PODCAST · health
Channel Your Enthusiasm
by Channel Your Enthusiasm
A chapter by chapter recap of Burton Rose’s classic, The Clinical Physiology of Acid Base and Electrolyte Disorders, a kidney physiology book for nephrologists, fellows, residents and medical students.
Episodes
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NephJC Fall Pledge Drive 2026
Time to dig deep and donate to NephJC: https://www.nephjc.com/news/2026/9/8/nephjc-fall-pledge-drive
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Chapter Twenty-Three: Hypoosmolal States–Hyponatremia part 2 of 3
References This is the thiazide induced hyponatremia reference mentioned by Friedman: Thiazide-Induced Hyponatremia: Reproducibility by Single Dose Rechallenge and an Analysis of Pathogenesis This is the study that Josh mentioned regarding genetic predisposition Phenotypic and pharmacogenetic...
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Chapter Twenty-Three: Hypoosmolal States–Hyponatremia
Roger’s Hydrogen to pH table References December 19, 2023 Joel had a patient with severe hypothyroidism and hyponatremia- case report Mel reviewed the endocrine factors that can contribute to hyponatremia in this report (from the 2020 ASN quiz and questionnaire): Pattern Recognition versus...
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Chapter Twenty-Two: Introduction to Disorders of Osmolality
References This is the famous Edelman equation from JCI in 1958 by Isodore Edelman! Interrelations between serum sodium concentration, serum osmolarity and total exchangeable sodium, total exchangeable potassium and total body water (not to be confused by Isildur House of Isildur - Tolkien…
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Chapter Twenty: Respiratory Acidosis
References Biff Palmer! Respiratory Acidosis and Respiratory Alkalosis: Core Curriculum 2023 Josh what is sensed- pCO2 or pH and some exploration suggests that it is not settled! Sensing, physiological effects and molecular response to elevated CO2 levels in eukaryotes - PMC and this one with...
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Chapter Twenty One: Respiratory Alkalosis
References Chapter 19, Part 3 August 30, 2023Biff Palmer’s Ted Talk-Why not? Biff Palmer at TEDxSMU 2013 Anna mentioned this issue of lactic acidosis in a panic disorder: The Lactic Acid Response to Alkalosis in Panic Disorder | The Journal of Neuropsychiatry and Clinical Neurosciences Reminder…
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Chapter Nineteen: Metabolic Acidosis, part 3
References Chapter 19, Part 3 August 30, 2023 Joel and Roger mentioned the most common cause seems to be Sjögren’s syndrome for an acquired distal RTA. We mentioned this in an earlier episode and referenced this example of an absence of the H+ ATPase, presumably from autoantibodies to this...
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Chapter Nineteen: Metabolic Acidosis, part 2
References Chapter 19, Part 12 Metabolic acidosis June 14, 2023 References Chapter 19, Part 2 Roger mentioned MELAS syndrome MELAS syndrome: Clinical manifestations, pathogenesis, and treatment options Josh mentioned this blog on lactate- Understanding lactate in sepsis & Using it to our…
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Chapter Eighteen: Metabolic Alkalosis, part 2
References Part 2, March 1, 2023 The alkaline tide phenomenon in studies that measured both the alkaline tide and acid secretion, the bicarbonate accumulation increased in linear fashion with the acid secretion. Melanie thought this was first recognized in the 60’s but later found this manuscript...
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Chapter Nineteen: Metabolic Acidosis, The Show, part 1
References Chapter 19, Part 1 Metabolic acidosis June 14, 2023 American Society of Nephrology | Medical Students - Kidney TREKS this is the program that Josh mentioned at Mount Desert Island! Effects of pH on Potassium: New Explanations for Old Observations - PMC here’s the review melanie from...
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Chapter Eighteen: Metabolic Alkalosis, part 1
We are a bit slappy at the beginning of the episode since we had just recorded our conversation with the Glaucomfleckens. References Chapter 18 Metabolic alkalosis! Part 1 February 23, 2023 It is chloride depletion alkalosis, not contraction alkalosis classic review by Galla and Luke, the…
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Chapter Seventeen: Introduction to Simple and Mixed Acid-Base Disorders
References I said I used MDCalc but I was mistaken I use MedCalX which is nice but getting dated. We talked about this out of print book that we love: Cohen, J. J., Kassirer, J. P. (1982). Acid-base. United States: Little, Brown. Josh mentioned this article that looked at over 17,000 samples with...
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Chapter Sixteen: Edematous States, part 2
References We talked about winning the 2022 ASN innovation contest and here’s a link to our promo video https://www.dropbox.com/scl/fi/g4osnf0nradsfryyo51fi/ASN-Education-Contest-Channel-Your-Enthusiasm-Podcast.mp4?rlkey=pnso45x07nr3pane9y8cux8yg&e=1&dl=0 We wondered about “permissive...
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Chapter Sixteen: Edematous States, part 1
References Capillary Hemodynamics Insights into Salt Handling and Blood Pressure | NEJM Amy mentioned about the 3 phases of the interstitium Are the precapillary sphincters and metarterioles universal components of the microcirculation? An historical review - PMC Safety factor? Renal Function...
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Chapter Fifteen: Clinical Use of Diuretics, part 2
References Proximal Tubule-Specific Deletion of the NHE3 (Na+/H+ Exchanger 3) in the Kidney Attenuates Ang II (Angiotensin II)-Induced Hypertension in Mice Melanie is in love with this paper that shows that sodium retention Bumetanide and furosemide in heart failure everyone agreed that we love...
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Chapter Fifteen: Clinical Use of Diuretics, part 1
Outline Chapter 15 — Clinical Use of Diuretics - Among most commonly used drugs - Block NaCl reabsorption at different sites along the nephron - The ability to induce negative balance has made them useful in multiple diseases - Edematous states - Hypertension - Mechanism of action - Three major...
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Chapter Fourteen: Hypovolemic States, part 2
Outline Chapter 14 — Treatment - Treatment - Both oral and IV treatment can be used for volume replacement - The goal of therapy are to restore normovolemia - And to correct associated acid-base and electrolyte disorders - Oral Therapy - Usually can be accomplished with increased water and…
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Chapter Fourteen: Hypovolemic States, part 1
Outline Chapter 14 - Hypovolemic States - Etiology - True volume depletion occurs when fluid is lost from from the extracellular fluid at a rate exceeding intake - Can come the GI tract - Lungs - Urine - Sequestration in the body in a “third space” that is not in equilibrium with the…
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Chapter Thirteen: Meaning and Application of Urine Chemistries
References JC mentioned that the diagnostic accuracy of 24 hour urine collection increases with more collections! Metabolic evaluation of patients with recurrent idiopathic calcium nephrolithiasis We didn't refer to a particular study on sodium intake and the 24 hour urine but this meta-analysis...
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Chapter Eleven: Regulation of Acid-Base Balance, part 2
References We considered the complexity of the machinery to excrete ammonium in the context of research on dietary protein and how high protein intake may increase glomerular pressure and contribute to progressive renal disease (many refer to this as the “Brenner hypothesis”). Dietary protein...
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The 2023 NKF Clinical Meeting Live Recording: Diuretic Draft
The Channelers went where no nephrology podcasters have gone before, recording in front of a live audience at the National Kidney Foundation Clinical Meeting in Austin. We had all eight Channelers doing a live podcast. We did a Freely Filtered-inspired draft of the best diuretics. The draft…
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Chapter Eleven: Regulation of Acid-Base Balance, part 1
References We considered the effect of a high protein diet and potential metabolic acidosis on kidney function. This review is of interest by Donald Wesson, a champion for addressing this issue and limiting animal protein: Mechanisms of Metabolic Acidosis-Induced Kidney Injury in Chronic Kidney...
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Chapter Ten: Acid-Base Physiology
References for Chapter 10 We did not mention many references in our discussion today but our listeners may enjoy some of the references below. Effects of pH on Potassium: New Explanations for Old Observations - PMC although the focus of this article is on potassium, this elegant review by Aronson...
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Chapter Nine: Regulation of Plasma Osmolality
References for Chapter 9 One of the few papers that Rose wrote as a single author explores electrolyte free water clearance. This seminal paper explores the issue in greater detail than the book. A New approach to disturbances in the plasma sodium concentration Wondering about the volume of…
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Chapter Eight: Regulation of The Effective Circulating Volume
References for chapter 8 Robert Schrier proposed a unifying hypothesis to explain the sodium retention seen in edematous states like cirrhosis and heart failure, coining the term effective arterial blood volume (EABV). An open access review in JASN 2007 can be found here:...
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Chapter Seven: The Total Body Water and The Plasma Sodium Concentration
Chapter 7 References Sands JM, Blount MA and Klein JD. Regulation of Renal Urea Transport by Vasopressin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116377/ In this invited piece, Sands and colleagues explain that although urea is permeable across membranes, this is slow, thus urea…
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Chapter Six: Effects of Hormones on Renal Function, part 2
Chapter 6 part 2. References Josh touts the PARADIGM-HF Trial Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure | NEJM which found this combination was superior to an ARB alone Joel mentions an early atrial natriuretic peptide trial by Julie Lewis et al. Atrial natriuretic…
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Chapter Six: Effects of Hormones on Renal Function part 1
Chapter 6 part 1 In this review of vasopressin, you can find an excellent discussion of basic stimuli and vasopressin receptors: Vasopressin V1a and V1b Receptors: From Molecules to Physiological Systems | Physiological Reviews X-Linked Nephrogenic diabetes insipidus is very rare and there was...
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Chapter Five: Functions of the Distal Nephron
References for Chapter 5--the Distal Nephron Roger pointed out the fact that the distal nephron can achieve very low urinary sodium as evidenced by observations in people from the Yanomamo tribe Blood pressure and electrolyte excretion in the Yanomamo Indians, an isolated population in this…
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Chapter Four: The Loop of Henle and Counter Current Exchange
Show notes with a full set of references are available here: http://www.rosebook.club/episodes/2021/6/22/chapter-four Also, please fill out our listener survey: https://forms.gle/DVdcJikKZkzY56mXA
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Chapter Three: The Proximal Tubule
Chapter Three: How the proximal tubule is like Elizabeth Warren and other truths my friends from Boston taught me
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Chapter Two: Renal Circulation and Glomerular Filtration Rate, part 2
The exciting conclusion toChapter Two: Renal Circulation and Glomerular Filtration Rate
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Chapter Two: Renal Circulation and Glomerular Filtration Rate, part 1
Back by popular demand…all two of you…the second chapter of The Clinical Physiology of Acid Base and Electrolyte Disorders.
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Chapter One: Introduction to Renal Function
The Channel Gang discusses the name of their new podcast and then discuss chapter one of The Book.
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ABOUT THIS SHOW
A chapter by chapter recap of Burton Rose’s classic, The Clinical Physiology of Acid Base and Electrolyte Disorders, a kidney physiology book for nephrologists, fellows, residents and medical students.
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Channel Your Enthusiasm
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A chapter by chapter recap of Burton Rose’s classic, The Clinical Physiology of Acid Base and Electrolyte Disorders, a kidney physiology book for nephrologists, fellows, residents and medical students.
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