3 blank"> </span>\ue002\ue009\ue007\ue00a\ue00b\ue002<span class="_3 blank"> </span>\ue00c\ue003</div><div class="t m0 x2a h22 y3a0 ff10 fs7 fc1 sc0 lse0 ws28a">\ue001\ue002\ue003\ue004\ue005\ue006\ue005\ue007\ue008<span class="_3 blank"> </span>\ue002\ue009\ue007\ue00a\ue00b\ue002<span class="_3 blank"> </span>\ue00c\ue003<span class="ff4 fs1 lscf ws7 v0"> </span><span class="lse1 ws28b">\ue00d\ue00e\ue00f \ue001\ue010</span></div><div class="t m0 x2b h22 y3a1 ff10 fs7 fc1 sc0 lse1 ws28b">\ue00d\ue00e\ue00f \ue001\ue010<span class="_40 blank"></span>\ue00d\ue00e\ue00f \ue001\ue010</div><div class="t m0 x2b h23 y3a0 ff10 fs7 fc1 sc0 lse1 ws28b">\ue00d\ue00e\ue00f \ue001\ue010<span class="ff2 lse2 ws7 v0"> </span></div><div class="t m0 x2c h3 y3a2 ff4 fs1 fc1 sc0 ls28 ws7"> </div><div class="t m0 x2a h22 y3a3 ff11 fs7 fc0 sc0 lse3 ws28c">\ue001\ue002\ue003\ue004\ue005\ue006\ue007\ue008\ue009\ue005 \ue00a\ue005 \ue00b\ue006\ue00c \ue00b</div><div class="t m0 x2a h22 y3a4 ff11 fs7 fc0 sc0 lse3 ws28c">\ue001\ue002\ue003\ue004\ue005\ue006\ue007\ue008\ue009\ue005 \ue00a\ue005 \ue00b\ue006\ue00c \ue00b<span class="_41 blank"></span>\ue001\ue002\ue003\ue004\ue005\ue006\ue007\ue008\ue009\ue005 \ue00a\ue005 \ue00b\ue006\ue00c \ue00b</div><div class="t m0 x2a h22 y3a3 ff11 fs7 fc0 sc0 lse3 ws28c">\ue001\ue002\ue003\ue004\ue005\ue006\ue007\ue008\ue009\ue005 \ue00a\ue005 \ue00b\ue006\ue00c \ue00b<span class="_3 blank"> </span>\ue004</div><div class="t m0 x2d h22 y3a4 ff11 fs7 fc0 sc0 ls28 ws28d">\ue004<span class="_42 blank"></span>\ue004</div><div class="t m0 x2d h22 y3a3 ff11 fs7 fc0 sc0 ls28">\ue004</div><div class="t m0 x2a h21 y3a5 fff fs1 fc0 sc0 lsc3 ws279">\ue011\ue008<span class="_2 blank"></span>\ue010\ue002<span class="_37 blank"></span>\ue006\ue00f\ue002<span class="_2 blank"></span>\ue00a\ue009\ue012<span class="_37 blank"></span>\ue009\ue013\ue009\ue014\ue015\ue009\ue004<span class="_37 blank"></span>\ue010\ue016\ue017\ue018\ue016<span class="_2 blank"></span>\ue007\ue019<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009\ue009\ue009</div><div class="t m0 x2a h21 y3a6 fff fs1 fc0 sc0 lsc3 ws279">\ue001\ue00c\ue003<span class="_2 blank"></span>\ue01a\ue002<span class="_37 blank"></span>\ue007\ue00f\ue00a\ue00d\ue00a<span class="_37 blank"></span>\ue01b\ue002\ue01c\ue005<span class="_37 blank"></span>\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009</div><div class="t m0 x2a h21 y3a7 fff fs1 fc0 sc0 lsc3 ws279">\ue01d\ue008\ue005<span class="_37 blank"></span>\ue01e\ue006\ue010\ue003<span class="_2 blank"></span>\ue002\ue008<span class="_37 blank"></span>\ue005\ue00c\ue003\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009\ue009\ue009<span class="_37 blank"></span>\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009</div><div class="t m0 x2b h22 y3a3 ff11 fs7 fc0 sc0 lse4 ws28e">\ue001\ue002<span class="_37 blank"></span>\ue003\ue004\ue00b\ue00d\ue00a<span class="_2 blank"></span>\ue00b\ue007\ue005<span class="_2 blank"></span>\ue00e\ue00f</div><div class="t m0 x2b h22 y3a4 ff11 fs7 fc0 sc0 lse4 ws28e">\ue001\ue002<span class="_37 blank"></span>\ue003\ue004\ue00b\ue00d\ue00a<span class="_2 blank"></span>\ue00b\ue007\ue005<span class="_2 blank"></span>\ue00e\ue00f<span class="_43 blank"></span>\ue001\ue002<span class="_37 blank"></span>\ue003\ue004\ue00b\ue00d\ue00a<span class="_2 blank"></span>\ue00b\ue007\ue005<span class="_2 blank"></span>\ue00e\ue00f</div><div class="t m0 x2b h22 y3a3 ff11 fs7 fc0 sc0 lse4 ws28e">\ue001\ue002<span class="_37 blank"></span>\ue003\ue004\ue00b\ue00d\ue00a<span class="_2 blank"></span>\ue00b\ue007\ue005<span class="_2 blank"></span>\ue00e\ue00f\ue004</div><div class="t m0 x2e h22 y3a4 ff11 fs7 fc0 sc0 ls28 ws28d">\ue004<span class="_42 blank"></span>\ue004</div><div class="t m0 x2e h22 y3a3 ff11 fs7 fc0 sc0 ls28">\ue004</div><div class="t m0 x2b h21 y3a5 fff fs1 fc0 sc0 lse5 ws28f">\ue01d\ue008\ue005\ue01f<span class="_2 blank"></span>\ue006\ue003\ue002\ue01c<span class="_2 blank"></span>\ue005\ue009</div><div class="t m0 x2b h21 y3a6 fff fs1 fc0 sc0 ls8b ws2a6"> \ue00c\ue00d\ue00a\ue00f<span class="_3 blank"> </span>\ue018\ue002\ue00a\ue009\ue009</div><div class="t m0 x2b h21 y3a7 fff fs1 fc0 sc0 lsd7 ws290">\ue01d\ue008\ue005\ue01e\ue006\ue010\ue003\ue002\ue008\ue005\ue00c \ue003\ue009 \ue009\ue009 \ue009\ue009 \ue009\ue009 \ue009 \ue009 \ue009 \ue009\ue009</div><div class="t m0 x2b h21 y3a8 fff fs1 fc0 sc0 lse6 ws291">\ue01d\ue008\ue004<span class="_2 blank"></span>\ue00a\ue009\ue009\ue009\ue009</div><div class="t m0 x2c h3 y3a9 ff4 fs1 fc0 sc0 ls28 ws7"> </div><div class="t m0 x2a h21 y3aa fff fs1 fc0 sc0 lse7 ws292">!\ue003 \ue004\ue008 \ue010\ue00a\ue00f\ue002\ue007\ue00a \ue007\ue009"<span class="_3 blank"> </span>\ue00f\ue002\ue005\ue00a\ue00f\ue002\ue00a\ue009<span class="_3 blank"> </span>#\ue009 \ue014\ue015 \ue015\ue009\ue004 ! \ue003 \ue004 \ue016\ue017<span class="_3 blank"> </span>\ue018\ue009 \ue009</div><div class="t m0 x2a h21 y3ab fff fs1 fc0 sc0 lse8 ws293">\ue001\ue00c\ue005\ue003\ue002\ue007\ue00a\ue007\ue009 "\ue00f\ue002\ue005\ue00a \ue00f\ue002\ue00a\ue009 # \ue009$ \ue015$\ue015\ue009 \ue009\ue009 \ue009 \ue009\ue009 \ue009 \ue009 \ue009\ue009 \ue009\ue009 \ue009 \ue009 \ue009 \ue009\ue009 \ue009\ue009 \ue009 \ue009</div><div class="t m0 x2b h21 y3aa fff fs1 fc0 sc0 lsc1 ws294">!\ue003 \ue004\ue008\ue010\ue00a\ue00f\ue002\ue007\ue00a \ue007\ue009" \ue00f\ue002\ue005\ue00a\ue00f \ue002\ue00a\ue009 \ue013 \ue009%\ue015 \ue015\ue009 &\ue009 \ue014\ue015\ue015\ue009 \ue009 \ue009</div><div class="t m0 x2c h21 y3ab fff fs1 fc0 sc0 lse9 ws295">\ue009\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue004!<span class="_2 blank"></span>\ue003\ue004\ue016\ue017\ue018<span class="_37 blank"></span>\ue009</div><div class="t m0 x2b h21 y3ac fff fs1 fc0 sc0 lsea ws1bc">'\ue008\ue007\ue002\ue008\ue009\ue006\ue00f\ue002\ue005 \ue00a\ue00f\ue002\ue008 \ue009<span class="_3 blank"> </span>\ue013\ue009 \ue014\ue015 \ue009\ue004 ()\ue016<span class="_3 blank"> </span>\ue010\ue009</div><div class="t m0 x2b h3 y3ad ff4 fs1 fc0 sc0 lseb ws2a7">Supresión<span class="_3 blank"> </span> de Aldost<span class="_3 blank"> </span>erona </div><div class="t m0 x2a h20 y3ae fff fs1 fc0 sc0 lsc3 ws279">*\ue002<span class="_37 blank"></span>+\ue00c\ue00f\ue005<span class="_2 blank"></span>\ue00a\ue00d\ue00f<span class="_2 blank"></span>\ue00c\ue004\ue002<span class="_37 blank"></span>\ue00a\ue009\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009\ue009\ue009\ue009\ue009\ue009\ue009<span class="_2 blank"></span>\ue009<span class="ff4 lsd0 ws7 v0"> </span><span class="lsec ws296">'\ue008\ue007\ue002\ue008\ue009 \ue011\ue010\ue00a\ue003\ue004,\ue00d \ue002\ue01b\ue008\ue009 #\ue009 $\ue014\ue015\ue009 \ue004 ()\ue016\ue010<span class="ff4 ls28 ws7 v0"> </span></span></div></div><div class="pi" data-data='{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}'></div></div>
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