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diagnosis nephrology differential causes metabolic algorithm hypokalemia urinary acidosis aniongap diuretics excretion gitelman im loopdiuretic management mechanismofaction medications metabolicalkalosis nejm
Metabolic Alkalosis - Differential Diagnosis Algorithm - Urinary Chloride • Cl- responsive metabolic alkalosis
Algorithm - Urinary Chloride ... Remote use of loop ... or thiazide diuretics ... blood pressure: Active ... diuretic use, Bartter
Mechanisms of Loop Diuretic Action and Resistance. Panel A, loop diuretics circulate bound to protein. As
Diuretic Action ... Panel A, loop diuretics ... shown in Panel C, diuretics ... step can mediate diuretic ... #Pathophysiology
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
Metabolic Alkalosis ... Remote use of loop ... or thiazide diuretics ... blood pressure: Active ... diuretic use, Bartter
Causes of Hypokalemia Transcellular Shifts: - Alkalosis, Increased plasma insulin (treatment of diabetic ketoacidosis), ß-Adrenergic agonists, Hypokalemic
Transcellular Shifts: - Alkalosis ... plasma insulin (treatment ... diuretics, and ... thiazide-like diuretics ... diuretic use),
Causes of Metabolic Alkalosis: Differential Diagnosis ECF volume contracted: urine chloride concentration <20 meq/L • Gastric alkalosis:
vomiting/ nasogastric suction ... • Thiazide or loop ... diuretics after ... renal tubule diuretic ... diuretics actively
Causes of High-anion Gap and Non-anion Gap Metabolic Acidosis Causes of High-anion Gap Acidosis: • Lactic acidosis
Ureterosigmoidostomy, jejunal loop ... , ileal loop ... Potassium-sparing diuretics ... loads (ammonium chloride ... #NonGap #Metabolic
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
Diuretics and Agents ... • Metabolic alkalosis ... +2Cl- Symport (Loop ... Diuretics) (Bumetanide ... Tolvaptan) • Treatment
Causes of Metabolic Alkalosis - Differential Diagnosis Algorithm GI Losses - Gastric • Vomiting • NG suction GI
Causes of Metabolic Alkalosis ... Vomiting • NG suction ... tubular transport • Diuretics ... (loop/thiazide) ... MetabolicAlkalosis #NonGap
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
with thiazide diuretic ... Hypochloremic metabolic alkalosis ... Surreptitious diuretic ... Rhabdomyolysis Treatment ... nephrology #management #pathophysiology
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