Considerable difficulties have been encountered in interpreting changes in the plasma sodium concentration. These difficulties derive from the unique place of sodium among the solutes of plasma. Ordinarily we are fully justified in considering deviations from normal of the concentration of a particular substance in plasma as indicating some disturbance in the metabolism of that substance. If the plasma glucose is high, we are safe in assuming that the rate of entry of glucose into the blood is high or its removal low. If the plasma potassium is high, we may conclude that there is an excess of potassium in the body or a disturbance in the distribution of potassium. But if we consider an abnormality of the plasma sodium concentration to indicate an abnormality of sodium metabolism, we will probably be wrong as often as we will be right. The unique place of sodium among the solutes of plasma
BERLINER RW. The Regulation of Water Balance and Plasma Sodium Concentration. AMA Arch Intern Med. 1958;102(6):986–989. doi:10.1001/archinte.1958.00260230132016
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