On a recent reading on Sodium and Water physiology, I realized again and again the following points
1. The best way to identify change in Na balance is to examine the extracellular volume status but there are no good ways to do that clinically( orthostatics, axillary sweat, skin turgor, physical exam??). Perhaps the hemotocrit might be the best marker we have.
2. There are no NORMAL values in electrolyte diseases, there are only what is EXPECTED of the kidney to do or the organ to do for the stimuli.
3. Classic one: " The acute discovery of a chronic condition does not make it an acute disorder"- By ML Halperin
4. Hypernatremia and "no thirst" leads to not a pleasant diagnosis to make requiring a MRI of the brain.
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