Why is there a picture of a toad on the Renal Fellow Network? In reading the most recent edition of ESRD/Dialysis “NephSAP” (the ASN’s periodic review of relevant nephrology-themed literature), I learned about an unusual cause of hyperkalemia:…
Quick case summary as presented in Renal Grand Rounds today: A 54 year-old man presents with altered mental status, a sky-high ammonia level (>200) and anemia requiring blood transfusion. Other unusual lab values include hypophosphatemia and hypokalemia with…
Potassium is obviously a key ion in nephrologists’ constant battle against reduced renal clearance. What about the potassium channels which are responsible for the trafficking of this ion in & out of the cell? There is a marked…
A subset of pediatric patients with a clinical and biochemical profile consistent with SIADH (the syndrome of inappropriate ADH secretion)–that is, euvolemic hyponatremia with an inappropriately elevated urine osmolarity–have low to undetectable levels of ADH. What’s going on?…
Here are a few random pearls that I took away from yesterday’s combined Beth Israel-Brigham-Mass General renal fellows’ educational talk by Burton Rose a.k.a. “The Up-To-Date Guy” and author of the highly-recommended “Clinical Physiology of Acid-Base and Electrolyte…
The recreational drug ecstasy (MDMA) is known to result in hyponatremia–which has been reported to result in seizures and death–has a multifactorial mechanism which is interesting. MDMA is associated with elevated ADH levels. In addition, individuals who take…
The situation: a 53 year old ESRD patient shows up with vomiting. She is normally dialyzed Monday, Wednesday and Friday and now [ Her Na level is 111. What to do? There are several reports of central pontine…
There are a variety of interesting genetic diseases that can cause hereditary Magnesium wasting. Renal magnesium handling is a little different than other ions in that the primary site of reabsorption is not the proximal convoluted tubule. Rather,…
For many years, the existence of “phosphatonins”–substances secreted by certain tumors which result in profound renal phosphorus wasting and resultant osteomalacia–has been postulated. Evidence has recently been accumulating that fibroblast growth factor 23 (FGF-23) is the phosphatonin we…
