Eclampsia and pre-eclampsia are characterized by the new onset of hypertension and proteinuria after 20 weeks of gestation in a previously normotensive woman. One of the major causes of morbidity to both mother & fetus is the occurrence…
Following on the heels of studies showing a potentially beneficial effect for vasopressin receptor antagonists and rapamycin in the treatment of renal cystic disorders, an article in this month’s JASN by Gattone et al suggests another class of…
This post is somewhat basic but it’s always good to review, right?The FENa is one of the most commonly used tools by both nephrologists and non-nephrologists to assess the etiology of oliguric renal failure in a patient. Classically,…
Changes in the regulation of serum osmolarity is just one of the many chances that occurs during the normal physiologic response to pregnancy. Beginning with the first trimester, the plasma osmolarity level, serum Na, and osmolarity thresholds for…
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…
One of the diagnostic dilemmas which frequently comes up in the outpatient evaluation of hypercalcemia (and also, I’m told, on boards-type exams) is how to differentiate familial hypocalciuric hypercalcemia versus primary hyperparathroidism–both of which are common causes of…
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…
The water deprivation test is useful in the workup of patients with polyuria under certain situations. The differential diagnosis of polyuria often comes down to the following: does the patient have diabetes insipidus (either central or nephrogenic), psychogenic…
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…
