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Curr Drug Saf 2022 May 18. Epub 2022 May 18.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Introduction/background: Losing-salt tubulopathies, such as Bartter syndrome, are rare and usually inherited due to mutations of tubular reabsorption channels of the nephrons. Despite its scarcity, some cases of acquired losing-salt tubulopathies have been described. In this case report, we discuss the main aspects of Bartter syndrome and present a rare pediatric case of probable tacrolimus-induced Bartter-like syndrome in a renal transplanted boy. Read More

Pediatr Nephrol 2022 May 17. Epub 2022 May 17.

Department of Pediatrics, University of Chieti-Pescara, Chieti, Italy.

Pediatr Nephrol 2022 May 17. Epub 2022 May 17.

Department of Pediatrics, University of Chieti-Pescara, Chieti, Italy.

BMC Nephrol 2022 May 12;23(1):182. Epub 2022 May 12.

Nephrology Department, Heraklion University Hospital, Voutes, 71500, Heraklion, Crete, Greece.

Background: Dent disease is an X-linked disorder characterized by low molecular weight proteinuria (LMWP), hypercalciuria, nephrolithiasis and chronic kidney disease (CKD). It is caused by mutations in the chloride voltage-gated channel 5 (CLCN5) gene (Dent disease-1), or in the OCRL gene (Dent disease-2). It is associated with chronic metabolic acidosis; however metabolic alkalosis has rarely been reported. Read More

ERJ Open Res 2022 Apr 9;8(2). Epub 2022 May 9.

The Leeds Regional Adult Cystic Fibrosis Centre, St James's University Hospital, Leeds Teaching Hospital NHS Trust, Leeds, UK.

https://bit.ly/3NFPkUu. Read More

Am J Kidney Dis 2022 May 4. Epub 2022 May 4.

Division of Nephrology, Department of Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico. Electronic address:

Metabolic alkalosis is a widespread acid-base disturbance, especially in hospitalized patients. It is characterized by the primary elevation of serum bicarbonate and arterial pH, along with a compensatory increase in Pco consequent to adaptive hypoventilation. The pathogenesis of metabolic alkalosis involves either a loss of fixed acid or a net accumulation of bicarbonate within the extracellular fluid. Read More

BMC Nephrol 2022 05 4;23(1):170. Epub 2022 May 4.

Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Curie-Skłodowskiej 9, 85-094, Bydgoszcz, Poland.

Background: Gitelman Syndrome (GS) is a hereditary tubulopathy associated with a biallelic inactivating mutations of the SLC12A3 gene encoding the thiazide-sensitive sodium-chloride cotransporter (NCCT). The typical clinical manifestation is a hypokalemic metabolic alkalosis with significant hypomagnesemia, and low urinary calcium excretion. Hypocalciuria is widely believed to be a hallmark of GS that distinguishes it from Barter's syndrome, presenting as hypercalciuria. Read More

Andes Pediatr 2022 Feb 29;93(1):110-116. Epub 2022 Mar 29.

Hospital Clínico Dra. Eloísa Díaz I., Santiago, Chile.

In the pediatric emergency department, dehydrated children are one of the most frequent causes for consultation, however, the coexistence of hyponatremia with hypochloremia and metabolic alkalosis is rare. The presence of metabolic alkalosis due to chloride depletion has been reported as a form of presentation of Cystic Fibrosis (CF).

Objective: to describe a case of cystic fibrosis of unusual presen tation in a pediatric patient. Read More

Cureus 2022 Mar 28;14(3):e23570. Epub 2022 Mar 28.

Department of Medicine, Roger Williams Medical Center, Providence, USA.

Long-term alcohol abuse can cause alcohol-related liver injury (acute alcoholic hepatitis, acute liver failure, hepatic steatosis, fibrosis, or cirrhosis), as well as cardiac injury. Alcoholic cardiomyopathy is a severe consequence of chronic alcohol abuse. Incidence of alcoholic cardiomyopathy ranges from 1-2% of all heavy alcohol users. Read More

Am J Med Sci 2022 Apr 23. Epub 2022 Apr 23.

Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address:

Diuretics are amongst the most prescribed medications in both the inpatient and outpatient settings. They are used extensively in diverse disease states including heart failure, acute and chronic kidney disease, cirrhosis, and diseases of excess capillary permeability such as sepsis, malignancy, and malnutrition. All are characterized by total body sodium overabundance which commonly manifests as edema. Read More

Front Med (Lausanne) 2022 7;9:862514. Epub 2022 Apr 7.

Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China.

Background: Bartter syndrome (BS) type II is a rare autosomal recessive renal tubular disorder caused by mutations in the gene, which encodes the apical renal outer medullary potassium (ROMK) channel in the thick ascending limb (TAL) of Henle's loop. BS type II is typically considered as a disorder of infancy and seldom seen in adults.

Case Presentation: A 34-year-old woman was admitted with generalized body numbness and hand convulsions, without growth retardation. Read More

J Clin Med 2022 Apr 8;11(8). Epub 2022 Apr 8.

Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Via Di Rudini 9, 20122 Milan, Italy.

Our aim was to investigate the distribution of acid-base disorders in patients with COVID-19 ARDS using both the Henderson-Hasselbalch and Stewart's approach and to explore if hypoxemia can influence acid-base disorders. COVID-19 ARDS patients, within the first 48 h of the need for a non-invasive respiratory support, were retrospectively enrolled. Respiratory support was provided by helmet continuous positive airway pressure (CPAP) or by non-invasive ventilation. Read More

World J Clin Cases 2022 Mar;10(9):2844-2850

Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan.

Background: Gitelman syndrome (GS) is an autosomal recessive renal tubular disorder characterized by renal wasting hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria. It is usually caused by mutations in the gene , which encodes the thiazide-sensitive Na-Cl cotransporter. GS is not usually diagnosed until late childhood or adulthood. Read More

Case Rep Nephrol 2022 6;2022:1320259. Epub 2022 Apr 6.

Johns Hopkins University School of Medicine, Department of Medicine, Division of Nephrology, Baltimore, MD, USA.

Calcium regulation is tightly controlled in the body. Multiple causes of hypercalcemia have been studied including primary hyperparathyroidism, hypercalcemia of malignancy, and chronic granulomatous disorders. Among the less studied causes is calcium-alkali syndrome. Read More

Case Rep Endocrinol 2022 31;2022:3739957. Epub 2022 Mar 31.

Department of Endocrinology, Changi General Hospital, 2 Simei Street 3 529889, Singapore.

Cushing's syndrome (CS) secondary to ectopic adrenocorticotrophic hormone (ACTH)-producing prostate cancer is rare with less than 50 cases reported. The diagnosis can be challenging due to atypical and variable clinical presentations of this uncommon source of ectopic ACTH secretion. We report a case of Cushing's syndrome secondary to prostate adenocarcinoma who presented with symptoms of severe hypercortisolism with recurrent hypokalaemia, limb oedema, limb weakness, and sepsis. Read More

Ther Apher Dial 2022 Apr 6. Epub 2022 Apr 6.

Department of Critical Care Medicine, Affiliated Hospital of Weifang Medical University, Weifang, China.

Introduction: This study aimed to compare the efficacy and safety of citrate and heparin in continuous renal replacement therapy (CRRT) for critically ill patients.

Methods: Searched in PubMed, Embase, and Cochrane Library databases.

Results: Analyses showed that there no difference existed in mortality, metabolic alkalosis, circuit loss, and the number of transfused between the two groups (RR = 0. Read More

Semin Dial 2022 Apr 5. Epub 2022 Apr 5.

Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: Hemodialysis solutions typically contain a high alkali concentration designed to counter interdialytic acidosis, but this could result in persistent alkalosis in some patients. The prevalence and significance of persistent alkalosis were therefore examined at four outpatient centers over a 10-year period.

Methods: Alkalosis was defined as a pre-dialysis serum [HCO ] ≥ 26 meq/L in >6 months of a 12-month period and was persistent if present in a majority of months thereafter. Read More

Intensive Care Med Exp 2022 Apr 4;10(1):11. Epub 2022 Apr 4.

Skåne University Hospital Perioperative and Intensive Care, Entregatan 7, 22242, Lund, Sweden.

Background/aims: Acid-base status is important for understanding pathophysiology, making a diagnosis, planning effective treatment and monitoring progress of critically ill patients. Manual calculations are cumbersome, easily result in wrong conclusions. We wanted to develop an automated assessment of acid-base status. Read More

Front Physiol 2022 15;13:852674. Epub 2022 Mar 15.

Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom.

In 2009, two groups independently linked human mutations in the inwardly rectifying K channel Kir4.1 (gene name ) to a syndrome affecting the central nervous system (CNS), hearing, and renal tubular salt reabsorption. The autosomal recessive syndrome has been named EAST (epilepsy, ataxia, sensorineural deafness, and renal tubulopathy) or SeSAME syndrome (seizures, sensorineural deafness, ataxia, intellectual disability, and electrolyte imbalance), accordingly. Read More

Clin Chim Acta 2022 Mar 28;531:120-125. Epub 2022 Mar 28.

Genetic and Metabolic Central Laboratory, Guangxi Birth Defects Research and Prevention Institute, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China; Guangxi Key Laboratory of Reproductive Health and Birth Defects Prevention, Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Guangxi Key Laboratory of Birth Defects and Stem Cell Biobank, Guangxi Key Laboratory of Birth Defects Research and Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China. Electronic address:

Background: Bartter syndrome is an inherited renal tubular disorder that is characterized by hypokalemic, hypochloremic metabolic alkalosis in which the primary defect is a deficiency of transporters involved in sodium chloride reabsorption. Bartter syndrome type 1 is caused by SLC12A1 mutations.

Methods: The patients were from two unrelated non-consanguineous Chinese families. Read More

FASEB J 2022 05;36(5):e22275

Department of Integrative Biology and Pharmacology, the University of Texas Health Science Center at Houston, Houston, Texas, USA.

The collecting duct is a highly adaptive terminal part of the nephron, which is essential for maintaining systemic homeostasis. Principal and intercalated cells perform different physiological tasks and exhibit distinctive morphology. However, acid-secreting A- and base secreting B-type of intercalated cells cannot be easily separated in functional studies. Read More

Medicina (Kaunas) 2022 Mar 12;58(3). Epub 2022 Mar 12.

Institute of Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany.

Dyspnea, shortness of breath, and chest pain are frequent symptoms of post-COVID syndrome (PCS). These symptoms are unrelated to organ damage in most patients after mild acute COVID infection. Hyperventilation has been identified as a cause of exercise-induced dyspnea in PCS. Read More

BMC Endocr Disord 2022 Mar 18;22(1):71. Epub 2022 Mar 18.

Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.

Background: Reninoma is a rare, benign renal neoplasm. Typical clinical features include severe hypertension, secondary hyperaldosteronism, hypokalaemia and metabolic alkalosis caused by the overproduction of renin.

Case Presentation: A 25-year-old lean Chinese woman with no family history of hypertension was hospitalized for stage 1 hypertension that gradually developed over two years. Read More

Pediatr Nephrol 2022 Mar 14. Epub 2022 Mar 14.

Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey.

Pediatr Nephrol 2022 Mar 11. Epub 2022 Mar 11.

Division of Nephrology, Children's Hospital of New Orleans, 200 Henry Clay Ave, New Orleans, LA, 70118, USA.

Pediatr Nephrol 2022 Mar 11. Epub 2022 Mar 11.

Division of Nephrology, Children's Hospital of New Orleans, 200 Henry Clay Ave, New Orleans, LA, 70118, USA.

Pflugers Arch 2022 Jun 11;474(6):603-612. Epub 2022 Mar 11.

Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.

The hypokalemic response to alkali infusion has been attributed to the resulting extracellular fluid (ECF) expansion, urinary potassium excretion, and internal potassium shifts, but the dominant mechanism remains uncertain. Hypertonic NaHCO infusion (1 N, 5 mmol/kg) to unanesthetized dogs with normal acid-base status or one of the four chronic acid-base disorders decreased plasma potassium concentration ([K]) at 30 min in all study groups (Δ[K], - 0.16 to - 0. Read More

Cureus 2022 Jan 31;14(1):e21768. Epub 2022 Jan 31.

Internal Medicine, Ascension Providence Hospital, Southfield, USA.

Diabetic ketoacidosis (DKA) is a well-known, serious complication that many patients with type 1 and 2 diabetes face due to either a relative or absolute insulin deficiency. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have gained increased popularity due to their diabetic, cardiovascular, and renal benefits. An associated complication of SGLT2 inhibitors is euglycemic DKA. Read More

High Alt Med Biol 2022 Feb 28. Epub 2022 Feb 28.

Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia-Okanagan, Kelowna, British Columbia, Canada.

Steele, Andrew R., Philip N. Ainslie, Rachel Stone, Kaitlyn Tymko, Courtney Tymko, Connor A. Read More

Saudi J Kidney Dis Transpl 2021 Jul-Aug;32(4):1163-1165

Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Liddle's syndrome is a rare cause of secondary hypertension (HTN). Basic characteristics of this disease are HTN, reduced concentration of aldosterone and renin activity, as well as increased excretion of potassium, leading to hypokalemia and metabolic alkalosis. The cause of Liddle syndrome is missense or frame shift mutations in SCNN1A, SCNN1B, or SCNN1G genes that encode epithelial sodium channel subunits. Read More