renal

Hyponatremia Correction For Hyperglycemia

Sodium is the primary cation (positive-charged ion) in the extracellular space. Therefore, dilutional hyponatremia can occur if free water is added to the extracellular space from fluid shifts and infusions. Let's look at this basic...

Hypernatremia And Free Water Deficit

Sodium (Na) fluctuations portend increased in-hospital death for ICU patients, and when working them up, it's essential to determine if these disorders are acute or chronic (> 48 hours or unknown duration). For hypernatremia...

Lactated Ringers And Normosol In Hyperkalemia

As an intensivist and anesthesiologist, I spend considerable time pondering the physiology and evidence for practices and questioning dogma rampant in the ICU/OR settings. I've heard one recurrent theme: the fear of using Lactated...

Green Urine Discoloration

Urine color is often under-appreciated in working up a patient's clinical status (especially in the ICU and OR). "Highlighter" yellow urine is often seen in patients on B vitamin complexes (it’s a water-soluble vitamin,...

Mannitol

Mannitol is a carbohydrate often administered as a hypertonic solution that is freely filtered by the renal glomerulus and not reabsorbed. Therefore, it serves as an osmotic diuretic that, if left unchecked, can lead...

Renal Replacement Therapy – Hemodialysis and Hemofiltration

The word "dialysis" evokes many clinical indications and contexts. In chronic end-stage renal disease (ESRD), patients typically have some form of long-term access like an AV fistula for their scheduled sessions. In the short...

Furosemide

Furosemide (Lasix) is a loop diuretic that works on the Na/K/2Cl cotransporter in the thick ascending loop of Henle. It's a medication I routinely use for patients with congestive heart failure (CHF) exacerbations who...

Finished With Nephrology

I'm officially finished with my first rotation as a resident... but I'm going to really miss everyone I worked with this past month on nephrology. Each day posed a new set of challenges in...

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