Endocrine disorders are in the differential diagnosis of hyponatremia. These need to be distinguished from SIADH (Syndrome of Inappropriate Antidiuretic Hormone). In the article on the laboratory evaluation of hyponatremia read here and watch here, we learned that in hypotonic hyponatremia if the urine osmolarity is > 100 ADH is present and that
What is your differential for nephrotic proteinuria? First: Nephrotic proteinuria > 3.5 grams/ 24 hrs or random urine protein creatinine ratio >3.5 grams per gram Nephrotic syndrome: Nephrotic proteinuria with associated clinical manifestations of hypoalbuminemia, edema, hyperlipidemia As mentioned here: Proteinuria What it is and How I Treat Begin considering these diagnoses when
A fundamental principle of nephrology is this: What comes in has to go out. If more comes in than goes out or more goes out than comes in sooner or later you're going to be in trouble. This is how I think out too much potassium in the blood - also known as
Primer for rounding on dialysis patients in the outpatient clinic. Intended for physician extenders, new fellows, and any other provider who wants to understand the mystery of dialysis. Topics: Acute Kidney Injury without recovery requiring continued outpatient dialysis Adequacy of dialysis Dialysis access Catheter Arteriovenous Access Anemia management Nutrition Mineral Bone Disease HTN/
What is normal GFR? GFR is the glomerular filtration rate. It is the amount of blood filtered by the glomeruli per unit time. We are born with about a million glomeruli. It is reported in milliliters per minute. From the age of 2 to the age of 25 a normal GFR is 125
Community Hospital Management of Renal Transplant Patients Kidney transplants are good. Messing up a kidney transplant is bad. As a nephrologist at a non transplant hospital this is an issue I fear. Maybe I fear it too much, more than necessary, but I fear it nonetheless. Here is my opinion. Going to break
As a nephrologist I get sent patients with resistant or difficult to control HTN. Here’s an approach, why I do it and what it tells me. 24 hour ambulatory BP monitoring What it tells me: Is it really HTN or is it pseudo resistance? White coat syndrome, white coat effect Technique of measurement.
First of all, what’s the difference between a fistula and a graft? To do dialysis you need to be able to consistently insert two large bore needles, 3 times a week. This is typically done via a fistula or graft. Fistula: An artery is redirected to directly connect to a vein. Over time
You know or can look up the standard diagnostic algorithm for hyponatremia. Hypovolemic Euvolemic Hypervolemic Not doing this here. Read on to find out what the labs tell you. Knowing this will supplement and deepen your understanding. We’ll be analyzing the following labs: Serum Sodium Serum Osmolarity Urine Osmolarity Urine Sodium Uric acid
Here’s my approach to proteinuria. Albumin, microalbumin, protein - What’s the difference? Most urinary protein is albumin In glomerular diseases urinary albumin is 55-60% of the total urinary protein If the percentage is low (urinary albumin < 40% of the total urinary protein) think tubulointerstitial disease If the percentage is very low (urinary
