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Christos Argyropoulos MD, PhD

Slidedeck from an internal presentation on diabetic kidney disease 👇

Nephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on Disease in people with

slideshare.net/slideshow/nephr

Nephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on Kidney Disease in people with diabetes
SlideShareNephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on Kidney Disease in people with diabetesNephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on Kidney Disease in people with diabetes - Download as a PDF or view online for free
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Christos Argyropoulos MD, PhD

Fresh from the press, my most recent collaboration about

Pseudohyponatremia: Mechanism, Diagnosis, Clinical Associations and Management mdpi.com/2344126 via @JCM_MDPI

@MRoumelioti

MDPIPseudohyponatremia: Mechanism, Diagnosis, Clinical Associations and ManagementPseudohyponatremia remains a problem for clinical laboratories. In this study, we analyzed the mechanisms, diagnosis, clinical consequences, and conditions associated with pseudohyponatremia, and future developments for its elimination. The two methods involved assess the serum sodium concentration ([Na]S) using sodium ion-specific electrodes: (a) a direct ion-specific electrode (ISE), and (b) an indirect ISE. A direct ISE does not require dilution of a sample prior to its measurement, whereas an indirect ISE needs pre-measurement sample dilution. [Na]S measurements using an indirect ISE are influenced by abnormal concentrations of serum proteins or lipids. Pseudohyponatremia occurs when the [Na]S is measured with an indirect ISE and the serum solid content concentrations are elevated, resulting in reciprocal depressions in serum water and [Na]S values. Pseudonormonatremia or pseudohypernatremia are encountered in hypoproteinemic patients who have a decreased plasma solids content. Three mechanisms are responsible for pseudohyponatremia: (a) a reduction in the [Na]S due to lower serum water and sodium concentrations, the electrolyte exclusion effect; (b) an increase in the measured sample’s water concentration post-dilution to a greater extent when compared to normal serum, lowering the [Na] in this sample; (c) when serum hyperviscosity reduces serum delivery to the device that apportions serum and diluent. Patients with pseudohyponatremia and a normal [Na]S do not develop water movement across cell membranes and clinical manifestations of hypotonic hyponatremia. Pseudohyponatremia does not require treatment to address the [Na]S, making any inadvertent correction treatment potentially detrimental.
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