Podcasts about Hyponatremia

GI distress. Muscle damage. Hyponatremia. Mental fatigue. Bad pacing. In this evidence-packed episode, we break down the five most common scientific causes of DNF (Did Not Finish) in ultramarathons—and how better training can help you avoid them.Whether you're training for your first 50K or aiming to shave time off a hundred-miler, this episode covers actionable strategies to improve your fueling, hydration, strength, mindset, and race-day decisions.

The FiltrateJoel TopfSwapnil HiremathAC GomezSopia AmbrusoNayan AroraSpecial Guests Michelle Rheault, Director, Division of Pediatric Nephrology, Professor of MedicineTiffany Caza, Nephropathologist, Scientist and self-described Freely Filtered fan girlEditing bySimon Topf and Sophia AmbrusoShow Notes10. Healthcare Cyberattacks9. ApoE in C3 glomerulonephropathy8. Workforce woes in Adult and Pediatric Nephrology7. Hyponatremia correction meta-analysis6. Microvascular inflammation increases risk of graft loss - in all of its forms5. Xenotransplantation4. KDIGO CKD Guidelines3. Hypertension control trials (ESPRIT, BPROAD)2. The Renaissance of IgAN: IgAN treatment trials1. FLOW: GLP-1 RAs in CKD

Hello everyone. Welcome to the latest episode of The Matchbox Podcast powered by Ignition Coach Co. I'm your host, Adam Saban, and on this week's episode we're entertaining a follow-up question from our nutrition episode, discussing whether or not sugar water is a viable option for fueling, and should you include easy Z2 in your training?   As always, if you like what you hear please share this with your friends and leave us a five star review and if you have any questions for the show drop us an email at matchboxpod@gmail.com with email title The Matchbox Podcast or head over to ignitioncoachco.com and fill out The Matchbox Podcast listener question form. Alight let's get into it!   For more social media content, follow along @ignitioncoachco @adamsaban6 @dizzle_dillman @dylanjawnson @kait.maddox   https://www.youtube.com/c/DylanJohnsonCycling https://www.ignitioncoachco.com  https://www.youtube.com/@DrewDillmanChannel   Intro/ Outro music by AlexGrohl - song "King Around Here" - https://pixabay.com/music/id-15045/    The following was generated using Riverside.fm AI technologies   Summary In this conversation, the hosts discuss various aspects of nutrition, focusing on the balance between healthy eating and enjoyment. They address listener questions about processed foods, the role of spices, and the importance of understanding food ingredients. The discussion emphasizes the personal nature of dietary choices and the need for mindful eating without falling into extremes. In this conversation, the hosts delve into various aspects of nutrition and training for endurance athletes. They discuss the balance between antioxidants and protein intake, the differences between homemade and pre-formulated sports drinks, and the critical role of electrolytes in hydration. The conversation also explores the debate over training intensity, particularly the effectiveness of zone one versus zone two training, and emphasizes the importance of balancing data analysis with personal perception of effort during training.   Takeaways Nutrition is a personal journey that requires experimentation. The healthfulness of food is often determined by its ingredients list. Spices can enhance the flavor and healthfulness of meals. Cooking at home allows for better control over food quality. Processed foods can vary widely in healthfulness based on ingredients. Meal prepping can help maintain a healthy diet without daily cooking. Enjoyment of food is crucial for sustainable healthy eating. Mindful eating helps avoid extremes and promotes balance. Whole foods are generally healthier than processed options. Understanding food processing helps make better dietary choices. Antioxidants are abundant in vegetables compared to pasta. Post-ride nutrition should include both antioxidants and protein. Pre-formulated sports drinks offer optimal absorption ratios. Homemade drink mixes can be effective but may lack precision. Electrolytes are crucial for hydration during endurance activities. Training intensity should be tailored to individual goals. Zone one training may not provide sufficient training load. Listening to your body is essential in training. Data can enhance training but shouldn't overshadow personal experience. Hyponatremia can be more dangerous than dehydration.   Chapters 00:00 Introduction and Listener Feedback 01:03 Nutrition and Processed Foods Discussion 05:59 The Role of Spices in Healthy Eating 12:14 Understanding Food Processing and Ingredients 20:04 Balancing Healthy Eating with Enjoyment 22:55 Mindful Eating and Avoiding Extremes 24:53 Antioxidants vs. Protein: The Nutritional Balance 26:21 Homemade vs. Pre-formulated Sports Drinks 30:40 The Importance of Electrolytes in Hydration 35:45 Training Intensity: Zone One vs. Zone Two 40:51 Data vs. Feel: The Balance in Training

In this episode, I sit down with Brooke Bjorge, the owner of Grit Sports Nutrition and an athlete herself, to dive into the critical role of sodium in endurance sports. We cover everything from the dangers of hyponatremia and how to avoid cramping in an ultramarathon, to the differences between sodium citrate and sodium chloride and why it matters for performance. Brooke also shares insights on sweat testing, building personalized hydration plans, and navigating the high-carb fueling trends in endurance racing. Whether you're training for a thru-hike, tackling a 100-miler, or just want to optimize your performance, this conversation is packed with practical tips and science-backed strategies. Follow Brooke: https://www.gritsportsnutrition.com/ takeaways Sodium is crucial for muscle contraction and cognitive function. Hyponatremia is more common than hypernatremia among athletes. Sodium citrate is better absorbed than sodium chloride. Athletes should aim to replace 60-90% of sodium losses during events. Sweat rate testing is essential for developing hydration protocols. Sodium intake can be adjusted based on environmental conditions. Recovery nutrition should include protein, carbs, and fats. Weight loss goals should not compromise athletic performance. Carbohydrate intake should be individualized based on athlete size and needs. Post-exercise hydration is critical for recovery. Sound Bites "Most people run the risk of consuming too little." "Sodium is in charge of so many essential functions." "Sodium citrate is much better absorbed by the body." "You want to replace 60 to 90% of sodium losses." "You don't want to go overboard either." "You can only right the ship to a certain extent." "Not everybody needs more carbs." "Recovery fueling and hydration is huge." Chapters 00:00 The Importance of Sodium in Athletics 03:08 Types of Sodium and Their Absorption 06:05 Sweat Rate and Sodium Replacement 09:13 Developing a Hydration Protocol 12:06 Methods of Sodium Ingestion 15:01 Addressing Sodium Deficiency During Events 17:52 Carbohydrate Intake and Performance 21:00 Navigating Weight Loss and Performance 23:49 Post-Run Recovery Strategies keywords: sodium, sports nutrition, endurance athletes, hydration, sweat rate, sodium replacement, electrolyte balance, carbohydrate intake, weight loss, recovery

Listen as Dr. London Smith (.com) and his producer Cameron discuss Hyponatremia in a Euvolemic State as they share their predictions for 2025 Films. Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Produced by: Dylan Walker Created by: London Smith

Listen as Dr. London Smith (.com) and his producer Cameron discuss Hyponatremia in a Hypovolemic State as they share their plans to Rule This School. Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Produced by: Dylan Walker Created by: London Smith

We have a short attention span in the ED….so it's okay to defer hyponatremia to the real nerds (psst internal medicine). But there are a few indications when we need to jump into action to save the day. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake. 240. A Salty Solution: SCARY Hyponatremia. November 25th, 2024. Accessed [date].

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On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

In this episode of the Elbows Tight podcast, host Travis interviews Riley Rogers, the owner of SALT Electrolytes and a brown belt in Jiu Jitsu. They discuss Riley's journey into Jiu-Jitsu, the importance of technicality and leverage in the sport, and the mindset of training at an older age. They also touch on rolling with lower belts and the significance of belts in Jiu-Jitsu. Riley shares his approach to teaching and preparing for classes, emphasizing the importance of curriculum and individualized instruction. In this part of the conversation, the principal themes revolve around the development of a jiu-jitsu coach and the use of strength and size in training. The subtopics include the reluctance to become a coach, the process of developing teaching skills, the use of strength and size in jiu-jitsu, and the importance of tapping early and controlling submissions. The conversation also touches on recovery strategies and the decision to decline rolling with certain partners. In this conversation, Travis and Riley discuss the importance of setting boundaries in Jiu-Jitsu and the negative connotation of turning down rolls. They also delve into the inspiration behind starting Salt Electrolytes, a clean and potent electrolyte drink. Riley shares his personal experience with dehydration and how it led him to develop a product that provides the necessary minerals for optimal performance. They also touch on the challenges of navigating the supplement industry and the importance of learning leverage in Jiu-Jitsu. Get $25 off the JordanTeachesJiuJitsu Theory Course and Wrestling for BJJ with ELBOWSTIGHT25 at Checkout - https://courses.jordanteachesjiujitsu.com Get 15% off at https://saltelectrolytes.com with code Elbowstight15 at checkout! Join the El-Bros Facebook and Discord Communities! https://www.facebook.com/groups/elbroscommunity/ https://discord.gg/sp2J8mPS LET'S EXCHANGE PATCHES! SEND A PATCH TO THE PO BOX, AND WE WILL SEND YOU A CUSTOM ELBOWS TIGHT PATCH BACK! Travis Motl PO Box 768 Seabeck, WA 98380 The Equipment Behind Elbows Tight Podcast: https://kit.co/ElbowsTightPodcast  Follow Our Social Media Pages! Instagram Podcast Page https://www.instagram.com/elbowstight/?hl=en Facebook https://www.facebook.com/ElbowsTightPodcast 00:00 Introduction and Podcast Announcement 00:24 Getting to Know Riley Rogers 02:22 The Magic of Technicality in Jiu-Jitsu 05:59 Training at an Older Age: Balancing Aggression and Playfulness 08:16 The Significance of Belts in Jiu-Jitsu 13:56 Rolling with Lower Belts and the Importance of Mindset 16:56 Teaching Jiu Jitsu: Curriculum and Individualized Instruction 22:08 Preparing for Classes and Answering Student Questions 25:21 The Challenges and Rewards of Coaching Jiu-Jitsu 25:58 The Reluctance to Become a Jiu-Jitsu Coach 27:13 Developing Teaching Skills in Jiu-Jitsu 32:17 The Use of Strength and Size in Jiu-Jitsu 34:24 Tapping Early and Controlling Submissions 51:28 Recovery Strategies for Jiu-Jitsu Practitioners 54:38 Setting Boundaries in Jiu-Jitsu 57:15 The Inspiration Behind Salt Electrolytes 01:00:39 Dehydration and the Need for Electrolytes 01:04:08 Understanding the Role of Electrolytes in the Body 01:08:54 The Creation and Packaging of Salt Electrolytes 01:18:04 The Importance of Saltiness in Electrolyte Drinks 01:20:31 The Dangers of Hyponatremia and the Importance of Learning Leverage  

In this new series, Drs. Alice Sheridan and Martina McGrath speak with guest editor Dr. Michael Emmett to discuss his editorial "Cystic Fibrosis and Hypoelectrolytemia With Metabolic Alkalosis" from nephSAP Volume 23, Number 2.

In this new series, Drs. Alice Sheridan and Martina McGrath speak with guest editor Dr. Michael Emmett to discuss his editorial "Cystic Fibrosis and Hypoelectrolytemia With Metabolic Alkalosis" from nephSAP Volume 23, Number 2.

Dr Tamara Hew-Butler is the Queen of Hyponatremia (@hyponaqueen on X). What's hyponatremia, you may be wondering? It is a condition that is far more dangerous than dehydration, and which can develop when we drink too much fluid during exercise, with potentially lethal and often tragic consequences. We have been conditioned to fear the health and performance risks of dehydration during exercise, to believe that we cannot afford to lose fluid, and that by the time we are thirsty, it's too late. But Hew Butler, a world authority on fluid requirements during exercise, is here to set the record straight, to explain how exquisitely our bodies regulate our sodium and fluid levels, and why we can and should trust our physiology instead of the marketing messages of sports drinks and water companies. This is an episode that will challenge beliefs, and set the record straight on exercise hydration.Show notesBecome a Patron and join the Discourse communityLinks to articles on the subject matter of the podcastTami is lead author on a series of consensus statements on Exercise Associated Hyponatremia. This is the most recent version of that consensusThe Men's Health article mentioned on the show, discussing overhydration and quoting TamiA review article by Tami, published in 2017, with details on the physiology, treatment and prevention of hyponatremiaA 2022 paper by Tami, on the Physiology, Psychology and pathophysiology of overhydrationA study Tami was involved in looking at soldiers doing a 40km march, showing that drinking to thirst avoided the dangers of both hyponatremia and dehydrationIn the show, we spoke about research we did at the Comrades Ultramarathon. Here is one of the papers from those studies in the medical tentTwo papers on what typically happens during ultra-endurance exercise, first in Ironman athletes, by Sharwood et alA second paper describing over 2000 endurance athletes and the changes in body weight, sodium levels and hydration statusThe first case series of hyponatremic athlete in the Comrades, going all the way back to the 1980sTami's X handle: @hyponaqueen Get bonus content on Patreon Hosted on Acast. See acast.com/privacy for more information.

Alex Larson, a prominent sports dietitian, is renowned for her expertise in optimizing athletes' performance through tailored nutritional strategies. With a background in nutrition science and a passion for sports, Larson has become a go-to figure for athletes seeking to enhance their training regimens and achieve peak physical condition. Her approach is characterized by a deep understanding of the specific nutritional needs of different sports and individual athletes, combining evidence-based research with practical, personalized advice. Larson's holistic approach not only focuses on fueling athletes for performance but also emphasizes recovery, injury prevention, and long-term health. Through her consultations, workshops, and educational outreach, Larson continues to make a significant impact in the realm of sports nutrition, helping athletes of all levels unlock their full potential.EPISODE OUTLINE:00:00 Introduction and Setting the Stage03:00 Optimizing Performance through Individualized Approaches06:17 The Role of Processed Supplements in Training10:49 Finding Affordable and Convenient Fueling Options14:17 Personal Preference in Fueling Workouts22:17 Misconceptions About Sodium25:38 Introduction to Hydration for Athletes29:38 Letting Go of the Dieting Mindset34:01 Don't Fear Weight Gain: Prioritize Fueling for Performance37:12 The Pitfalls of Quick Fixes and Extreme Diets40:27 Using Leftover Chicken in Multiple Dishes43:19 The Importance of Breakfast for Athletes43:40 Navigating Time Zones with Athletes43:46 Navigating Time Zone Challenges44:04 Strategies for Managing Time Zone Changes44:16 Coordinating with People in Different Time Zones44:27 The Benefits of Flexibility45:08 Staying Connected through Social Media45:37 CloseTRANSCRIPT:https://share.transistor.fm/s/48eec58b/transcript.txtMORE FROM ALEX:Website: https://alexlarsonnutrition.com/PODCAST INFO:Podcast Website: www.relaxedrunning.comApple Podcasts: https://podcasts.apple.com/au/podcast...Spotify: https://open.spotify.com/show/2MMfLsQ...RSS: https://feeds.transistor.fm/relaxed-r...SOCIALS:- Facebook: https://www.facebook.com/relaxedrunning- Instagram: https://www.instagram.com/relaxed_run...

Treating hyponatremia, a condition characterized by low sodium levels in the blood, can be both complicated and quite risky.. Disruptions to the delicate balance of sodium in the body can lead to a spectrum of outcomes, from an asymptomatic presentation to life-threatening seizures, coma, and death.Through the patient story of Mrs. Saltman, host Sarah Lorenzini explains the role of sodium in the body, breaking down the science of osmosis and electrolytes so nurses can better understand the causes of hyponatremia. She goes over the three levels of hyponatremia that are categorized by blood tonicity and volume status, and how each level impacts the diagnosis and management of hyponatremia. Sarah also dives into the nuances of treating hyponatremia, including the risks of rapid sodium correction, the importance of knowing a patient's baseline, the underlying cause of their condition, and more.This episode will provide nurses with the knowledge needed to recognize the signs of hyponatremia and navigate the risks of treatment. Tune in now!Topics discussed in this episode:Introduction to Mrs. Saltman's caseThe pathophysiology of hyponatremiaCauses of hyponatremiaTypes of hyponatremia: hypertonic, hypotonic, and isotonicHyponatremia treatment strategies and their risksMentioned in this episode:Rapid Response and Rescue Intro CourseCONNECT

HOST: Andy Herber, P.A.-C. GUEST: Mira T. Keddis, M.D. Join our host, Andy J. Herber, P.A.-C., as he explores Hyponatremia and Hypernatremia; common findings in both the inpatient and outpatient settings. Sodium disorders are associated with an increased morbidity and mortality for patients. Guest, Mira T. Keddis, M.D. , renown Mayo Clinic Nephrologist, joins the podcast to provide guidance on understanding evaluations and management of sodium abnormalities. Mayo Clinic Talks: Lab Medicine Edition | Mayo Clinic School of Continuous Professional Development Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

People have asked us many times what we think of CrossFit, so it's about time we just laid it all out. In this episode we work our way through CrossFit's various philosophies, protocols, and teachings and highlight where we agree and where we don't. In general, the first half of the conversation is more critical while the second half is more positive. If you want to dive in on your own, we framed this conversation around the CrossFit Level 1 Training Guide, which you can download for free. They describe it as "the most comprehensive CrossFit training resource available" and "foundational to the CrossFit methodology" so it's arguably the best primary source for understanding the CrossFit system. We talk about all the classics in here: - Defining "fitness" and CrossFit's "fitness in 100 words"- What "functional fitness" means- Kipping- Nutrition (including Paleo and Zone)- Olympic Lifting- Uncle Rhabdo and Pukey the Clown And so much more... In one section we mentioned a series of articles on hydration. The Hyponatremia of Exercise is a 12 part series by Tim Noakes. Here's a link to part one which links to all the subsequent parts. Skip to part 4 if you want to see where the Army (and specifically USARIEM) got involved, but it comes back up throughout the series.

Welcome to Part 2 of our collaboration with #NephMadness! This week we sit down with Dr. Jeff Kott (Nephrologist and Critical Care Fellow) from the NephMadness Exec to discuss the latest and greatest in hyponatremia correction rates.  Support the show

We partnered up with the NephMadness team to release two special episodes on hyponatremia. In this one we take you through a new(er) approach to hyponatremia and its workup. Stay tuned later this week for our Ask a Fellow episode where we cover the latest and greatest controversy on rates of correction! Written by: Dr. Caitlyn Vlasschaert (Internal Medicine Resident) Reviewed by: Dr. Jeffrey Kott (Nephrologist & ICU Fellow) and Dr. Laiya Carayannopoulos (Intensivist & Internist) Support the show

Sit back and grab some salty treats as you enjoy the mindful musings of master nephrologist Dr. Joel Topf (X: @Kidney_Boy) who joins Nick & Cyrus to chat about hyponatremia in critical illness - a very common condition. Here we discuss diagnosis and management of hyponatremia with special attention to those in the intensive care unit. Of course, no discussion is complete without plenty of time dedicated to osmotic demyelination syndrome (aka: central pontine myelinolysis) which gets plenty of face-time during this episode. Give it a listen and leave feeling confident in your ability to diagnose and manage a very prevalent condition in our patient population! Hosted on Acast. See acast.com/privacy for more information.

Show notes at pharmacyjoe.com/episode894. In this episode, I’ll discuss how correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely. The post 894: Correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode894. In this episode, I’ll discuss how correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely. The post 894: Correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely appeared first on Pharmacy Joe.

Hyponatremia is a side effect of most diuretics but the incidence from thiazides is unknown. Join host, Geoff Wall, as he evaluates a new study from Denmark evaluating hyponatremia and thiazides. The GameChangerThiazide diuretics are considered first-line therapy but electrolyte side effects are underevaluated. A new study suggests hyponatremia is significantly more common than previously reported, especially in the elderly. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint Health ReferenceAndersson NW, Wohlfahrt J, Feenstra B, et al. Cumulative Incidence of Thiazide-Induced Hyponatremia: A Population-Based Cohort Study. Ann Intern Med. 2023 Dec 19. doi: 10.7326/M23-1989. Epub ahead of print. PMID: 38109740.https://www.acpjournals.org/doi/abs/10.7326/M23-1989?journalCode=aim Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the use of thiazides in hypertension and their adverse effects 2. Assess the strengths and weaknesses of the Andersson et al study0.05 CEU/0.5 HrUAN: 0107-0000-24-032-H01-PInitial release date: 1/15/2024Expiration date: 1/15/2025Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

Renowned pediatric nephrologist, Michelle Starr, returns to the podcast to help unravel and simplify the approach to pediatric hyponatremia, providing valuable insights into diagnosis and treatment strategies. Tune in to elevate your salt game to the next level!

ReferencesJC mentioned that the diagnostic accuracy of 24 hour urine collection increases with more collections! Metabolic evaluation of patients with recurrent idiopathic calcium nephrolithiasisWe didn't refer to a particular study on sodium intake and the 24 hour urine but this meta-analysis Comparison of 24‐hour urine and 24‐hour diet recall for estimating dietary sodium intake in populations: A systematic review and meta‐analysis - PMC 24‐hour diet recall underestimated population mean sodium intake.Anna looking up ace i and urinary sodium Effects of ACE inhibition on proximal tubule sodium transport | American Journal of Physiology-Renal PhysiologyThe original FENa paper by Espinel: The FeNa Test: Use in the Differential Diagnosis of Acute Renal Failure | JAMA | JAMA NetworkSchreir's replication and expansion of Espinel's data: Urinary diagnostic indices in acute renal failure: a prospective studyHere's a report from our own JC on the Diagnostic Utility of Serial Microscopic Examination of the Urinary Sediment in Acute Kidney Injury | American Society of NephrologyJC shared his journey regarding FENa and refers to his recent paper Concomitant Identification of Muddy Brown Granular Casts and Low Fractional Excretion of Urinary Sodium in AKIAnd Melanie's accompanying editorial Mind the Cast: FENa versus Microscopy in AKI : Kidney360 (with a great image from Samir Parikh)JC referenced this study from Schrier on FENa with a larger series: Urinary diagnostic indices in acute renal failure: a prospective study​​Nonoliguric Acute Renal Failure Associated with a Low Fractional Excretion of Sodium | Annals of Internal MedicineUrine sodium concentration to predict fluid responsiveness in oliguric ICU patients: a prospective multicenter observational study | Critical Care | Full TextA classic favorite: Acute renal success. The unexpected logic of oliguria in acute renal failure Marathon runners had granular casts in their urine without renal failure. Kidney Injury and Repair Biomarkers in Marathon RunnersCute piece from Rick Sterns on urine electrolytes! Managing electrolyte disorders: order a basic urine metabolic panelThe Urine Anion Gap: Common Misconceptions | American Society of NephrologyThe urine anion gap in context CJASNExcellent review from Halperin on urine chemistries (including some consideration of the TTKG): Use of Urine Electrolytes and Urine Osmolality in the Clinical Diagnosis of Fluid, Electrolytes, and Acid-Base Disorders - Kidney International ReportsRenal tubular acidosis (RTA): Recognize The Ammonium defect and pHorget the urine pH | SpringerLinkOutlineChapter 13- New part: Part 3, Physiologic approach to acid-base and electrolyte disorders - Do you remember the previous two parts? - Renal physiology - Regulation of water and electrolyte balance- Chapter 13: Meaning and application of urine chemistries - Measurement of urinary electrolyte concentrations, osmolality and pH helps diagnose some conditions - There are no fixed normal values - Kidney varies rate of excretion to match intake and endogenous production - Example: urine Na of 125/day can be normal if patient euvolemic on a normal diet, and wildly inappropriate in a patient who is volume depleted. - Urine chemistries are: - Useful - Simple - Widely available - Usually a random sample is adequate - 24-hour samples give additional context - Gives example of urinary potassium, with extra renal loss of K, urine K should be < 25, but if the patient has concurrent volume deficiency and urine output is only 500 mL, then urine K concentration can appropriately be as high as 40 mEq/L - Table 13-1 - Seems incomplete, see my notes on page 406 - What is Gravity ARF?- Sodium Excretion - Kidney varies Na to maintain effective circulating volume (I'd say volume homeostasis) - Urine Na affected by RAAS and ANP - Na concentration can be used to determine volume status - Urine Na < 20 is hypovolemia - Says it is especially helpful in determining the etiology of hyponatremia - Calls out SIADH and volume depletion - Used 40 mEq/L for SIADH - Also useful in AKI - Where differential is pre-renal vs ATN - In addition to urine Na (and FENa) look at urine osmolality - Again uses 40 mEq/l - Mentions FENa and urine osmolality - Urine Na can estimate dietary sodium intake - Suggests doing this during treatment of hypertension to assure dietary compliance - 24 hour urine Na is accurate with diuretics as long as the dose is stable and the drugs are chronic - Diuretics increase Na resorption in other segments of the tubule that are not affected by the diuretic - Points to increased AT2 induced proximal Na resorption and aldosterone induced DCT resoprtion - In HTN shoot for less than 100 mEq/Day - Urine Na useful in stones - Urine uric acid and urine Ca can cause stones and their handling is dependent on sodium - Low sodium diet can mask elevated excretion of these stone forming metabolites - 24-hour Na > 75 and should be enough sodium to avoid this pitfall - Pitfalls - Low urine sodium in bilateral renal artery stenosis or acute GN - High urine sodium with diuretics, aldo deficiency, advanced CKD - Altered water handling can also disrupt this - DI with 10 liters of urine and urine sodium excretion of 100 mEq is 10 mEq/L but in this case there is no volume deficiency - Opposite also important, a lot of water resorption can mask volume deficiency by jacking up the urine sodium - Advises you to use the FENa - THE FENA - < 1% dry - >2-3% ATN - It will fail with chronic effective volume depletion - Heart failure, cirrhosis, and burns - Suggests that tubular function will be preserved in those situations - Also with contrast, rhabdo, pigment nephropathy - Limitations - Dependent on the amount of Na filtered - Goes through the math of a normal person with GFR of 125/min and Na of 150 has filtered sodium of 27,000/day so if they eat 125-250 mEq their FENa will be 600-800 - Urine osm < plasma osm in face of hypernatremia indicates renal water loss due to lack of or resistance to ADH - In ATN urine OSM < 400 - In pre-renal disease it could be over 500 - Specific but not sensitive due to people with CKD who are unable to concentrate urine- Specific gravity - Plasma is 8-10% igher than plasma so specific gravity is 1.008 to 1.010 - Every 30-35 mOsm/L raises urine Osm of 0.001 - so 1.010 is 300-350 mOsm/L H2O - Glucose raises urine specific gravity more than osmolality - Same with contrast - Carbenicillin- pH - Normally varies with systemic acid-base status - PH should fall before 5.3 (usually below 5.0) with systemic metabolic acidosis - Above 5.3 in adults and 5.6 in children indicate RTA - PH goal 6.0-6.5 - Separate individual RTAs through FR of HCO3 at various serum HCO3 levels - Also can monitor urine pH to look for success in treating metabolic alkalosis - Look for pH > 7 - In treatment of uric acid stone disease - Want to shift eq: H + urate – uric acid to the left because urate is more soluble - PH goal 6.0-6.5

Aneurysmal Subarachnoid Hemorrhage (aSAH) Part II Special Guest: Casey May, PharmD, BCCCP, FNCS 04:24 – Guideline overview 09:15 – Blood pressure management 22:03 – Nimodipine 31:15 – Antifibrinolytics 36:58 – Hyponatremia and adjunctive treatments 46:20 – Seizure prophylaxis 49:10 -- Cerebral vasospasm/DCI treatment 52:46 -- Gaps in guidelines, future trials, ideas for future studies 60:25 – Take-home points  Reference List: https://pharmacytodose.files.wordpress.com/2023/08/asah-part-ii-references.pdf PharmacyToDose.Com  @PharmacyToDose  PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Drinking too much water can cause serious health problems! Find out why.

Dr. Douglas Casa has been the CEO of the Korey Stringer Institute since it was founded in 2010 and has been a professor of Kinesiology at the University of Connecticut since 1999. The mission of the KSI (ksi.uconn.edu) is to provide research, education, advocacy, and consultation, to maximize performance, optimize safety, and prevent sudden death of athletes, warfighters, and laborers.Dr. Casa has written several books and authored many papers on maximizing performance and safety while training or working in the heat. He has treated hundreds of cases of heat stroke with zero fatalities and has served on the International Olympic Committee's Adverse Weather Impact Expert Group, where he helps to ensure the safety of athletes competing in extreme heat during summer Olympic games.In this episode, we talk with Dr. Casa about his work at KSI, the science of heat stroke and how to manage it, how our bodies adapt to extreme heat, and how factors like saunas, hydration, and electrolytes affect our bodies in the heat. Timestamps:00:00:25 Intro00:02:01 Origins of KSI00:03:19 What Brought You to KSI00:04:42 What Does KSI do00:06:09 The Science of Heat Stroke00:09:34 The Consequences of Excessive Core Temp00:11:09 How to Recognize the Signs of EHS00:13:52 How to Treat EHS 00:19:19 Common Misconceptions00:22:20 What Conditions Create the Greatest Risk00:28:41 Objective Environmental Factors 00:30:23 Performance Clothing00:32:49 What Can an Athlete Do to Acclimate to Extreme Heat00:35:11 How do You Know Your Core Temp00:36:41 Type of Thermometers Recommended 00:37:19 Plasma Volume Expansion00:40:03 Train For Heat Adaptations at Home00:42:49 Sauna Guidelines00:43:22 Infrared Saunas 00:44:12 Manage Hydration00:47:36 Hyponatremia and Electrolyte Balance00:52:45 What do You Recommend For Hours Long Stressful Events00:55:02 Hydration Recommendations00:56:27 Are You More Likely to Get HS if You've Had it Before00:58:20 How do You Sign up For The Course00:59:20 Average Range of Cost to Work With KSI1:00:19 Outro

For five years I've been struggling with dehydration and finally found that it's due to a lack of sodium. It's not that I haven't taken electrolytes in the past, it's just that I haven't taken nearly enough. Listen in to hear how I finally conquered this long on going problem. Hopefully this can help out others who have dealt with the same issues.

The following episode covers the basics of hyponatremia. This episode is a bit longer than most but the prevalence of hyponatremia in critical care warrants a slightly longer conversation.  For further reading on hyponatremia: https://emcrit.org/ibcc/hyponatremia/  

Download for FREE today -  special Mnemonics Cheatsheet - so you can be SURE that you have that Must Know information down:  bit.ly/nursing-memory   Outline SALT LOSS S-Stupor/coma A-Anorexia, N&V L-Lethargy T-Tendon reflexes decreased L-Limp muscles (weakness) O-Orthostatic hypotension S-Seizures/headache S-Stomach cramping Description Hyponatremia is decreased levels of sodium in the blood. It can be caused by inadequate sodium or excess free water which leads to lower concentration of sodium. Sodium and potassium work together to allow depolarization of muscles. Low sodium levels can limit this ability and cause muscle weakness. Sodium in the blood helps maintain the oncotic pressure. If fluid leaves the blood vessels, it can lead to decreased blood pressure.

Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of Acid Base and Electrolyte Disorders by Dr. Burton Rose (who, incidentally, is the creator of the original UpToDate). Dr. Topf wrote his own book on fluids, electrolytes and acid-base homeostasis.  He's the co-editor for the fourth edition of Nephrology Secrets and the first edition of The Handbook of Critical Care Nephrology. Dr. Topf joined us to talk about a new paper he co-authored on osmotic demyelination syndrome and hyponatremia. I'm also joined by Dr. Mita Hoppenfeld, hospitalist at the University of Utah, to talk about a new DOAC vs warfarin trial in On-X aortic valves, whether it's better to avoid hypertension or hypotension around time of surgery, and the diagnostic accuracy of CT abdomen scans without contrast. Check it out! Osmotic Demyelination and HyponatremiaApixaban vs Warfarin for On-X Aortic ValvePerioperative Blood Pressure Strategies Diagnostic Accuracy of CT Abdomen Without ContrastMusic from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

In this excerpt, Raeann Sparks talks about how she determines and then replaces low sodium levels while on keto.

Episode 9! In this episode we step a little out of our comfort zone to talk about a couple of analyses which caught our interest recently: 1) "Comparative Effectiveness of Fludrocortisone and Hydrocortisone vs Hydrocortisone Alone Among Patients With Septic Shock" published  by Bosch et al March 2023 in JAMA Internal Medicine2) "Osmotic Demyelination Syndrome in Patients Hospitalized with Hyponatremia" published by MacMillan et al March 2023 in NEJM EvidenceFludrocortisone: https://pubmed.ncbi.nlm.nih.gov/36972033/COIITSS: https://pubmed.ncbi.nlm.nih.gov/20103758/ODM: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200215ODM Editorial: https://evidence.nejm.org/doi/full/10.1056/EVIDe2300014If you enjoy the podcast please share on social media or by word of mouth! Thank you!Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

We tackle the knotty dilemma of diagnosing and treating hyponatremia, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources

It's February 22, 2023. Dragon Ranger Owl is back! Clementine, Jasper, and Jarvis teach us about the Old Latin Mass revival, how drinking too much water may have killed Bruce Lee, deaf TikTok streamers, exposure therapy, and how an app called OnX is helping hunters and also everyone else see public lands that are closed off by private lands.

In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing... The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on Emergency Medicine Cases.

Dr. Alexis "AC" Gomez, a second year fellow at the combined MGH, Brigham and Women's, and Boston Children's nephrology program, discusses her approach to hyponatremia with host Dr. Joyce Zhou. She shares the pathophysiology behind her diagnostic framework for hyponatremia and her systematic approach, and discusses pearls such as how to use ddAVP clamps in treating this disorder. Run the List podcast on AccessMedicine: https://accessmedicine.mhmedical.com/multimedia.aspx#1460

-emia: suffix derived from Greek ἐμός (emos) meaning “blood” It comes from the Greek root word, haima, which translates to “blood”. Anemia: a condition in which an individual has low levels of healthy red blood cells. Etymological Definition: From the Greek root word, haima, which translates to “blood”. Leukemia: a type of cancer that affects the body's ability to produce healthy white blood cells. Etymological Definition: From the Greek root word, leukos, which means “white”. Thrombocytopenia: a condition in which the body produces fewer blood platelets than it should. Etymological Definition: From the Greek roots words, thrombos, which means “clot” and kytos, which means “hollow”. Stylemia: a condition in which the body has high levels of iron in the bloodstream. Etymological Definition: From the Greek root word, stylos, which translates to “an iron bar”. Hypervolemia: a condition in which the body has an excess of plasma in the blood. Etymological Definition: From the Greek root word, hyper, which means “over” and volêma, which means “volume”. Polycythemia: a condition in which the body produces too many red blood cells. Etymological Definition: From the Greek root words, poly, which means “many” and kytos, which means “cell”. Hyponatremia: a condition in which the body has a low sodium level in the blood. Etymological Definition: From the Greek root words, hypo, which means “under” and natrêm, which means “salt”. Dyskalemia: a type of electrolyte imbalance that affects the body's sodium and potassium levels. Etymological Definition: From the Greek root words, dys, which means “abnormal” and kalêm, which means “potassium”. Eosinophilia: a condition in which the body produces more eosinophils (a type of white blood cells) than normal. Etymological Definition: From the Greek root words, eos, which means “dawn” and phulon, which means “light”. Hematemia: the presence of red blood cells in the blood Etymology: mid 19th century; from Greek haimat- ‘blood' + -emia Neutropenia: a condition in which there is an abnormally low number of neutrophils in the blood Etymology: early 20th century; from Greek neuter ‘neutrophil' + -penia ‘deficiency' + -emia Leukocytosis: an increase in the number of white blood cells in the blood Etymology: late 19th century; from Greek leukos ‘white' + kytos ‘cell' + -osis ‘condition' + -emia Erythrocytosis: an increase in the number of red blood cells in the blood Etymology: late 19th century; from Greek erythros ‘red' + kytos ‘cell' + -osis ‘condition' + -emia Anoxemia: a lack of oxygen in the blood Etymology: early 20th century; from Greek an- ‘without' + oxys ‘sharp' + -emia Hypoxemia: a low amount of oxygen in the blood Etymology: early 20th century; from Greek hypo- ‘below' + oxys ‘oxygen' + -emia Hyperoxemia: a high amount of oxygen in the blood Etymology: early 20th century; from Greek hyper- ‘over' + oxys ‘sharp' + -emia Uremia: a condition in which the amount of waste products in the blood is abnormally high Etymology: early 20th century; from Greek ouros ‘urine' + -emia --- Support this podcast: https://anchor.fm/liam-connerly/support

This week, Rob and Zach will be talking about Hyponatremia.We will be discussing the following topics within this episode on Hyponatremia!Introduction to HyponatremiaCauses / PathophysiologyClinical FeaturesPhysical Exam FindingsDiagnosisTreatmentTo follow along with Notes & Illustrations for our podcasts please become a member on our website! https://www.ninjanerd.org/podcast/hyponatremiaFollow us on:YouTube: https://www.youtube.com/ninjanerdscienceInstagram: https://www.instagram.com/ninjanerdlecturesFacebook: https://www.facebook.com/NinjaNerdLecturesTwitter: https://twitter.com/ninjanerdsciDiscord: https://discord.com/invite/3srTG4dngWTikTok: https://www.tiktok.com/@ninjanerdlecturesThe Good Mood ShowWhen you feel like your BEST SELF, you are your best self. This is The Good Mood ShowListen on: Apple Podcasts Spotify Radical Health Rebel PodcastThe Radical Health Rebel Podcast brings you weekly discussions on all things health...Listen on: Apple Podcasts Spotify Beyond the BoxWhere unconventional thinking intersects with societal and cultural norms. We represent...Listen on: Apple Podcasts Spotify Smells Like HumansLike spending time with funny friends talking about curious human behavior. Listen on: Apple Podcasts SpotifySupport the show

This episode terminology:Hypo- Low.   Na - Sodium .  Emia - presence in blood.Hyponatremia: Low sodium presence in bloodPseudo-False.  Hypo- Low.   Na - Sodium .  Emia - presence in blood.Pseudohyponatremia: False low sodium presence in blood.--Often happens when sodium is artificially driven from the extra-cellular space into the intracellular  space.----Extra-Outside.  Cellular-pertaining  to cells:  Extracellular : Outside the cell----Intra-Inside.  Cellular-pertaining to cells:  Intracellular: Inside the cellLinks to things discussed:- JAMA Podcast- Diagnosis and management of hyponatremia- Urea for treatment of hyponatremia- Central Pontine MyelinolysisCoder vs. CDI is the industry's first talk show format podcast focused on bringing you interesting and new perspectives on clinical and coding topics. Regularly you'll hear the voices of Allen Frady, Amy Czahor, and Kyle Boyd discussing things that we all think but nobody wants to say out loud. Make sure you listen to our Saturday episodes when Dr. Stark, Physician Advisor Extraordinaire, will answer YOUR questions on clinical and coding topics -  You can submit your questions here.Follow us!- Linkedin- Twitter- WebsiteBuzzsprout — Easiest Way to Start a PodcastStart podcasting today. It's the easiest way to start, grow, and monetize your podcast.Brand Support the show

Hyponatremia affects approximately 5% of adults and approximately 35% of hospitalized patients. Even mild hyponatremia can be associated with cognitive impairment; in hospitalized patients, hyponatremia is associated with longer hospital stays and increased mortality. In this podcast, JAMA Deputy Editor Mary M. McDermott, MD, interviews Nicolaos E. Madias, MD, a nephrologist and professor of medicine at Tufts University School of Medicine, about the clinical approach to diagnosing hyponatremia and management of both acute and chronic hyponatremia. Related Content: Diagnosis and Management of Hyponatremia

The SLS team tackles the case of a young woman presenting with a prolonged, inflammatory pulmonary syndrome is found to have pulmonary granulomas, headaches and hyponatremia. Join them as they apply CPSolvers schemas to real life Patient care to facilitate the diagnostic reasoning process.   Download CPSolvers App here Patreon website

In this episode Emma is joined by Emily Cole, a senior XC / track and field student-athlete at Duke. After a scary experience with Hyponatremia - a medical condition caused by drinking too much water - Emily became passionate about teaching athletes the importance of nutrition and is soon releasing her book, The Players' Plate. She has also built a strong social media following on TikTok and Instagram where she shares her story and everyday life as a student-athlete at Duke. Throughout this convo, Emily talks about her experience with Hyponatremia, how she began to redefine what healthy nutrition was and what would work best for her, why content creators in the running world are important, how social media has changed her life, more. Follow Emily on Instagram: @emilycoleYou can find Emma on Instagram at @emmaabrahamson and on her YouTube Channel. Follow Convos Over Cold Brew Podcast on Instagram at @convosovercoldbrewpod.Click here to shop Convos Over Cold Brew merchandise!Offers:-Inside Tracker | Go to insidetracker.com/emma or use code EMMA20 for 20% off the top selling Ultimate Plan Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In this episode, we'll be discussing hyponatremia in the critical care world. From diagnosis to management, we've got you covered. Reach out: Instagram: @coffeebreakhems Email: kisercpr@gmail.com Buy the book! www.kisercpr.com/shop Rate us on Amazon!

What are the 3 types of solutes you can use in hyponatremia? What are each of their drawbacks? How do loop diuretics work help in hyponatremia? What can you use to tell you on day 1 that fluid restriction alone will not work?Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/08/03/hyponatremia-man…5-pearls-segment/Sponsor: https://go.amboss.com/CoreIM-E4Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps:01:20 Intro04:46 Pearl 113:13 Pearl 224:03 Pearl 332:49 Pearl 437:05 Pearl 5

Digital Education Conference 2022 in Oct 7 & 8 2022: https://cmecatalog.hms.harvard.edu/digital-educationWhat does each diagnostic test tell you? How do you interpret urine osmolality, urine sodium, or urine urea? What studies can be used to better assess response to treatment? How can uric acid be utilized as a diagnostic tool? What is the interplay between ADH and UOsm?Show notes, Transcript and References: https://www.coreimpodcast.com/2021/02/10/5-pearls-on-hyponatremia-episode-1/ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-imTags: urine studies, SIADH, Core IM, IMCore, antidiuretic hormone, hospital medicine, family medicine, nephrology