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📌#Cardiorenal Syndrome
Pathophysiology as a key to the therapeutic approach
#CardioTwitter #CardioEd #NephroTwitter #Review
Pathophysiology as a key to the therapeutic approach
#CardioTwitter #CardioEd #NephroTwitter #Review
Management & therapeutic approach📝
Urine Trouble: A review of Immune checkpoint inhibitor associated nephritis
See below some of the data I collected on this topic from a recent inservice! @OncoPharmPod #nephrotwitter #oncopharm
See below some of the data I collected on this topic from a recent inservice! @OncoPharmPod #nephrotwitter #oncopharm
Immune checkpoint inhibitors (ICI) ➡️revolutionized tx 💊 of various malignancies
✅Treatment that offers some pts🙋🏻♀️a chance of cure🤯
Also see a range of unique toxicities⚠️➡️autoimmune in nature
An emerging one of which is nephritis! (Insert a needed kidney emoji)
✅Treatment that offers some pts🙋🏻♀️a chance of cure🤯
Also see a range of unique toxicities⚠️➡️autoimmune in nature
An emerging one of which is nephritis! (Insert a needed kidney emoji)
Pathogenesis of ICI-nephritis is unknown
Some hypothesis exist 🧐
✅stopping the breaks on the immune system results in excessive immune activation➡️ATIN
✅Previous renal insult or concurrent medications that lead to ATIN can accelerate the emergence of renal injury ☢️
Some hypothesis exist 🧐
✅stopping the breaks on the immune system results in excessive immune activation➡️ATIN
✅Previous renal insult or concurrent medications that lead to ATIN can accelerate the emergence of renal injury ☢️
1/
I've heard this argument before that "an amp of sodium bicarb raises blood pressure as it is hyperosmolar". I thought it'd be a good idea to quantify its effects:
Let's consider an average 70kg adult with TBW = 42L, ICFV = 25L (60%), and ECFV = 17L (40%), osmolality = 280.
I've heard this argument before that "an amp of sodium bicarb raises blood pressure as it is hyperosmolar". I thought it'd be a good idea to quantify its effects:
Let's consider an average 70kg adult with TBW = 42L, ICFV = 25L (60%), and ECFV = 17L (40%), osmolality = 280.
2/
1 amp of bicarb=50 meq of Na and 50 meq HCO3 --> a total of 100 mosm of solutes are added. A key point is that all new osmoles remain in ECF-->ECF osmoles increase to 4860 mosm
To predict changes after equilibration, we have to look at changes in total body solutes and water.
1 amp of bicarb=50 meq of Na and 50 meq HCO3 --> a total of 100 mosm of solutes are added. A key point is that all new osmoles remain in ECF-->ECF osmoles increase to 4860 mosm
To predict changes after equilibration, we have to look at changes in total body solutes and water.
3/
Total body solutes now increase to 11860 mosm from 11760 mosm. TBW increases only by 50cc (the volume of 1 amp).
So after equilibration, new osmolality should be 11860/42.05 = 282.05 mosm/L
Now let's see how the 2 compartments would settle after equilibration (figure)
Total body solutes now increase to 11860 mosm from 11760 mosm. TBW increases only by 50cc (the volume of 1 amp).
So after equilibration, new osmolality should be 11860/42.05 = 282.05 mosm/L
Now let's see how the 2 compartments would settle after equilibration (figure)
