Brain and CSF water and ions during dilutional and isosmotic hyponatremia in the rat

Dilutional (DH) and isosmotic (IH) hyponatremia (plasma [Na+] = 103-109 meq/l) were produced in conscious rats over 3-6 h by intraperitoneal injection of water or mannitol Ringer solution. During DH, CSF [Na+], [Cl-], and osmolality decreased as predicted by passive dilution by the water load. During IH, these variables exhibited little change. Brain water was unchanged during IH despite significant reduction of brain Na+ and Cl- content suggesting that tissue ions lost were replaced by other osmoles. During DH, brain water increased but less than predicted by passive osmotic equilibration. Cell volume increased as predicted by passive swelling while the extracellular volume (Cl space) decreased. Tissue K+ content decreased by a small but significant amount. Tissue Na+ and Cl- decreased by 21 and 28%. This pattern of fluid compartmental and electrolyte changes suggests that brain volume regulation during acute DH occurs via reduction of extracellular volume as cells swell. This may result from bulk flow of extracellular fluid to CSF or from ion and water movement across the blood-brain barrier.