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…
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…
Did you know that the inventor of the popular sports drink “Gatorade” was a Nephrologist? The 2007 NY Times obituary of J. Robert Cade, the University of Florida nephrologist who concocted Gatorade, describes the story of the beginning…
The term “cerebral salt wasting” has always been a confusing one to me, and in the most recent issue of C-JASN, the authors of an article “More on Renal Salt Wasting Without Cerebral Disease : Response to Saline…
There is a popular belief that drinking lots of water is good for one’s health. One classic recommendation from doctors to patients–nobody knows where it comes from–is to drink 8 glasses of 8 ounces of liquid beverages daily….
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…
