Dr. Goldfarb is Clinical Chief of Nephrology at NYU Langone Medical Center and Professor of Medicine & Physiology at NYU School of Medicine. He is also Chief, Nephrology of the New York Harbor VA Healthcare System. Follow him @weddellite.
Note: Below is a collection of tweets by Dr. Goldfarb in response to Dr Rosner’s commentary, so read that first. There’s a paragraph at the end for added context. And full disclosure: Dr Goldfarb was on our Blue Ribbon Panel 2015-2017.
Competitors for the Hyponatremia Region
The Hyponatremia region is a natural place for impassioned opinion as it really addresses a topic that engenders confusion, and that’s just among nephrologists. Having just finished teaching NYU medical students about sodium and water balance and disorders of sodium and water balance, I am acutely aware of how interesting and challenging the field is. That the existence of cerebral salt wasting or renal salt wasting (CSW/RSW) is controversial is pretty astounding in this era of molecular and genetic sophistication.
I have closely followed the careful work of my fellow New Yorker, Dr. John Maesaka of NYU Winthrop Hospital, and come to think that there is indeed an unusual entity that can be distinguished from SIADH or SIAD. A distinguishing characteristic, that could lead to less uncertainty about which patients actually have this problem, is the uricosuria which persists after correction of effective arterial blood volume. That is not a feature of other cases of hyponatremia and SIAD.
Maybe it’s premature to choose CSW/RSW as the eventual winner of NephMadness 2018 but as a NY Mets fan, I NEVER root for the favorite…
– Post by David S. Goldfarb
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