If you’ve never heard the biochemical sleuthwork involved in the legal case of Patricia Stallings, it’s definitely worth reading about: a good summary of the case can be found here. Briefly, it involves a St. Louis-area woman who,…
One of the more common (and potentially successful) suicide attempts is to drink a bunch of antifreeze, which contains ethylene glycol. As we all know, this is typically diagnosed by characteristic lab abnormalities: patients present initially with an…
One of the rare (but potentially underdiagnosed) causes of anion gap metabolic acidosis is acquired 5-oxoprolinuria due to excessive Tylenol ingestion. To explain how this works, you need to familiarize yourself briefly with the gamma-glutamyl cycle, a series…
Following up on the discussion of milk-alkali syndrome, a similar syndrome (hypercalcemia, metabolic alkalosis, and acute renal failure) may also occur due to betel nut chewing. Betel nut chewing is a common habit and cultural practice amongst Indian…
Heard about a case of milk-alkali syndrome at Renal Grand Rounds yesterday. This is an interesting condition whose pathophysiologic mechanism really tests your knowledge of calcium and acid-base homeostasis. I won’t attempt to chart the pathway but a…
Us renal fellows are likely to take for granted the fact that virtually all dialysis buffers used today are bicarbonate-based buffer systems. The bicarbonate-CO2 buffer system is the dominant buffer system in the human body, patients without renal…
Heard a great talk today from the 2007 recipient of the Homer Smith Award & editor of Kidney International: Qais Al-Awqati of Columbia. The full details of much of the talk can be found in this JASN article…
I was recently alerted to a great lecture series on acid-base & electrolytes by Mitch Halperin and colleagues which are published in the Quartery Journal of Medicine (QJM). They are generally case-based articles which use an imaginary physician…
Pendred Syndrome is an autosomal recessive disorder caused by mutations in the solute carrier family 26 member 4 gene (SLC26A4) which has some relevance to nephrology and acid-base metabolism. Its main phenotypic manifestations are thyroid goiter and sensorineural…
Licorice–particularly European licorice which contains higher doses of the natural sweetener glycyrrhizic acid (GZA)–needs to be considered in the differential diagnosis of hyperaldosteronism. Here’s how it works: The mineralocorticoid receptor, expressed in cortical collecting duct cells, is the…
