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differential pathophysiology syndrome alkalosis hypokalemia metabolic bartter causes defects epithelial hypochloremia hypotonic inherited kidney management physiologic sodium tubule urinary urine
Algorithm for Differentiating Gitelman syndrome from Bartter syndrome • Urine Chloride • Urine Ca/Cr ratio Dr. Krithika
Gitelman syndrome ... syndrome • Urine Chloride ... • Urine Ca/Cr ... #nephrology #hypokalemia ... #diagnosis
Gitelman Syndrome Pathophysiology Gitelman Syndrome is a rare autosomal recessive salt-losing tubulopathy with a prevalence of 1-
thiazide-sensitive sodium-chloride ... in the distal tubule ... Contraction → ↑ Renin ↑ Ca ... Pathophysiology #nephrology ... #diagnosis
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
Algorithm Cl- ... Bartter syndrome, Gitelman ... #urine #Algorithm ... #nephrology #differential ... #diagnosis
Causes of Metabolic Alkalosis: Differential Diagnosis ECF volume contracted: urine chloride concentration <20 meq/L • Gastric alkalosis:
: Differential Diagnosis ... indicates a renal tubule ... furosemide-like lesion) • Gitelman ... #Differential #Diagnosis ... #Causes #nephrology
Inherited Defects in Kidney Tubule Epithelial Cells Renal glucosuria - Na+-dependent glucose cotransporter Cystinuria - Amino acid transporter Bartter
Defects in Kidney Tubule ... ascending limb Gitelman ... Defects #Kidney #Nephrology ... #Diagnosis #Differential ... #Table
Hypochloremia - Differential Diagnosis Algorithm Cause - Decreased Intake: • Low salt in diet • Exclusive D5W
- Differential Diagnosis ... Algorithm Cause ... - Bartter - Gitelman ... • Fatigue Chloride ... #Nephrology #Chloride
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
thiazide-sensitive sodium chloride ... distal convoluted tubule ... • Congenital chloride ... #Syndrome #diagnosis ... #nephrology #management
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... normal volume-based algorithm ... #differential #diagnosis ... #table #sodium ... #nephrology
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