Electrolytes Advanced Module

Clinical Mastery Series — Advanced Electrolyte Disorders

Clinical Mastery Series Urine Nephrology Now

Andrew Bland, MD, MBA, MS

Module Contents

Hyponatremia 2025 Comprehensive Guide

Complete 10-chapter clinical guide: dual hormonal control, classification framework, laboratory evaluation, U-shaped correction rate curve with evidence table, 2024 RIB therapy protocol, oral urea, SGLT2i (EMPAHYPO), dDAVP clamp, protein-urea conversion, special populations (liver disease, cancer), and quality improvement.

Acute vs Chronic Hyponatremia Correction & Idiogenic Osmoles

Focused review: temporal classification, brain volume regulation through organic osmolytes (myo-inositol, taurine, glutamate, GPC, betaine), the asymmetry of osmolyte reaccumulation, five-step ODS pathophysiology cascade, Lien electrolyte-osmolyte mismatch, and correction rate guidelines with rescue protocols.

Magnesium Disorders: The Forgotten Electrolyte

Comprehensive review of hypo- and hypermagnesemia: renal Mg handling (claudin-16/19, TRPM6), causes by category, FE_Mg calculation, oral vs parenteral treatment, hyperMg threshold effects, Mg-containing laxatives in CKD, PPI-induced hypoMg, diuretic effects, and the critical Mg-K and Mg-Ca-PTH interrelationships.

Hypernatremia Comprehensive Review

Water deficit pathophysiology, central vs nephrogenic diabetes insipidus (genetic and acquired), osmotic diuresis, desmopressin challenge interpretation, correction rate rules (acute vs chronic), free water deficit calculation, thiazide paradox in NDI, amiloride for lithium-NDI, and ICU-acquired hypernatremia.

Hyponatremia in Intracerebral Hemorrhage

Acute hyponatremia in ICH patients: SIADH vs CSW differentiation, dual therapeutic roles of hypertonic saline (electrolyte correction and ICP management), when to target supranormal sodium, correction rate in neurological emergencies, and outcome data. 32 min read.

Salt-Losing Enteropathy

Underrecognized cause of hyponatremia in GI disease. Pathophysiology, diagnostic approach, relationship to short bowel syndrome and inflammatory bowel disease, volume assessment, and management strategies. 16 min read.

Acid-Base Disorders

Renal Tubular Acidosis: Types I-IV

Comprehensive RTA review: distal (Type I), proximal (Type II), combined (Type III), and hyperkalemic (Type IV). Etiologies, urine anion gap/osmolal gap interpretation, fludrocortisone/alkali therapy, Sjogren-associated RTA, drug-induced causes, and the role of aldosterone. 46 min read.

Metabolic Alkalosis: Pathogenesis, Urine Chloride, and Management

Chloride-responsive vs chloride-resistant classification, urine chloride as the key diagnostic test, generation vs maintenance phases, contraction alkalosis, Bartter/Gitelman syndromes, primary aldosteronism, and acetazolamide/HCl therapy protocols. 40 min read.

Metabolic Acidosis: Evaluation, Diagnosis, and Management

Anion gap vs non-anion gap approach, delta-delta ratio interpretation, GOLDMARK and HARDUPS mnemonics, lactate physiology, DKA/euglycemic DKA, pyroglutamic acidosis, sodium bicarbonate evidence (BICAR-ICU), and the Stewart physicochemical approach. 31 min read.

Potassium Disorders

Hyperkalemia Treatment: Comprehensive Review

Complete hyperkalemia management: membrane stabilization (calcium), transcellular shift (insulin-glucose, beta-agonists, bicarbonate), elimination (kayexalate/SPS, patiromer, ZS-9, loop diuretics, hemodialysis), EKG changes and cardiac risk, RAAS inhibitor management, and chronic hyperkalemia in CKD. 30 min read.

Hypokalemia: Cardiac Effects and Mortality Risk Stratification

U-wave physiology, QT prolongation mechanisms, torsades de pointes risk, digoxin interaction, mortality risk by serum K level (J-shaped curve), ICU outcomes data, and evidence-based repletion targets. 25 min read.

Calcium & Phosphorus

Calcium and Phosphate Homeostasis: Comprehensive Review

PTH-vitamin D axis, hypocalcemia and hypercalcemia differential diagnosis and treatment, phosphorus disorders, FGF23, CKD-MBD mechanisms, citrate chelation, ionized vs total calcium, and hungry bone syndrome. 23 min read.

Hypercalcemia: Recent Evidence and Evolving Strategies

Bisphosphonate safety and optimal dosing (2020-2024 evidence), denosumab in renal impairment, calcitonin bridge therapy, furosemide role reassessment, and cinacalcet for primary hyperparathyroidism. 19 min read.

Other Clinical Mastery Modules

Cardiorenal Module CKD Advanced Module Dialysis Advanced Module All Mastery Modules

© 2026 Urine Nephrology Now — Andrew Bland, MD, MBA, MS

Clinical Mastery Series • Electrolytes Advanced Module