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electrolytes

A spoonful of sugar…

Cholera epidemics have been a major public health issue throughout recorded history and much energy was devoted towards preventing them and treating affected patients once they occurred. However, it was not until 1831 that it was recognized that…

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Hypercalcaemia induced polyuria

So Leo’s post got me thinking about the pathophysiology of hypercalcaemia-induced polyuria. I wanted to share what I have learned in relation to the mechanisms of this phenomenon. Calcium-sensing receptors (CaSR) are found on the basolateral membrane of…

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Linked: Sodium and Potassium

Emily mentioned in her recent post on the Rule of 6s that potassium administration needs to be taken into account when correcting the plasma sodium in cases of hyponatremia. Why is this the case? When potassium is given…

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Pitfalls with paraproteins

We were recently consulted on a patient with a history of multiple myeloma who had developed severe hypercalcemia and acute renal failure. The calcium on admission was 15mg/dl (albumin 2.6) and the patient was treated aggressively with IV…

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What about the Bicarb?

In our dialysis unit, the standard HCO3 bath is 35 mmol/L. While it is adjustable, it is rarely changed but recently we had a patient with a pre-dialysis HCO3 of 12 which got me thinking about what constitutes…

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Hypokalemia and deafness

I attended a research seminar last week given by the discoverer of EAST syndrome. This a rare, autosomal recessive condition in which children present with Epilepsy, Ataxia, Sensorineural deafness and Tubulopathy. It was a fascinating lecture detailing the…

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