What’s the most common cause of ESRD in the U.S. after diabetes? The classic answer here is “hypertension”, though this answer is a controversial one, as there are many who believe that hypertension alone is not sufficient to…
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…
There is an insightful article in this month’s C-JASN entitled “Misapplications of Commonly-Used Kidney Equations: Renal Physiology in Practice” by Nguyen et al which is kind of fun to read. One of the clinical vignettes they present involves…
In last week’s New England Journal of Medicine there was a cool article by Rees et al describing a unique pair matching strategy for kidney transplants in which an ongoing chain of kidney transplantations–beginning with a single altruistic…
Malignant hyperthermia is a rare but potentially life-threatening genetically-inherited condition in which severe autonomic instability is induced by exposure to various anesthetics. The most common offending agents are halothane (and any other halogenated anesthetic compound) and succinylcholine, and…
For any 2nd year renal fellows out there reading this: your first chance to take the ABIM Nephrology Boards is coming up this November 18, 2009. You can sign up by May 1st for the amazingly low-price of…
In 1939, Irwin Page performed an experiment in a dog model in which one kidney was wrapped in cellophane. The resultant external compression on the kidney resulted in elevated renin-angiotensin-aldosterone levels and severe hypertension. Over time, a loss…
In recent years, there has been the suggestion that thiazide diuretics–long considered a front-line therapy for hypertension based on the ALLHAT study and others–may increase the risk of diabetes. Subsequent retrospective analysis of other major historical cohorts by…
