When Does Metabolic Acidosis Require Treatment with Bicarbonate? Administration of bicarbonate in patients with metabolic acidosis is an area of medicine that has resulted in some confusion for trainees over…
What Exactly Is Dialysis and When Is It Needed? A frequent reason for inpatient nephrology consultation is either a need for dialysis (in a patient with end-stage renal disease [ESRD]…
Is It “Acute Renal Failure” or “Acute Kidney Injury”? For decades, nephrologists used the term acute renal failure (ARF), defined as a sudden (within hours to days) decrease in renal…
How Does One Interpret the Urine Anion Gap and Urine Osmolal Gap? The serum anion gap (AG) is a time-honored tool in nephrology. As discussed in Chapter 6, the AG…
What Is Free Water Clearance and How Useful Is It? Over 50 years ago, Homer Smith (1952) introduced the concept that the urine flow could be thought of as two…
Why Are Disorders of Sodium Concentration So Difficult? There are two important reasons why sodium concentration disorders (dysnatremias) are challenging. First, making the correct clinical diagnosis can be difficult. Second,…
Is It Helpful to Diagnose a Triple Acid-Base Disturbance? (Or Is It Just a Mental Exercise?) If nephrologists love ratios, they get absolutely ecstatic over complex acid-base disturbances. Back in…
What Is the Meaning of the Urine-to-Plasma Creatinine Ratio? Nephrologists seem to love ratios. The urinary albumin-to-creatinine ratio (UACR) and the urinary protein-to-creatinine ratio (UPCR) are discussed in Chapter 4….
What Is Urine Albumin-to-Creatinine Ratio? (Or Is It Protein-to-Creatinine Ratio?) The amount of urinary albumin or protein is an important diagnostic and prognostic factor in patients with kidney disease (Peterson…
What Is Fractional Excretion and How Does Measuring It Help in Clinical Practice? DERIVATION OF THE FORMULA Fractional excretion is a term that nephrologists frequently use in clinical practice (Schrier,…
