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World J Nephrol. Jan 21, 2019; 8(1): 23-32
Published online Jan 21, 2019. doi: 10.5527/wjn.v8.i1.23
Dehydration and volume depletion: How to handle the misconceptions
Muhammad Asim, Mohamad M Alkadi, Hania Asim, Adil Ghaffar
Muhammad Asim, Mohamad M Alkadi, Hamad General Hospital, Hamad Medical Corporation and Weill Cornell Medicine-Qatar, Doha 3050, Qatar
Hania Asim, Birmingham City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom
Adil Ghaffar, Saint Vincent Hospital, Worcester, MA 01608, United States
Author contributions: Asim M and Asim H conceived the original idea; all authors equally contributed to literature review, drafting, critical revision and final approval of the final version; Asim H also designed the figures.
Conflict-of-interest statement: No potential conflicts of interest in relation to this article. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Muhammad Asim, BSc, MBBS, Associate Professor, Hamad General Hospital, Hamad Medical Corporation and Weill Cornell Medicine-Qatar, Al-Rayan Street, Doha 3050, Qatar. masim@hamad.qa
Telephone: +974-55-838342 Fax: +974-43-92273
Received: August 27, 2018
Peer-review started: August 27, 2018
First decision: October 4, 2018
Revised: November 2, 2018
Accepted: January 3, 2019
Article in press: January 4, 2019
Published online: January 21, 2019
Abstract

Dehydration and volume depletion describe two distinct body fluid deficit disorders with differing pathophysiology, clinical manifestations and treatment approaches. However, the two are often confused or equated with each other. Here, we address a number of commonly encountered misconceptions about body-fluid deficit disorders, analyse their origins and propose approaches to overcome them.

Keywords: Body fluids, Dehydration, Volume depletion, Misconceptions

Core tip: The conceptual error of using the term “dehydration” as a non-specific generic term to represent any type of fluid deficit affecting any fluid compartment, or even worse, to imply extracellular fluid volume depletion remains disturbingly prevalent among medical students and doctors. Careless and casual use of the term “dehydration” for patients who, in fact, have intravascular “volume depletion” contaminates the medical language, creates misleading impressions and unfortunately, in some cases, leads to inappropriate management. We propose a multi-faceted approach that supplements real life clinical scenarios with reflective activities through active participation of students and helps remove these robust misconceptions and instigate conceptual restructuring.