Visual reference
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What Do the Kidneys Regulate?
The BMP Skeleton Key Layout
How clinicians quickly sketch and interpret the basic metabolic panel
Additional Key Electrolytes
Ca++
Mg++
PO4
Electrolyte Disorders
๐ BMP + Ca + Mg + PO4 Overview & Approach
Systematic approach to complete electrolyte interpretation
Complete Electrolyte Panel
Na
K
Cl
CO2
BUN/Cr
+ Ca++ + Mg++ + PO4
- Master Skeleton Key: BMP + Ca + Mg + PO4 approach
- Systematic Review: Don't miss critical interactions
- Clinical Context: History trending and patterns
- Emergency Priorities: Life-threatening findings first
- Urinalysis Integration: The ultimate diagnostic key
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Essential Foundation
๐ฌ Creatinine & Glomerular Hemodynamics
Determinants of GFR, creatinine handling, and eGFR limitations
GFR = Kf ร (PGC โ PBS โ ฯGC)
Interactive hemodynamics visualization included
- Starling Forces: Arteriolar tone, PGC, and filtration pressure
- 3 Fates of Creatinine: Filtered, secreted, reabsorbed
- Drug Effects: TMP, Tagamet, triamterene raise Cr without ฮeGFR
- eGFR Limitations: When to trust (and not trust) the number
- AKI Disconnect: Why Cr rise lags behind GFR changes
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Comprehensive Guide + Interactive
๐ Hyponatremia
Na+ < 135 mEq/L - Most common electrolyte disorder
- Emergency Protocol: RIB therapy (2024)
- Diagnostic: Urine osmolality key
- Correction: 4-8 mEq/L per 24h
- Risk Factors: Chronic, severe cases
Available
๐ฅ Hypernatremia
Na+ > 145 mEq/L - Water deficit state
- Water Deficit: TBW ร [(Na/140) - 1]
- Correction: โค0.5 mEq/L/hr
- Volume Status: Hypo/Eu/Hypervolemic
- Monitoring: Neurologic status
Available
โฌ๏ธ Hypokalemia
K+ < 3.5 mEq/L - Check magnesium first!
- Critical Step: Mg++ must be >1.7 mg/dL
- Replacement: PO preferred over IV
- ECG Changes: U waves, flattened T
- Complications: Arrhythmias, weakness
Available
โก Hyperkalemia
K+ > 5.0 mEq/L - Cardiac emergency
- Stabilize: Calcium gluconate 30mL IV
- Shift: Insulin + D50 + Albuterol
- Remove: K+ binders or dialysis
- ECG: Peaked T, wide QRS
Available
๐ฆด Calcium Disorders Reference
Comprehensive Ca++ Homeostasis Guide
- Complete physiology: PTH, Vitamin D, FGF23
- Hypocalcemia guide: Emergency protocols
- Hypercalcemia guide: VITAMINS TRAP mnemonic
- Drug interactions: Critical safety information
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Reference Available
๐ Hypocalcemia
Ca++ < 8.5 mg/dL - Neuromuscular irritability
- Emergency: Ca-gluconate 1-2 amps IV
- Critical: Check Mg++ first!
- Signs: Chvostek, Trousseau
Available
๐ Hypercalcemia
Ca++ > 10.5 mg/dL - "Stones, bones, groans"
- 2 Ps: Primary hyperPTH vs PTHrP
- Emergency: IV fluids + bisphosphonates
- VITAMINS TRAP: PTH-independent causes
Available
๐ Hypomagnesemia
Mg++ < 1.8 mg/dL - The forgotten electrolyte
- Recognition: PPI use, alcoholism, diuretics
- Replacement: Must correct FIRST
- Priority: K+ refractory until Mg++ corrected
- Formulations: Citrate/gluconate preferred
Available
๐ Hypermagnesemia
Mg++ > 2.6 mg/dL - Rare but dangerous
- Risk Factor: CKD + Mg-containing meds
- Emergency Antidote: IV Calcium
- Definitive: Saline diuresis, dialysis
- Monitor: DTRs, respiratory depression
Available
๐ Metabolic Acidosis & Acid-Base Analysis
Comprehensive acid-base disorders with systematic approach
- ABC Method: Systematic acid-base interpretation
- Anion Gap Analysis: MUDPILES vs USED CARP
- Delta-Delta Ratio: Mixed disorder detection
- UAG Differentiation: Renal vs GI causes
- Interactive Calculator: Complete analysis tool
โ
Comprehensive Guide
๐ Metabolic Alkalosis
Chloride-responsive vs resistant: The urine chloride key
- Urine Clโป < 20: Volume/chloride depletion
- Urine Clโป > 20: Ongoing mineralocorticoid activity
- Contraction Alkalosis: Pathophysiology explained
- Treatment Protocols: Saline vs cause-specific
- Interactive Calculator: Complete assessment tool
โ
Complete Guide
๐งช Phosphorus Disorders Reference
Comprehensive POโ Management Guide
- FGF23-Klotho axis: Modern understanding
- CKD-MBD: Complete pathophysiology
- Refeeding syndrome: Prevention protocols
- Binder comparison: Evidence-based selection
โ
Reference Available
๐ Hypophosphatemia
POโ < 2.5 mg/dL - Energy crisis
- โ ๏ธ Refeeding: Life-threatening
- Severe <1.0: Respiratory failure risk
- Replace: IV if <2.0 mg/dL
Available
๐ Hyperphosphatemia
POโ > 4.5 mg/dL - CKD complication
- CaรPOโ <55: Prevent calcification
- Binders: Take WITH meals
- Emergency: Tumor lysis syndrome
Available
๐ฝ๏ธ Eating Disorders & the Kidney
Renal complications of anorexia, bulimia, and purging behaviors
- Electrolyte Emergencies: Hypokalemia, metabolic alkalosis, hypomagnesemia
- Refeeding Syndrome: Hypophosphatemia risk and prevention
- Pseudo-Bartter: Purging-induced electrolyte patterns
- Renal Complications: AKI, nephrolithiasis, CKD risk
โ
Comprehensive Guide
๐ Comprehensive Hyponatremia Guide Available!
2024 evidence-based protocols including RIB therapy, correction science, and emerging treatments