Malignant Hyperthermia

Malignant hyperthermia is a rare but potentially life-threatening genetically-inherited condition in which severe autonomic instability is induced by exposure to various anesthetics. The most common offending agents are halothane (and any other halogenated anesthetic compound) and succinylcholine, and…

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Nephrology Boards

For any 2nd year renal fellows out there reading this: your first chance to take the ABIM Nephrology Boards is coming up this November 18, 2009. You can sign up by May 1st for the amazingly low-price of…

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Page Kidney

In 1939, Irwin Page performed an experiment in a dog model in which one kidney was wrapped in cellophane. The resultant external compression on the kidney resulted in elevated renin-angiotensin-aldosterone levels and severe hypertension. Over time, a loss…

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Thiazide-Induced Hyperglycemia

In recent years, there has been the suggestion that thiazide diuretics–long considered a front-line therapy for hypertension based on the ALLHAT study and others–may increase the risk of diabetes. Subsequent retrospective analysis of other major historical cohorts by…

Refeeding Syndrome

The clinical entity of refeeding syndrome was first described in U.S. POWs in Japan who had been starved for many months to years, then developed extreme electrolyte abnormalities upon the reintroduction of food. The most common electrolyte abnormalities…

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Beer Potomania

One of the admittedly rare causes of hyponatremia is beer potomania–the excessive consumption of beer in the absence of much food. How does beer potomania work? Beer has a very low content of sodium and protein–and if an…

SGK1 Polymorphisms

The most recent issue of NephSAP (“Fluids, Electrolytes, and Acid-Base Disturbances”) features a mini-review describing the role of the kinase SGK1 in the regulation of various nephrology-related disorders, such as salt-sensitive hypertension, metabolic syndrome, and renal fibrosis. How…

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Renal Adaptations to Hyperkalemia

Are ESRD patients “protected” from the arrhythmogenic effects of hyperkalemia if they are chronically exposed to elevated potassium levels? I’m not sure if there is a clear answer to this question, but it is certainly a relevant question….

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Outside Hospital

At the risk of offending community hospitals out there…I present to you “Outside Hospital”, a video I helped make during my residency in Internal Medicine parodying some of the outside hospitals from which we used to receive patient…

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Underuse of ACS Therapy in CKD

A recent paper in AJKD by Patel et al describes a curious but well-documented phenomenon: the finding that patients with CKD who are hospitalized with acute coronary syndrome (ACS) are less likely to receive therapies known to be…

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