1/N My Family and I Rece...
Highlights
- 3/n so I took acetazolamide ahead of the trip. Remember hearing or reading that acetazolamide is a “weak” diuretic? Well, I’m glad it’s just a weak one because I don’t recall having to pee sooo much within an hour of taking a pill! It works people! Makes coffee look like placebo https://t.co/hzw7hDMYFc (View Tweet)
- 4/n frankly, the notion that acetazolamide is a weak diuretic likely applies to states of avid Na reabsorption (hypovolemia, heart failure) or in AKI. But I’m sure my “volume expanded state” (🧂) made it easier for carbonic anhydrase (CA) inhibition to induce natriuresis
(View Tweet)
- 5/n some legendary nephcelebrities like @kidney_boy and @NephRodby claimed to have experienced some weird taste disturbance, I didn’t experience it, who knows, maybe they were transiently uremic 😏 https://t.co/6ptRRXluDk (View Tweet)
- 6/n at any rate, taking acetazolamide took me to refresh my understanding of why does it work in high altitude sickness. Altitude➡️Drop in atmospheric pressure ➡️hypoxia/dyspnea➡️>ventilation ➡️alkalemia➡️self-limits >ventilation.
(View Tweet)
- 8/n found this review by 2 nephrologists! @weddellite and @DavidLeaf9 wrote a nice deep dive into it. They concluded that acetazolamide likely works thru: 1)⬇️renal CA➡️MA 2)⬇️tissue CA➡️tissue resp acidos➡️⬆️central chemoR 3)⬇️carotid CA➡️⬆️sleep Q https://t.co/W1z8d22h6g
(View Tweet)
- 9/n before getting to Machu Picchu, we stopped at Maras for their impressive salt mines. Millions of yrs ago, ocean must’ve covered the area. Aside from NaCl, the extract is rich in K, Ca and Mg, and has a distinct pink color, like Himalayan salt. All I could think was #nephbbq🥩
(View Tweet)
- 10/n the last part of our trip was deeper into the Amazon rain forest, at Tambopata National Reserve. There, while enjoying the majestic nature, my #nephrocentric mind took me back to another salty mystery, that of the diet of a scarlet macaw
(View Tweet)
- 11/n watching these amazing birds fly early am to arrive at the clay banks is quite a spectacle. Locals had postulated that they needed something found there to cleanse their bodies from toxins. Currently, the dominant theory is that they crave salt https://t.co/WRxI3PsjjD (View Tweet)
- 12/ a study showed that the “collpas” (clay banks) where macaws display geophagy, the Na concentration is 5 times higher than that of control riverbank soil. https://t.co/IirsQsTrRf
(View Tweet)
- 13/n turns out, Na is pretty sparse in some areas of the rain forest, particularly those further away from the ocean. It all comes back to evolution and Homer W. Smith
(View Tweet)
- 14/14 gotta finish with some #NephMadness Peruvian #AnimalRegion inspired pearls: sloths incredibly low metabolism includes being heterothermic, body temp can b ⬇️25 C! And llamas, as camelids, are really good at concentrating the urine, with a uOsm as high as 2500 mOsm/Kg / END
(View Tweet)
1/N My Family and I Rece...
Highlights
- 3/n so I took acetazolamide ahead of the trip. Remember hearing or reading that acetazolamide is a “weak” diuretic? Well, I’m glad it’s just a weak one because I don’t recall having to pee sooo much within an hour of taking a pill! It works people! Makes coffee look like placebo https://t.co/hzw7hDMYFc (View Tweet)
- 4/n frankly, the notion that acetazolamide is a weak diuretic likely applies to states of avid Na reabsorption (hypovolemia, heart failure) or in AKI. But I’m sure my “volume expanded state” (🧂) made it easier for carbonic anhydrase (CA) inhibition to induce natriuresis
(View Tweet)
- 5/n some legendary nephcelebrities like @kidney_boy and @NephRodby claimed to have experienced some weird taste disturbance, I didn’t experience it, who knows, maybe they were transiently uremic 😏 https://t.co/6ptRRXluDk (View Tweet)
- 6/n at any rate, taking acetazolamide took me to refresh my understanding of why does it work in high altitude sickness. Altitude➡️Drop in atmospheric pressure ➡️hypoxia/dyspnea➡️>ventilation ➡️alkalemia➡️self-limits >ventilation.
(View Tweet)
- 8/n found this review by 2 nephrologists! @weddellite and @DavidLeaf9 wrote a nice deep dive into it. They concluded that acetazolamide likely works thru: 1)⬇️renal CA➡️MA 2)⬇️tissue CA➡️tissue resp acidos➡️⬆️central chemoR 3)⬇️carotid CA➡️⬆️sleep Q https://t.co/W1z8d22h6g
(View Tweet)
- 9/n before getting to Machu Picchu, we stopped at Maras for their impressive salt mines. Millions of yrs ago, ocean must’ve covered the area. Aside from NaCl, the extract is rich in K, Ca and Mg, and has a distinct pink color, like Himalayan salt. All I could think was #nephbbq🥩
(View Tweet)
- 10/n the last part of our trip was deeper into the Amazon rain forest, at Tambopata National Reserve. There, while enjoying the majestic nature, my #nephrocentric mind took me back to another salty mystery, that of the diet of a scarlet macaw
(View Tweet)
- 11/n watching these amazing birds fly early am to arrive at the clay banks is quite a spectacle. Locals had postulated that they needed something found there to cleanse their bodies from toxins. Currently, the dominant theory is that they crave salt https://t.co/WRxI3PsjjD (View Tweet)
- 12/ a study showed that the “collpas” (clay banks) where macaws display geophagy, the Na concentration is 5 times higher than that of control riverbank soil. https://t.co/IirsQsTrRf
(View Tweet)
- 13/n turns out, Na is pretty sparse in some areas of the rain forest, particularly those further away from the ocean. It all comes back to evolution and Homer W. Smith
(View Tweet)
- 14/14 gotta finish with some #NephMadness Peruvian #AnimalRegion inspired pearls: sloths incredibly low metabolism includes being heterothermic, body temp can b ⬇️25 C! And llamas, as camelids, are really good at concentrating the urine, with a uOsm as high as 2500 mOsm/Kg / END
(View Tweet)