Joel Topf is a nephrologist in Detroit working for St Clair Specialty Physicians. He is faculty for the Nephrology Fellowship at St John Providence.
Co-creator: NephMadness, Co-creator: NephJC, Co-creator: DreamRCT
* Tweetorial on the Case
* Slides for the Case
* Topf thoughts on DDAVP in hypoNa
* DDAVP clamp in hyponatremia
* EMCrit Intro to Hyponatremia
* Curbsiders Hyponatremia Episode
* IBCC Hyponatremia
* Taking control of severe hyponatremia with DDAVP
Joel admits elderly with Na 130
* Make sure they are not DI and then replete their free water deficit
* Acetazolamide for Nephrogenic DI1
* Hypernatremia is a marker of poor quality ICU Care2
* EMCrit Hypernatremia Episode
* IBCC Hypernatremia
Joel's Furosemide dose is Cr x 20
* Curbsiders on HyperK with Joel
* EMCrit HyperK
* IBCC HyperK
* Recent RCT on Kayexalate3
* The odds ratio for death was 10 at a potassium of 5.5 to 6 mEq/L. It rose to 31 for potassium above 6!4
Who Needs RRT?
* Is A,E,I,O,U still the answer?
AEIOU mnemonic for indications for emergent dialysis (from EM Cases)
Acidemia – pH7.1 despite medical management
Electrolyte abnormalities – hyperkalemia refractory to medical management
Ingestion – nephrotoxic drug ingestion amenable to dialysis
Overload – volume overload resulting in respiratory failure
Uremia with bleeding, pericarditis or encephalopathy
* Get Joel's Free Electrolyte and Acid Base Book
Now on to the Podcast...
Gordon CE, Vantzelfde S, Francis JM. Acetazolamide in Lithium-Induced Nephrogenic Diabetes Insipidus. N Engl J Med. 2016;375(20):2008-2009. doi:10.1056/nejmc1609483
Polderman K, Schreuder W, Strack van, Thijs L.