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Sodium is the primary extracellular cation. Sodium is responsible for almost one-half the osmolality of the plasma and, therefore, plays a central role in maintaining the normal distribution of water and the osmotic pressure in the extracellular fluid compartment. .Na+ may be lost in the kidneys as a result of diuretic therapy, salt-losing nephropathies, or adrenal insufficiency, with the urinary Na+ concentration usually more than 20 mEq/L. In these hypovolemic states, urine Na+ values less than 10 mEq/L indicate extrarenal Na+ loss. In hypervolemic states, a low urine Na+ (<10 mEq/L) may indicate nephrotic syndrome in addition to non-kidney causes.
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