It is important to realize the difference between HYPOVOLEMIA and DEHYDRATION, two terms which are often used interchangeably but in fact reflect different things. Read the Up-To-Date entry « Dehydration is not synonymous with hypovolemia » by Burton…
One logical way to classify the different etiologies of hypocalcemia is to break them down into LOW PTH STATES and HIGH PTH STATES. Today I’ll review the HYPOCALCEMIA WITH LOW PH STATES, or in other words, the causes…
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…
I didn’t learn this until recently, but some commonly used oral contraceptives–for example Yasmin-28 (the progestin-derivative drospirenone + ethinyl estradiol)–has some mineralocorticoid blocking effect, similar to that seen for spironolactone. It may therefore be associated with hyperkalemia, particularly…
Calcium is a critical ion for a number of cellular signaling events. As such, it is not surprising that hypocalcemia leads to a wide variety of signs and symptoms. The dominant presentation of hypocalcemia is usually neurologic in…
In central diabetes insipidus induced by cerebral trauma or following neurosurgery, there is a “triphasic” presentation which may occur. Briefly, the patient begins with a tendency towards hypernatremia, then develops a tendency towards hyponatremia, and finally ends with…
Hypokalemic periodic paralysis is a relatively rare disease in which individuals experience transient, severe episodes of hypokalemia as a result of rapid intracellular potassium shift into skeletal muscle. The attacks typically manifest as muscle cramps, muscle paralysis, or…
It has been long recognized that IVIG–given for a variety of immune-mediated diseases and infections–has been associated with hyponatremia. In the recent “Electrolytes” edition of Neph-Sap, their explanation is a multifactorial one: 1. pseudohyponatremia: there is a massive…
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…
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…
