key Try Dr. O'Callaghan's QUIZ: What are millimoles, milliequivalents, and milliosmoles? How is the formula for osmolarity computed? How is dextrose different from glucose in terms of molecular weight? What is the difference between BUN and urea?

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Emmett
Radhakrishnan

Nephrology Quiz and Questionnaire: Fluid and Electrolyte and Glomerulonephritis Cases

Michael Emmett, MD, and Jai Radhakrishnan, MD
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Emmett: Case 2: Was it laxative that the patient drank? The wife said it was magnesium citrate. Anyway, now he's comatose with normal electrolytes. Then his creatinine goes up and his serum osmolality does, also, with positive ketones, but no acidosis. How would you treat him? Case 6: A woman who takes Topamax for migraines presents with hyponatremia and hyperchloremic acidosis. How does topiramate affect the kidney and what indications is it being used for? Radhakrishnan: Case 4: Young AA woman with nephrotic syndrome and elevated ANA. OK, it's membranous: lupus or not? If lupus, how do we treat it? Case 8: Middle-aged female with acute fulminant GN picture and a creatinine of 10. Is it worth treating her? What if she has anti-GBM? What if she has MPO-ANCA? .
(more...)


Palmer
Verbalis

Novel Therapeutics for Fluid and Electrolyte Disorders

Joseph G. Verbalis, MD, and Biff F. Palmer, MD
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Verbalis: What are the potential benefits of the vaptans in the treatment of SIADH? What are the proven advantages? Unproven advantages? Are there nonresponders to vaptans? If so, by what mechanism? Should vaptans be used in the treatment of acute hyponatremia? What are the potential lesser known adverse effects of hyponatremia in terms of cognitive function? Falls? Bone density? Palmer: How common is hyponatremia? What are the risk factors? How effective are the vaptans? What were the results of SALT1 and SALT2? How expensive is treatment with conivaptan? How might these high costs be justified in a hospital setting? Why does hyponatremia after vaptan treatment sometimes persist after vaptans are discontinued? What is one genetic basis of resistance to vaptans? (more...)

Updated: July 12, 2016 (Jul12)
Jul12 Dr. Fred Coe videos on urine calcium supersaturation in stone disease.
Dec14 Even more news on the new HDCN Facebook page!
Dec01 Higher serum Mg associated with decreased risk of sudden death in dialysis patients.
Jun29 Drink when thirsty advice for athletes from Sports Medicine group
Nov17 JAMA: New hyperkalemia sorbent effective in reducing hyperkalemia
Jan14 ZS Pharma announces positive results from extended treatment results of hyperkalemia drug.
Nov19 New study of spironolactone in heart failure fails to show improvement in many hard outcomes.
Nov01 New oral sorbent targeting hyperkalemia; trial results to be presented at ASN.
Oct27 New K-absorbing compound prevents hyperkalemia with spironolactone.
Mar15 New Handbook of Nephrology title available from LWW.
Jan10 Simulated Mars mission reveals body's sodium rhythms
Oct17 Lower chloride use in intravenous fluids may reduce risk of acute kidney injury.
Oct16 Some turtles excrete more urea via the mouth than in the urine.
Sep25 Intravenous hypertonic saline solution reduces inflammation by shrinking cells.
Aug31 Manuscript describing effects of acetic acid and sodium diacetate on acid-base balance now available.
Industry Advances Emphasis
archive
Disorders of Serum Sodium in the Elderly (F. Michelis) ASN Renal Week 2008
Urinary Concentration and Dilution in the Aging Kidney (M. Sands) ASN Renal Week 2008
Pharmacological Correction of Nephrogenic Diabetes Insipidus (M.T. Deen) ASN Renal Week 2008
Nephrology Quiz and Questionnaire: Fluid and Electrolyte and Glomerular Disease Cases (Emmett, Radhakrishnan) ASN Renal Week 2007
Fluid & Electrolytes (Emmett) ASN Renal Week 2007
Genetic Heterogeneity in Dent Disease (J. Scheinman) ASN Renal Week 2007
Novel Therapeutics for Fluid and Electrolyte Disorders (Verbalis, Palmer) ASN Renal Week 2007
Electrolyte/Acid-Base Emergencies in the ICU (Palmer) ASN Board Review 2007
Magnesium Balance: Hypomagnesemia and Hypermagnesemia (Coyne) ASN Board Review 2006
Disorders of Sodium Metabolism: Case Presentations (Berl, Stokes) ASN Board Review Course 2006
Permissive Hypercapnia in Acute Pulmonary Disorders: Morbidity and Mortality and Treating the Respiratory Acidosis (Lanken) ASN Renal Week 2005
Literature Review: Non-Potassium Fluid-Electrolyte and Acid-Base Disorders (Palmer) ASN Renal Week 2005
Workshop Cases - Non-Anion Gap Acidosis (Alexander) ASN Board Review 2005
Case Discussions of Hyponatremia and Hypernatremia (Berl and Gluck) ASN Board Review 2005
Current Concepts in Neurohormones: Vasopressin and the Kidney (Schrier, Sterns) ASN Renal Week 2005
Acid-Base Enigmas: New Observations (Oh, Lanken, Kraut) ASN Renal Week 2005 (audio only)
Nephrology Quiz & Questionnaire: Fluids and Electrolytes (Halperin) ASN Renal Week 2005 (audio only)
Calcium and Phosphorus: Key Physiologic Principles (Bushinsky) ASN Board Review 2004
Literature review: A year in nephrology - fluids and electrolytes (Arruda) ASN Renal Week
Anion gap metabolic acidosis . Part one of two. (Emmet) ASN Annual Board Review Course
Anion gap metabolic acidosis . Part two of two. (Emmett) ASN Annual Board Review Course
Potassium : Key physiologic principles; hypokalemic and hyperkalemic disorders . Part 1 of 2 (Palmer) ASN Annual Board Review Course
Potassium : Key physiologic principles; hypokalemic and hyperkalemic disorders . Part 2 of 2 (Palmer) ASN Annual Board Review Course
Issues of volume regulation . Case studies. Part two of two (Weisberg) ASN Annual Board Review Course
Issues of volume regulation . Case studies. Part one of two (Weisberg) ASN Annual Board Review Course
Renal water handling : A summary of practical physiology (Sterns) ASN Annual Board Review Course
Edema states, pathosphysiology and therapy. Part one of two: Pathophysiology (Weisberg) ASN Annual Board Review Course
Regulation of sodium balance: A summary of pratical physiology (Schuster) ASN Annual Board Review Course
Hypercalcemia and hypocalcemia: Associated disorders and therapy (Suki) ASN 2002 Renal Week
Renal tubular acidosis (Arruda) ASN 2002 Board Review Course
Disorders of potassium metabolism: Case discussions (Arruda) ASN 2002 Board Review Course
Metabolic alkalosis (DuBose) ASN 2002 Board Review Course
Distal renal tubular acidosis: from the ammonium chloride test to genetic analysis (Wrong) NKF Illinois Special Symposium
Lactic acidosis (Szerlip) ASN/ISN 2001 Meeting
Renal tubular acidosis: Basics of proximal and distal RTA (Arruda) ASN 2001 Board Review
Renal tubular acidosis: Case Presentations (Arruda) ASN 2001 Board Review
Potassium physiology and pathophysiology (Alpern) ASN 2000 Board Review
Syndromes of hypo- and hypermagnesemia (Goldfarb) ASN 2000 Board Review
Calcium and phosphorus regulation: Gut, parathyroid glands, and kidney (Moe) ASN 2000 Board Review
Management of hyperkalemia in ESRD (Allon) ASN 1998 Annual Meeting
Pathogenesis and diagnosis of hypo- and hypernatremia (Ayus) ASN 1998 Board Review Course
Treatment of hypo- and hypernatremia (Berl) ASN 1998 Board Review Course
Introduction to metabolic acidosis (Narins) ASN 1998 Board Review Course
Distal renal tubular acidosis: a simplified pathophysiologic approach to diagnosis (DuBose) NY Soc Nephrol Lecture Series

Early and Late Presentations of Ethylene Glycol Poisoning Am J Kidney Dis (Jun 2009)
Hypertension, Salt and Bread (Akpolat et al) Am J Kidney Dis (Jun 2009)
Gitelman Syndrome (Roser M et al) Hypertension (Jun 2009)
Fluid, electrolyte and acid-base disorders associated with antibiotic therapy Nat Rev Nephrol (Apr 2009)
Citrate- vs. acetate-based dialysate in bicarbonate haemodialysis: consequences on haemodynamics, coagulation, acid-base status, and electrolytes (Gabutti et al) BMC Nephrol (March 2009)
Mechanisms in hyperkalemic renal tubular acidosis J Am Soc Nephrol (Feb 2009)
Changes in serum potassium mediate thiazide-induced diabetes Hypertens (Dec 2008)
Acid-base disturbances in gastrointestinal disease Clin J Am Soc Nephrol (Nov 2008)
Hyperkalemia caused by penicillin Am J Med (Aug 2008)
Changes in serum potassium mediate thiazide-induced diabetes Hypertens (Dec 2008)
Idiopathic membranous nephropathy: diagnosis and treatment Clin J Am Soc Nephrol (May 2008)
WNK kinases and renal sodium transport in health and disease: an integrated view Hypertens (Mar 2008)
Changes in the potassium content of different potato varieties after cooking J Ren Nutr (Mar 2008)
The utility of the transtubular potassium gradient in the evaluation of hyperkalemia J Am Soc Nephrol (Mar 2008)
Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study Brit Med J (Feb 2008)
Cerebral salt wasting versus SIADH: What difference? J Am Soc Nephrol (Feb 2008)
Metabolic acidosis inhibits soft tissue calcification in uremic rats Kidney Int (Feb 2008)
24-h uric acid excretion and the risk of kidney stones Kidney Int (Feb 2008)
Fatal hyperammonemic encephalopathy after gastric bypass surgery Am J Med (Jan 2008)
Thiazide-induced subtle renal injury not observed in states of equivalent hypokalemia (Reungjui et al) Kidney Int (Dec 2007)
Hyponatremia, arginine vasopressin. dysregulation, and vasopressin receptor antagonism (Rai et al) Am J Nephrol (Dec 2007)
Management of hyperkalemia in dialysis patients (Putcha et al) Semin Dial (Oct 2007)
Is there an unrecognized epidemic of primary aldosteronism? (debate) (Calhoun & Kaplan) Hypertens (Sep 2007)
Use of the {delta}AG/{delta}HCO3- Ratio in the diagnosis of mixed acid-base disorders (Rastegar) J Am Soc Nephrol (Sep 2007)
Hospital-acquired hyponatremia - why are hypotonic parenteral fluids still being used? (Moritz et al) Nature Clin Pract Nephrol (Jul 2007)
Hypophosphatemia: clinical consequences and management (Brunelli et al) J Am Soc Nephrol (Jul 2007)
Vasopressin receptor antagonists Dial Transplant (Jul 2007)
Hospital-acquired hyponatremiaA?€twhy are hypotonic parenteral fluids still being used? (Moritz ML and Ayus JC) Nature CP Nephrol (Jul 2007)
Neurologic effects of hyponatremia and its treatment (Widdess-Walsh P et al) Cleveland Clinic J Med (May 07)
Hypomagnesemia in patients with type 2 diabetes (Pham et al) CJASN (03-2007)
Serum anion gap: its uses and limitations in clinical medicine (Kraut, Madias) CJASN (01-2007)
Electrolyte disturbances in the intensive care unit (Sedlacek , Schoolwerth, Remillard) Sem Dial 12-06
Hyponatremia, arginine vasopressin. dysregulation, and vasopressin receptor antagonism (Rai et al) Am J Nephrol 12-06
Acid-base transport by the renal proximal tubule (Boron). JASN 09-06
Tools, Calculators
Normal values+
Moles and molarity
Henderson-Hasselbach
Calculating osmolarity
Topic Pages
Acidosis
Alkalosis
Hyponatremia
Hypernatremia
Hypokalemia
Hyperkalemia
Hypomagnesemia
Hypermagnesemia
Hypocalcemia
Hypercalcemia
Polyuria
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Dr. Chris O'Callaghan, M.D.
BA, BM, BCh, MA, MRCP (UK), DPhil
Medical Research Council Clinician Scientist
Institute of Molecular Medicine and, Nuffield Department of Clinical Medicine University of Oxford, John Radcliffe Hospital, Oxford, UK