VictorHugoG.Johnson Profile picture
Internal Medicine @ABCcentromedico | Nephrology Fellow @NefrologiaINC | #POCUS Enthusiast | Working to be #DiuresisJedi | Music Lover | Calisthenics
5 Nov
🧵🚨 THREAD ALERT 🚨🧵

I think there is a misconception about hemodialysis (HD), definitely not a recipe. We have to individualize every patient; when we combine HD + plasma refilling rate (PRR) + #POCUS I can assure you, we are improving our game! All made in @NefrologiaINC
As we all know, 2/3 of total body water (TBW) is intracellular and 1/3 extracellular this last one subdivides in extravascular (75%, interstitial & lymph; connective tissue & bone; body cavities; adipose tissue), and intravascular (25%, plasma volume) DOI: 10.1681/ASN.2011080865
What about forces governing water distribution? Starling forces pops out into our head, but we should not forget charged proteins, which generate colloid osmotic pressure (Donnan effect) favoring untenable water entry.
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