The question of reference is, again, dependent upon what you think about. For example, if one thinks that protein synthesis is dependent upon concentration of relative aminoacids, then the concentration relationship becomes important. But it may not be dependent upon concentration; it may be dependent upon certain enzyme activities with vast excesses of substrate, serum concentration; overdoses may not be important. There is one thing to say for the ratio and that is that if the ratio excludes the independent division so that if one is concerned with phenilalanine and valine for example, they are both divided by the same thing, that is to say water content and the water cancels out. So, the relationship of each to the other is at least stabilized by the ratio; that is also arbitrary. I just wanted to comment about one more thing. I did not mean to imply that measurement of plasma values is useless. Of course they are not useless. They are invaluable, but what I did want to emphasize is that the plasma value by itself is not going to tell you the whole story. High plasma potassium could mean that, a lot of potassium is coming out of the cells or it could mean that not enough potassium is going into the cells or it could mean that not enough potassium is excreted or that too much has been given.
KeywordsPanel Discussion Uremic Patient Intracellular Water Intracellular Sodium Extracellular Water
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