The Curbsiders Internal Medicine Podcast Reboot - Diuretics, leg cramps, and resistant hypertension
Mar 4, 2019
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Kidney Nephron Physiology Basics
- The kidney's nephron segments perform distinct functions in filtering and reabsorbing substances to maintain balance.
- Understanding how diuretics target specific nephron parts explains their effects and uses in therapy.
Prefer Chlorthalidone Over HCTZ
- Prefer chlorthalidone over hydrochlorothiazide due to longer half-life and greater blood pressure control.
- Start with appropriate dosing; adjust carefully to avoid hyponatremia and hypokalemia.
Manage Thiazide-Induced Hyponatremia
- Stop thiazide diuretics if sodium drops below 130 to prevent subtle but serious issues like osteoporosis and fall risk.
- Monitor electrolytes one to two weeks after starting thiazides to catch hyponatremia early.