Study

Guide over Water, Sodium, Potassium, Chloride, and Iron

Where it is Found:

Water: Sodium: Potassium: Chloride: Iron:

14L in ECF (1/3) Major ECF cation Major ICF cation Major ECF anion 2-4g stored in body
- 11L interstitial
- 3L Plasma 30-40% on bone 65% in RBC
28L in ICF (2/3) surface 10% in muscle cells
1-5% as part of
enzymes

Absorption/Digestion:

Sodium: Potassium: Chloride: Iron:

Where it is Small Intestine & Small intestine Intestines Small Intestine
Absorbed: Proximal Colon

How it is Na+/glucose Passive diffusion Na+/glucose Heme Iron is hydrolyzed into

Absorbed transporter (small cotransport system ferrous iron (Fe2+) and
intestine) K+/H+ ATPase protoporphrin
Na+/Cl- cotransport
Na+/Cl- cotransport absorption Non-heme Iron is hydrolyzed,
exchange transporter Fe3+ is reduced to Fe2+ and
(small intestine & *stimulated by Electrogenic Na+ transported by DMT1 into the
colon) insulin absorption blood

Functions:

Water: Sodium: Potassium: Chloride: Iron:

1. Lubrication 1. Osmotic 1. Resting 1. Formation of 1. Oxygen delivery
& protection Pressure membrane gastric HCL via hemoglobin &
of organs maintenance potential of myoglobin
2. Temp. 2. Nerve cells 2. WBC release
Regulation transmission 2. Water and 2. Electron
3. Transport and impulse acid/base 3. Exchange Transport Chain
medium conduction balance anion for HCO3-
4. Acid/Base 3. Muscle 3. Cellular in RBC 3. Amino Acid
Balance contraction metabolism metabolism
4. Signals for
decreased 4. Procollagen
excretion of synthesis
Ca2+

Excretion:

Water: Sodium: Potassium: Chloride: Iron:

Major: Urine Urine Urine Urine Feces
Minor: Feces, sweat, & Sweat Feces & sweat GI tract & sweat Sweat & urine
respiration (menstrual blood in women)

AI, RDA, & UL

Water: Sodium: Potassium: Chloride: Iron:

AI: Males: 3.7L 1500mg/day 4700mg/day 2300mg/day ---
Females: 2.7L
RDA: --- --- --- --- Males: 8mg
Females:
- Pre-menopause: 18mg
- Post-menopause: 8mg
- Pregnancy: 27mg
- Lactating: 9mg
UL: Hyponatremia from 2300mg/day --- --- 45mg
overconsumption (debatable)
Hemochromatosis: chronic iron
overload – genetic disorder

Water: Sodium: Potassium: Chloride: Iron:

Assessment: Urine 24-hour urinary excretion Plasma/Serum Serum conc. Typically with a
levels Conc. blood test
Deficiency: Hypernatremia Rare Could result 7g per 100ml blood
– losses of … but could be linked to from loss of
water without causes in CVD for people fluids and Poor intake is
solutes on low sodium diets electrolytes common
Toxicity: Hyponatremia – Hypertension Intakes are Hemochromatosis
diluted plasma usually low even – body cannot
from over in US sense iron stores
consumption and won’t down-
reg. intestinal
absorption

Iron Paper Review:

1. Why is deficiency of iron in the late prenatal and postnatal are problem?

Because iron deficiency during these times can lead to neuro-behavioral issues in the long run, even when iron
treatment is eventually administered.

2. Why is giving all pregnant women and infants an iron supplement a problem?

Benefits of supplementation vary depending on other foods the pregnant mother may be consuming. For example,
mothers in India were known to consume large amounts of black tea which binds iron in the lumen of the intestinal tract
and does not allow it to be absorbed. High supplemental doses of iron was also found to raise levels of Hgb
concentration which was associated with adverse effects for the mother and fetus.

3. When are children at risk for iron deficiency?

Children are at risk during the late prenatal and neonatal period, between 6 and 24 months, and during adolescence.

6. What is the biomarker for iron deficiency? What secondary biomarker was used and why? Why is this a problem?

Screening for anemia is endorsed by the American Academy of Pediatrics, but anemia is the final stage of iron deficiency
due to our body’s prioritization of RBC iron needs over organs. So, neuroprotection is unlikely in this screening process.

Cord Blood Ferritin concentration predicts brain iron deficiency, yet lacks more research.

Reticulocyte Hbg content is the strongest predictor of iron deficiency, but needs to be tested on human infants before it
can be recommended as a screening tool.

7. What two, non-iron supplement process is thought to be beneficial to newborns?

Delaying the cutting of the umbilical cord for about 30-45 seconds right after birth, or clamping of a long segment of
umbilical cord and “milking” it towards the infant showed signs of higher Hgb concentration and iron store in infants

8. In section 5.1.3 the authors make a claim for supplementation. Do you agree with them? Why/why not?

It has yet to be determined that supplementation had any long-term positive effects on infant brain function. Some of
the studies listed were not published. We learned in class that lower percentages of iron are absorbed via supplements
opposed to foods high in iron. Also, not all women have access or money for iron supplements. So, no, I do not agree
with the authors about supplementation.

Things to Remember:

RAAS System and Sodium Balance:

- RAAS enhances reabsorption of sodium and chloride
- Aldosterone promotes reabsorption of sodium and excretion of potassium
- When BP & plasma fluid volume is low, Renin is released

ß Sodium Absorption

- Na+/glucose co-transporter
allows sodium inside the cell
- Na+/Cl- co-transport
exchanges Na+ for K+

Chloride Absorption:

Active – Na+/glucose co-transport system

Passive – electrogenic Na+ absorption

Exchange – Na+/Cl- co-transport absorption – chloride absorbed in exchange for bicarbonate, while sodium is absorbed
in exchange for K+
 Decreased calcium
potassium intake
excretion is caused by...

How is Chloride
serum concentrations
assessed?

How much Water is in the ECF: 14L

ECF and ICF? ICF: 28L

Increased sodium intake

Calcium excretion
also increases what?

What are the carrier proteins Heme: HCP1

for each iron type? Non-Heme: DMT1

What cation is found in the

Potassium
ICF?

What is the AI for

2300mg/day
chloride?

What is the difference between Ferrous: Fe2+

Ferrous and Ferric iron? Ferric: Fe3+

What part does water Water provides a medium for exchange

of nutrients and metabolic products to
play in interstitial fluid? and from plasma and cells

Where is heme and non- Heme: animal products

heme iron found? Non-heme - plants and supplements
 Which mineral is absorbed in
completely in the small intestine and Sodium
proximal colon?

Which mineral is absorbed via

passive diffusion or K+/H+ ATPase? Potassium