Tolvaptan is a vasopressin receptor antagonist, specific for the V2 receptor. This impairs urinary concentration and increases water excretion. Tolvaptan is classified as an aquaretic. In contrast to diuretics, aquaretics stimulate water excretion without significant electrolyte loss. What is Vasopressin? Vasopressin is the same thing as antidiuretic hormone (ADH). It is a hormone
A normal sodium on a lab test is 140 mEq (or mmol) / liter, but normal saline (which is purportedly isotonic to plasma) is 154 mEq/liter. What gives? This article will describe how sodium is measured clinically and explain this apparent discrepancy. How Sodium is Measured Historically sodium was measured by flame photometry,
Primary hyperaldosteronism is the most common modifiable cause of secondary hypertension with an estimated prevalence as high as 20%. This article will review normal aldosterone secretion and oversecretion, indications for screening, how to screen and confirm the diagnosis. Normal Aldosterone Secretion and Mechanism of Action Secreted by the zona glomerulosa of the adrenal
The definition of dialysis is: “the separation of particles in a liquid on the basis of differences in their ability to pass through a membrane”. Clinically dialysis requires: Access to blood A semipermeable membrane Dialysis solution Particles (urea, creatinine, other uremic molecules and electrolytes) diffuse between blood and dialysate down the concentration gradient.
Sleep has always been important to me, not because of any specific health benefit. I just don’t like being tired. It turns out sleep has important health benefits too. Not the least of which is an association with living longer and healthier. How sleep helps prevent chronic disease | Peter Attia, M.D. Over the past
Many, if not most patients with chronic kidney disease (CKD) will have indications and benefit from pharmacologic treatment of hyperlipidemia. Despite this patients and some clinicians may have concerns about nephrotoxicity with use of these medications. This article will review the data regarding renal safety and the potential for adverse renal effects of
What Is Abiraterone? Abiraterone (Zytiga) is a medication used in the treatment of metastatic prostate cancer. It works by decreasing the production of androgens in the testes, adrenal glands and the prostate tumor (androgen deprivation therapy). Abiraterone inhibits the enzyme Cytochrome P450 C17A1 (CYP17A1). This enzyme has two functions: 17𝝰-hydroxylase 17,20 lyase Inhibition
Alport syndrome is the most common inherited kidney disease, more prevalent than autosomal dominant polycystic kidney disease (ADPKD). Awareness of this condition, particularly the autosomal recessive and autosomal dominant variants, has increased as genetic testing has become mainstream. What is Alport syndrome? Alport syndrome is a genetic condition with an abnormality of type
Creatine and creatinine sound similar, similar enough that patients may mistake them. And then there’s creatinine kinase (CK) or creatinine phosphokinase (CPK). If you’ve wondered what the difference is you're in luck - read on. Creatine Creatine is a molecule composed of 3 amino acids: glycine, arginine, and methionine. 90% of creatine is
Bisphosphonates and denosumab are anti resorptive medications used for the treatment of: Osteoporosis Hypercalcemia, especially hypercalcemia of malignancy Hypercalcemia, Nephrology and the Milk Alkali Syndrome @BCNephro Hypercalcemia BCNephro Malignancy, particularly multiple myeloma and bone metastasis with solid tumors (prostate, breast, lung) Both classes of medications exert their anti resorptive effects by inhibiting osteoclast
