Mitchell L Halperin

..This analysis provides the basis for diagnosis and may indicate where non-emergency therapy should then be directed...

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..The source of glutamine for renal ammonium production is ultimately dietary protein in the fed state and body proteins in fasting...

..In contrast, the objective in the patient with chronic hyponatremia is to prevent ODS. An even slower rate of rise of the PNa is required in patients who are malnourished and/or K+ depleted...

..Formation of this precipitate requires medullary alkalinization; K(+) -depletion and augmented medullary H(+)/K(+) -ATPase may be predisposing factors...

..This suggests that the GFR and the renal blood flow rate should be examined in patients with unexplained anemia or erythrocytosis...

..Our goal is to suggest how the renal concentrating mechanism is regulated in vivo...

..These patients may develop osmotic demyelination if a large solute load leads to a very rapid excretion of electrolyte-free water...

..Using a similar approach, it is possible to understand how the risk of the formation of kidney stones can be minimized...

..Patients with CaHPO(4) kidney stones belong to a diagnostic category that has a high urine pH as its common feature. Our objective was to provide a new clinical approach to examine the basis for this high pH...

..Thus, to understand which of the potential control mechanisms are operating, one must look very closely at the conditions imposed by the experimental setting...

..This provides a way of limiting changes in urine pH without sacrificing acid-base balance, a process that might lessen the risk of kidney stone formation...

..Our objective is to integrate these new insights into an understanding of the pathophysiology of renal potassium handling. We also propose different ways to think about some of the unresolved issues in this area...

..0 must be maintained in order to reduce the risk of precipitating uric acid in the urine. Possible ways of resolving these conundrums require novel physiological interpretations...

..Higher doses of FS should be avoided, as they induce high rates of Mg(2+) excretion, which can deplete the body of this essential electrolyte...

..This review aims to illustrate why urea recycling may play an important role in potassium (K⁺) excretion and to emphasize its potential clinical implications...

..Thus hypernatraemia was the most important factor associated with a higher urine tonicity...

..CONCLUSION: The most important factor for hospital-acquired hyponatremia is the administration of hypotonic fluid. We suggest that hypotonic fluid not be given to children when they have a P(Na) <138 mmol/L...

..A very low urine pH is the major risk factor for uric acid stone formation...

..Although a very large water load can induce a water diuresis, smaller water loads can be retained for future heat dissipation...

..05). One explanation for this difference is that the rats escaped from the renal action of vasopressin. Nevertheless, based on a quantitative analysis, other possibilities will be considered...

..CONCLUSIONS: Cerebral salt wasting is probably much less common than the literature suggests. With optimal treatment in the intensive care unit, hyponatremia should not develop...

..Owing to the precarious blood supply to the renal medulla and the high metabolic requirement of the medullary thick ascending limb of Henle's loop, this nephron segment should be especially vulnerable when its supply of O(2) declines...

..The enormous osmotic driving force for the reabsorption of water in the inner medullary collecting duct may play a role in this reabsorption of water. Possible clinical implications are illustrated in the discussion of a case example...

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..This article provides a "brain protein-centered" view, which leads to different conclusions concerning the way H(+) are removed physiologically...

..Failure to make a distinction between HPP and non-HPP may lead to improper management. Therefore, we evaluated the diagnostic value of spot urine tests in patients with hypokalemia and paralysis during 3 years...

..Recent molecular advances in inherited hypokalemic disorders affecting transcellular K+ shift, gastrointestinal and renal K+ excretion are also discussed...

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..Long-term licorice ingestion should be kept in mind as a cause of paralysis with an extreme degree of hypokalemia to avoid missing this recognizable and curable medical disorder...

..Although the severity of symptoms may vary in patients who have the same mutations, a markedly different clinical presentation in family members with identical mutations is truly rare...