An interesting case was reported in Nephrology this month that highlights the importance of questioning whether or not a lab result is true. This is a very important skill for all internists but particularly nephrologists who are dependent…
Summer has come to the northern hemisphere and it is time to praise our kidneys for all the hard work of preserving the intravascular volume. Although only 30% of Na reabsorption takes place in the distal nephron, this…
A patient was recently seen on the consult service for evaluation of hyponatremia. She had a history of multiple myeloma and a previous bone marrow transplant and had significant cholestatic liver dysfunction related to GVHD. Her serum sodium at…
Recently in the clinic we were asked to review a patient with suspected diabetes inspidus. She had been taking lithium for more than 20 years for bipolar disorder that was very well controlled. During a routine medical examination,…
The normal saline we use in the hospital contains 9 grams of sodium chloride per liter of water. If you look on the bag you will see 0.9% which is the mass concentration expressed as g/dl (0.9 grams…
The fractional excretion of sodium (FeNa) is a test that is often used in the setting of acute renal failure to help distinguish between pre-renal and intra-renal causes that has been mentioned in previous blog posts. In general,…
Cholera epidemics have been a major public health issue throughout recorded history and much energy was devoted towards preventing them and treating affected patients once they occurred. However, it was not until 1831 that it was recognized that…
Dr. Arthur C. Guyton (1919-2003) was one of the greatest physiologists of our time. One of Dr. Guyton’s many seminal contributions to medicine was to establish the role of kidneys in long-term blood pressure regulation via a mechanism…
An observational study of urinary sodium excretion (a surrogate of dietary salt intake) and it’s association with cardiovascular mortality was published in JAMA last week. The trial involved 3681 patients in Europe without cardiovascular disease at baseline. The…
When managing patients with metabolic acidosis, some nephrologists are afraid of prescribing NaHCO3 because of the potential adverse consequences of increasing ECF volume and worsening blood pressure. However, there is significant evidence that the kidneys handle NaCl in…
