One of the major problems we struggle with in haemodialysis patients is excess, volume, inter-dialytic weight gain and ultrafiltration. Despite constant reminders by nursing staff, physicians and nutritionists, patients seem to find it extremely hard to restrict their…
Ok, so here is the brief review of the various clinical methods of detecting sodium concentration (as I understand it): Flame photometer The older flame photometer method measured the concentration of sodium in plasma. The preparation of the…
Sodium is the most abundant extracellular cation in humans. The concentration in the extracellular fluid is highly influenced by the amount of fluid it is dissolved in – the reason why we always say that most low sodium…
Eculizumab is a humanized monoclonal antibody that binds to and prevents activation of the C5 complement protein. As you may remember, this protein is critical to the formation of the membrane attack complex (MAC) in complement dependent immune…
A randomized controlled trial of loop diuretics was published in NEJM two weeks ago. The trial involved 308 patients, from 26 clinical sites. The details are below: Type: Prospective double-blind randomized controlled trial (intention to treat analysis) Inclusion:…
A recent post got me thinking of the differential diagnosis of blood-stained peritoneal dialysis effluent. I thought it would be interesting to share some of the differentials and to remember that the Tenchkoff catheter can truly be a…
There are two major types of intercalated cell in the collecting duct of the nephron – the alpha and beta intercalated cells. We are probably most familiar with the alpha intercalated cells in terms of acid-base handling by…
Just a quick piece to review the inheritance pattern of Fabry’s disease, a relatively rare, but under-recognized cause of End-Stage Kidney Disease in adults. Fabry’s disease is an X-linked recessive disease, caused by a defect in the gene…
No time like the present for a quick review of urine electrolytes. Is there any such thing as a ‘normal’ urine sodium? Not really – like all great answers in medicine, ‘it depends’. In general, in patients who…
As part of the regular hemodialysis prescription, we as providers have to prescribe the type of membrane we want used for the procedure. This decision is mostly based on what membranes our dialysis unit chooses to buy –…
