Basics in Clinical Nutrition: Water and Electrolytes in Health and Disease

e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 2008 Dec 1; 3(6):E259-E266. doi: 10.1016/j.eclnm.2008.06.004. Epub 2008 Sep 22.
Sobotka, L., Allison, S., & Stanga, Z.


Water and electrolytes are essential components of the “milieu interieur” of the body, creating an environment which surrounds nearly all cells and through which the metabolites and gases pass to and fro. They are also major intracellular components, being 75% of muscle cells but less than 5% of fat cells. The electrolyte gradient across cell membranes is a prerequisite for cell excitability, signal conduction, transport processes and cell movement. Electrolytes also serve as second messengers, co-enzymes or have structural functions. It is important to consider fluid and electrolyte balance in terms not only of external gain or loss, but also in relation to the shifts, which occur between the internal fluid compartments as a consequence of disease.

Learning objectives

  • To understand basic concepts in water and electrolyte metabolism.
  • To be aware of the influence of trauma and sepsis on fluid and electrolyte physiology.
  • To understand the consequences and treatment of extrarenal losses of water.

Information NutriBib

Reference work for leading, current and selected literature in the field of clinical nutrition

Publications on clinical nutrition have grown steadily in recent years and the scientific evidence has been improved by numerous observational as well as intervention studies. Various umbrella organisations, such as the Swiss Society for Clinical Nutrition (GESKES), the German Society for Nutritional Medicine (DGEM) or the European Society for Clinical Nutrition and Metabolism (ESPEN) publish guidelines on nutrition in various clinical situations at regular intervals. Thus, a large amount of literature is available for evidence-based nutritional medicine.

The NutriBib aims to filter out authoritative publications in the various fields of nutritional medicine and thus to provide an overview of the abundance of literature. A large number of experienced nutrition experts contributed to the selection of relevant sources and allow a broadly based selection. Nevertheless, the literature selection cannot be considered exhaustive. Specific literature can be found by entering search words (using the magnifying glass at the top right) or by searching the table of contents.

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List of abbreviations

DGEM German Society for Nutritional Medicine (German Deutsche Gesellschaft für Ernährungsmedizin)
GESKES  Swiss Society for Clinical Nutrition (German Gesellschaft für klinische Ernährung der Schweiz) 
ESPEN European Society of Clinicl Nutrition and Metabolism