14 results
Gitelman Syndrome Pathophysiology
Gitelman Syndrome is a rare autosomal recessive salt-losing tubulopathy with a prevalence of 1-
autosomal recessive salt-losing ... thiazide-sensitive sodium-chloride ... H+ secretion → Hypokalemia ... Pathophysiology #nephrology ... #diagnosis
Gitelman Syndrome Overview

What?
• Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter
• Gitelman's syndrome
salt-losing tubulopathies ... thiazide-sensitive sodium ... thiazide-sensitive sodium ... #Syndrome #diagnosis ... #nephrology #management
Inherited Defects in Kidney Tubule Epithelial Cells

Renal glucosuria - Na+-dependent glucose cotransporter
Cystinuria - Amino acid transporter
Bartter
ascending limb Gitelman ... cell epithelial sodium ... of epithelial sodium ... Defects #Kidney #Nephrology ... #Diagnosis #Differential
Hypokalemia Differential Diagnosis Algorithm
Hypertensive:
 • High Al, Low R - Primary aldosteronism
 • High Al, High
Hypokalemia Differential ... Diagnosis Algorithm ... Bartter's syndrome, Gitelman's ... syndrome #Hypokalemia ... #Algorithm #nephrology
Algorithm for patients with hypokalemia on the basis of the potassium-to-creatinine ratio in the urine
Urine K+
patients with hypokalemia ... • Cell shift: Hypokalemic ... Bartter syndrome, Gitelman ... differential #algorithm #diagnosis ... #nephrology
Gitelman Syndrome - Diagnosis and Workup
Blood Work:
 - Hypokalemia
 - Hypomagnesemia
 - Metabolic Alkalosis
 - Elevated
Gitelman Syndrome ... : - Hypokalemia ... Fractional excretion of Cl ... dr_missyhanna #Gitelman ... #Workup #nephrology
Gitelman Syndrome - Management
Treatment includes
 - Electrolyte replacement - K & Mg, preferably Cl salts
Gitelman Syndrome ... Mg, preferably Cl ... food - Liberal salt ... In persistent hypokalemia ... Management #Treatment #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
- Differential Diagnosis ... Workup Algorithm ... Hypervolemic (Excess salt ... #Workup #Algorithm ... #nephrology #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
ON (UNa < 30): Hypovolemia ... osmostat, Cerebral salt ... Hyponatremia #Algorithm #diagnosis ... #sodium #nephrology
Metabolic Alkalosis - Urinary Chloride Algorithm
Cl- responsive metabolic alkalosis
 • Kidney loss of Cl-
Bartter syndrome, Gitelman ... settings, the urine sodium ... the excretion of sodium ... urine #Algorithm #nephrology ... #differential #diagnosis