I’m going to review 5 sets of equations that I often use in the evaluation of hospitalized patients with acid base and electrolyte disorders. I believe that familiarity with these is not only helpful for board testing, but also in clinical practice. Although there are apps that make it easy to do
Most people don’t like having kidney stone attacks and are motivated to prevent recurrences. However, there are some misconceptions. Some of the interventions patients try such as a low oxalate diet, avoiding tea, drinking citrus containing beverages or restricting dietary calcium are of minimal benefit or counter productive. What does the data show? 8 dietary
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
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
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
What is the Anion Gap? The anion gap is used in the diagnosis and evaluation of metabolic acidosis and is calculated by the following equation. Na+ - (Cl- + HCO3-) In reality all of the positive and negative charges in the body are equal. This equation only includes the major anions and cations.
What is a Renal Scan? A nuclear medicine renal scan involves imaging with a compound taken up by the kidney that is bound to a radioisotope. There are different compounds used that are bound to the radioisotope technetium: MAG3: 99m dimercaptosuccinic acid Most common compound used for renal scans Rapid extraction by renal
