Renal system fluid loss from

A small amount of Lewisite on the skin will cause local edema because of the effects of this agent on local capillaries. With a large amount of Lewisite, the pulmonary capillaries are also affected (because they are more sensitive to Lewisite than other capillaries or because absorbed Lewisite reaches the lungs before it reaches the systemic circulation) there is edema at the site of exposure and pulmonary edema. With even larger amounts of Lewisite, all capillaries are affected, and proteins and plasma leak from the circulation into the periphery. Even after small amounts of Lewisite, the fluid loss can be sufficient to cause diminution of renal function and hypotension.104... 

The sodium ion concentrations in body fluids are listed in Table 1 [2]. From a physiological viewpoint, Na provides the bulk of osmotically active solutes in plasma with its associated anions, thus affecting the distribution of the body water significantly. An excess translocation of Na into cells or a loss of it from the body results in a decrease of extracellular fluid volume, affecting circulation, renal function, and nervous system function. 

From the point of view of potassium balance, there is increased renal excretion of potassium, loss of potassium in the vomitus and no potassium being delivered for absorption in the alimentary tract. All these factors contribute to a severe depletion of the body s total potassium content. Yet another factor contributes to potassium loss. A drop in volume of the circulating blood leads to aldosterone secretion via the renin-angiotensin mechanism which, in turn, promotes sodium reabsorption in the renal tubule this contributes further to excessive renal loss of potassium and hydrogen ions. The acidity of the urine is inappropriate as a response to metabolic alkalosis, but the preservation of electrolyte and fluid volume takes precedence over the acid-base disturbance. These various efiects all combine to yield a positive feedback system driving the metabolic alkalosis which, if not treated, reaches lethal levels in a few days. 

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