Persistent Hyponatremia due to Sodium Wasting via External Biliary Drainage

Hyponatremia is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a broad spectrum of clinical symptoms and is associated with increased mortality, morbidity, and length of hospital stay. A 76-year-old female patient was referred to the nephrology department for kidney dysfunction and hyponatremia. She has an external biliary drainage catheter due to an inoperable Klatskin tumor. Initially, she was treated with isotonic fluid because of vomiting-related hypovolemic hyponatremia. Kidney dysfunction had recovered, but targeting sodium levels were not achieved and remained below 125 mM. Controlled urine sodium level remained below 20 mM. Thus, we considered a sodium loss to third spaces and the biliary drainage was the first presumption. Daily sodium wasting was calculated as 164 mmol/24 h (3.8 g sodium) via biliary drainage fluid. So, we added biliary sodium decrement count to the patient’s diet as oral salt supplementation; 10 g salt (sodium chloride) per day was equal to daily sodium wasting. The follow-up sodium levels remained around 135 mM, and the patient is asymptomatic since discharge

The effect of sodium exchange and dialytic biochemical parameters on blood pressure, arterial stiffness, and endothelial functions in patients with peritoneal dialysis

Objective This study aimed to investigate the relationship between fluid and sodium excretion and blood pressure, echocardiographic parameters, and arterial stiffness in peritoneal dialysis (PD) patients and to evaluate the effect of sodium excretion on patients' survival

Relationship between disease awareness and severity of kidney disease in autosomal dominant polycystic kidney disease patients

Introduction Polycystic kidney disease (PKD) is responsible for 5%-10% of end-stage renal disease. We examined the relationship between renal and extrarenal findings, disease severity, and the level of consciousness of PKD patients. Methods Patients were asked to answer the questionnaire about PKD. Disease severity was determined according to estimated glomerular filtration rate, and disease awareness was assessed by adapting the Disease Perception Scale to PKD. Awareness of patients was evaluated comparatively with chronic kidney disease stage, age, region, and symptoms. Results One out of five patients does not know that this disease is inherited. Mean awareness scores of the patients decreased significantly with increasing age. Awareness scores were significantly higher in patients with flank pain, hematuria, and urinary tract stones. Conclusion Although PKD is the most common hereditary kidney disease, the rate of patients' knowledge on this subject is low. Increased awareness might lead to better treatment in those patients

Serum paraoxonase activity is associated with epicardial fat tissue in renal transplant recipients

Cardiovascular disease is a major cause of mortality in renal transplant recipients. Paraoxonase-1 (PON-1) has been shown to protect against atherosclerosis by modifying lipoproteins. Epicardial fat tissue (EFT) has been proposed as a new cardiovascular risk factor. The aim of this study was to investigate the relationship between PON-1 activity and EFT in renal transplant recipients