By David J. Leehey MD, Dr. Irfan Moinuddin MD
This pocket-sized booklet deals scientific scholars, interns, and citizens a concise creation to the sphere. fundamental care physicians, internists, surgeons, nurse practitioners, pharmacists, and surgeon assistants also will locate this ebook useful.
FEATURES
• sufficiently small to slot right into a coat pocket
• A precious instructing relief to nephrology fellows and faculty
• comprises tables of accepted info — putting off the necessity for memorization
• sufferer instances at finish of every bankruptcy strengthen the concepts
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Additional resources for Handbook of Nephrology
Example text
British trial shows clear effects of treatment, especially blood pressure reduction. BMJ. ;317(7160):693–694, 1998. Peterson JC, Adler S, Burkart JM, et al. Blood pressure control, proteinuria, and the progression of renal disease—The Modification of Diet in Renal Disease study. Ann Intern Med. 123:754–762. 1995. Poortmans JR, Brauman H, Staroukine M, et al. Indirect evidence of glomerular/ tubular mixed-type postexercise proteinuria in healthy humans. Am J Physiol. 254(2, pt 2):F277–F283, 1988.
A: Anxiety Poor dietary intake Diuretic abuse Bartter syndrome Gitelman syndrome This patient has a combination of hypokalemia, hypomagnesemia, and metabolic alkalosis and appears volume depleted on examination. Although these plasma electrolyte disorders could be seen with poor dietary intake, the inappropriately elevated urine sodium and chloride concentrations in the face of volume depletion and elevated urinary potassium and magnesium concentrations in the face of profound hypokalemia and hypomagnesemia suggest a renal tubular disorder, which could be genetic or acquired.
In response to hypernatremia, water moves out of cells with a resulting decrease in brain volume. The brain responds by intracellular uptake of electrolytes, amino acids, and other organic solutes. Therefore, rapid hydration can cause cerebral edema. Pathogenesis of Hypernatremia ■ Hypernatremia = increased [Na+] = decrease in TBW relative to TBNa+. Some examples are as follows: ■ ↓ TBW with normal TBNa+. This is typical of two clinical conditions: (1) patients in nursing homes with decreased thirst or inability to drink water; (2) diabetes insipidus (DI), in which ADH Chapter 5 / Disorders of Plasma Sodium Concentration 43 release is impaired or absent (central DI) or the kidney does not respond to ADH (nephrogenic DI).