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ABSTRACT: Correction of chronic hyponatremia is associated with a very high risk of CNS complications; avoid a rapid increase in serum sodium concentration if you suspect a patient's condition is […]

ABSTRACT: To identify the cause of hyponatremia, determine the patient's volume status and measure urinary sodium and osmolality; also ask about diuretic use. Hypovolemic hyponatremia is associated with vomiting, diarrhea, […]

CASE 1: FEVER AND SEVERE DIARRHEA IN A MAN WITH CROHN DISEASE A 34-year-old man has had Crohn disease for 12 years. He presented initially with ileitis and has had [...]

ABSTRACT The interpretation of add-base data can be greatly facilitated by applying 5 rules: (1) use the arterial pH to detect acidemia or alkalemia, (2) use the [PCO.sub.2] and bicarbonate [...]

ABSTRACT: In evaluating a patient with acute oliguria, first determine whether the cause is postrenal, prerenal, or renal. Ultrasonography can rule out obstruction; minimal or no proteinuria excludes glomerular involvement. [...]

ABSTRACT: Typical urinalysis results in patients with nephritic disease are proteinuria greater than 2 to 3 g/24 h, blood detected by dipstick and microscopic examination, and red blood cell (RBC) [...]

You need to be 'fluent' in interpreting acid-base disorders - a process that can be greatly simplified if you follow five easy rules. Routine application of these rules, which were [...]

Must primary care physicians be 'fluent' in acid-base physiology? Yes, for two major reasons: First, many common disease states can become evident through acid-base disorders. Patients with early septicemia, for [...]

Although drug-reduced acute renal failure (ARF) has become a common cause of morbidity and mortality, early recognition, appropriate prophylaxis, and dose adjustment or discontinuation may prevent catastrophic complications. It is [...]

Drug-induced acute renal failure (ARF) has become a common cause of morbidity and mortality. It is essential that primary care physicians be familiar with the risk factors and presentation of [...]

After potassium, magnesium is the second most common intracellular cation in the body. Within the cell, magnesium is ubiquitous; it is essential for the maintenance of energy homeostasis and is [...]

Regulation of potassium concentrations within very narrow confines (3.5 to 5.2 mEq/L) is crucial to the maintenance of life. From the second to second discharge of cardiac pacemaker tissue that […]

The emotional and physical toll, as well as the cost of caring for patients with autosomal dominant polycystic kidney disease (ADPKD), is staggering.[1,2] The most common inherited disease in this [...]

The control of blood pressure and prevention of hypertensive complications is the most we can hope to achieve in patients with essential hypertension. We can hope for much more--a cure--for [...]

Early detection of renal vascular disease makes it possible to cure a patient with hypertension--and avert severe renal damage and lifelong dependence on dialysis. As we discussed in our first [...]

At first glance, hypothyroidism, AIDS, and congestive heart failure may seem to have little in common.[1] Despite the diverse pathophysiology underlying each disorder, all three may be complicated by hyponatremia. [...]

Despite the common thread of findings from physical examination and volume status in categorizing hyponatremia, the presence of two urinary electrolyte subgroups within the low- and high-volume groups may engender [...]

The impact of kidney disease is staggering--in terms of both cost and human suffering. Dialysis evolved from humble beginnings in 1960, when four patients were first treated in Seattle; by [...]

Oliguria is defined as a decrease in urine flow to less than 500mL/d (|+ or -~ 100 mL) or less than 25 mL/h. This condition occurs in such a wide [...]

In last month's article, we introduced five easy rules for interpreting clinical acid-base physiology (Box). We applied the Five Rules to cases that were representative of simple acid-base disturbances. In [...]

The reputed complexity of interpreting acid-base disorders can be greatly simplified. The methodical five-point scheme we outline and illustrate here will help you in the everyday cases we describe in [...]

Since 3000 years BCE, headache sufferers have been writing about their painful history. (1) More specifically, migraines have been a bane to such notable figures as Alexander Pope, Edgar Allan [...]

I read with great interest the recent commentary by Dr Gregory Rutecki, 'Predicting the Risk of Type 2 Diabetes: When Does the Clock Start Ticking?' (CONSULTANT, March 2010, page 99). [...]

One of the most important roles for primary care practitioners is the review and implementation of necessary immunizations across a broad spectrum of age. Although adherence to the recommended schedule [...]

Although the diagnosis and treatment of Parkinson disease is tricky enough to warrant subspecialty consultation and follow-up, affected patients frequent primary care practice for a host of related problems. A [...]