Nephrology

Electrolyte disorders

Questions discussed in this category

Has your management of severe hyponatremia changed after a recent observational study described higher in-hospital mortality for sodium correction of <6 mEq/L compared to 6-10 mEq/L in the first 24 hours?

Seethapathy et al., NEJM

5 Answers available

What are your next steps when managing patients with suspected Gitelman syndrome for whom genetic testing reveals variants of uncertain significance or novel mutations not well characterized?

2 Answers available

Do you routinely use 3% sodium chloride and desmopressin to correct hypovolemic hyponatremia in an asymptomatic patient with serum sodium of less than 120 mEq/L?

3 Answers available

Is there a role for SGLT-2 inhibitors in the treatment of chronic hypomagnesemia?

1 Answer available

What is your daily correction goal for those patients being treated for hypernatremia?

2 Answers available

Do you recommend obtaining a spot urine or 24-hour urine magnesium measurement when evaluating patients with persistent hypomagnesemia of unknown etiology?

3 Answers available

How often do you check urine osmolality and urine electrolytes when treating hospitalized patients with hyponatremia?

2 Answers available

How do you approach a patient with biochemical evidence of primary hyperparathyroidism, but normal parathyroid scan?

4 Answers available

What is your approach to using bisphosphonates in those with severe hypercalcemia and chronic kidney disease?

1 Answer available

What are your top takeaways from ASN 2023?

2 Answers available

Do you recommend checking urine sodium 2 hours after loop diuretic administration to determine the need for dose adjustment in a patient with acute decompensated heart failure?

1 Answer available

In a patient with severe hyponatremia and acute kidney injury in the setting of hypovolemic shock, would fluid resuscitation take precedence over the rate at which sodium is corrected?

2 Answers available

Do you consider hyperuricemia as a potential etiology of an anion gap metabolic acidosis in patients with elevated uric acid levels and no other readily explainable causes of acidosis?

1 Answer available

What is your preferred intravenous fluid type for matching volume loss in a patient with persistent surgical drain output and pre-renal acute kidney injury?

1 Answer available

What additional studies would you obtain for a patient with end stage kidney disease on hemodialysis who has persistent hypercalcemia and low PTH?

1 Answer available

Do you recommend using dextrose based solutions to induce osmotic diuresis for euvolemic patients with acute kidney injury in the setting of a hemolytic condition?

1 Answer available

Can an acid loading test be used to assist with the diagnosis of RTAs other than an incomplete distal RTA?

1 Answer available

Does your goal rate of correction in patients with chronic hypoosmolar hyponatremia differ based on the degree of hypoosmolarity?

4 Answers available

Do you recommend stopping Vitamin D supplementation in a patient with hypercalcemia and a low 25(OH)D level?

1 Answer available

Do you use tolvaptan for management of hyponatremia related to heart failure given the side effect profile and lack of mortality benefit seen in a previous trial?

The EVEREST Outcome trial (Konstam et al., PMID 17384437)

1 Answer available

How do you treat sarcoidosis associated hypercalcemia in a patient with adenopathy and no other signs of systemic involvement?

1 Answer available

How would you manage hemodialysis for an ESKD patient who presents with a phosphorus of 1.6 mg/dl and potassium of 6.5 mEq/L without ECG changes?

1 Answer available

What degree of hyperkalemia do you tolerate for those with proteinuric chronic kidney disease and persistently elevated serum potassium levels?

1 Answer available

What is your approach to managing hypocalcemia following a parathyroidectomy in patients with end stage kidney disease?

1 Answer available

Do you prefer transtubular potassium gradient (TTKG) or urine potassium to urine creatinine ratio when evaluating patients with abnormal potassium levels?

1 Answer available

What is your daily correction goal for those patients being treated for hyponatremia?

1 Answer available

How do you manage calcium and vitamin D supplementation in patients with sarcoidosis on chronic steroids?

1 Answer available

Papers discussed in this category

Clin Chim Acta, 2020 Oct 20

Diagnostic value of parameters from a spot urine sample for renal potassium loss in hypokalemia.

Am J Kidney Dis, 2019 Jun 19

Physiology and Pathophysiology of Potassium Homeostasis: Core Curriculum 2019.

Curr Opin Nephrol Hypertens, 2011 Sep

Intrarenal urea recycling leads to a higher rate of renal excretion of potassium: an hypothesis with clinical implications.

Kidney Int, 2002 Jul

Hyperkalemia: An adaptive response in chronic renal insufficiency.

Clinical journal of the American Society of Nephrology : CJASN, 2019-05-07

Rate of Correction of Hypernatremia and Health Outcomes in Critically Ill Patients.

Curr Opin Cell Biol, 1995 Aug

Cell volume regulated transporters of compatible osmolytes.

AACE Clin Case Rep, 2020 Aug 06

METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA.

Am J Med, 1987 Jun

Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis.

Sarcoidosis Vasc Diffuse Lung Dis, 2012 Mar

Hypercalcemia from sarcoidosis successfully treated with infliximab.

Arch Osteoporos, 2017 Jul 19

Glucocorticoid sparing effect of zoledronic acid in sarcoid hypercalcemia.

BMJ Case Rep, 2022 Jul 08

Hungry bone syndrome like presentation following single-dose denosumab for hypercalcaemia secondary to sarcoidosis with IgA nephropathy.

Arthritis Res Ther, 2014 Mar 24

Bone fragility in sarcoidosis and relationships with calcium metabolism disorders: a cross sectional study on 142 patients.

Kidney international, 1997 Oct

Mannitol therapy revisited (1940-1997).

The American journal of medicine, 2016-05

Diagnosing and Treating the Syndrome of Inappropriate Antidiuretic Hormone Secretion.

Clinical journal of the American Society of Nephrology : CJASN, 2018-07-06

Risk Factors and Outcomes of Rapid Correction of Severe Hyponatremia.

Journal of critical care, 2023 May 13

Effects of correction rate for severe hyponatremia in the intensive care unit on patient outcomes.

The Journal of urology, 1992-06

Functional obstructive uropathy: a significant factor in the hyponatremia of psychogenic polydipsia?

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2013-04

Hypertonic saline and desmopressin: a simple strategy for safe correction of severe hyponatremia.

Nephrology

Electrolyte disorders

Questions discussed in this category

Papers discussed in this category

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