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Old 12-19-2012
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Urine Sample Urinary chloride levels in diuretic use...?

Guys i'm so confused reg this.....in the endocrinology chapter of uworld, he mentions that the urinary chloride levels are increased when anyone uses diuretics and subsequently in electrolytes section, they say diuretic usage causes decrease in urinary chloride levels(due to volume contraction and increased Nacl reabsorption).......

whats the real deal here....???
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The first one describes the effect of diuretic on the kidneys and the second one is the body's response to the diuretic use (RAS kicks in to stem the loss).
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so the urinary chloride levels could be high or low depending on the timing of diuretic use and the onset of compensatory mechanism......

Thank u Novo....
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Quote:
Originally Posted by anomali View Post
so the urinary chloride levels could be high or low depending on the timing of diuretic use and the onset of compensatory mechanism......

Thank u Novo....
Remember, for the test purposes-only Diuretic abuse & Bartter syndrome (works like a Loop diuretic)/Gitelman's syndrome (works like a Thiazide diuretic) can cause high urinary chloride levels in the absence of the features of Conn's syndrome, Renin secreting tumors and liquorice which will have HT in the HPE while the Diuretic abuse & Bartter/Gitelman's syndrome will be normotensive.
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Last edited by Novobiocin; 12-19-2012 at 05:29 PM.
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Old 07-19-2013
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So when we are referring to the saline responsive metabolic alkolosis, we say that the urinary chloride is low in Diuretic abuse....

I'm still confused--> if the question gives a high urinary chloride i.e >20 does that classify as saline reponsive because diuretic abuse is saline responsive but has a high Urinary chloride

Isn't the urinary chloride the way to classify saline responsive and unresponsiveness?

Thnks in advance!!!
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Quote:
Originally Posted by Varun723 View Post
So when we are referring to the saline responsive metabolic alkolosis, we say that the urinary chloride is low in Diuretic abuse....

I'm still confused--> if the question gives a high urinary chloride i.e >20 does that classify as saline reponsive because diuretic abuse is saline responsive but has a high Urinary chloride

Isn't the urinary chloride the way to classify saline responsive and unresponsiveness?

Thnks in advance!!!
you need to look at BP , HR , hydration status of the pts.
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