Disorders of Volume: Core Curriculum 2025

Area of Science:

• Nephrology
• Physiology
• Internal Medicine

Background:

• Historically, disease was attributed to humor imbalance; modern medicine focuses on volume balance.
• The kidneys regulate extracellular volume via pathways like the sympathetic nervous system and renin-angiotensin-aldosterone system.
• Conditions like sepsis, heart failure, and cirrhosis disrupt fluid balance.

Purpose of the Study:

• To review the physiology of volume disorders.
• To discuss management strategies for hypovolemia and hypervolemia.
• To highlight the importance of volume management in nephrology practice.

Main Methods:

• Review of physiological principles of volume regulation.
• Discussion of clinical implications of volume imbalances.
• Case-based learning approach.

Main Results:

• Volume dysregulation is central to various critical illnesses.
• Understanding endothelial glycocalyx and venous congestion is key.
• Both volume overload and depletion have negative patient outcomes.

Conclusions:

• Effective volume management is essential for nephrologists.
• Current understanding challenges traditional volume management paradigms.
• Clinical cases illustrate complex volume disorder management.