10-minute Rounds: The Trans-tubular Potassium Gradient (Calculation and Interpretation)

[@VektraCasler]

Sincere gratitude for your efforts. Your video helped this visual learner tremendously.

[@AjmalShahaban]

I must say, your way of teaching is simple and very understandable. thank you so much.

[@R999soup]

Excellent explanation😊

[@ogtsui]

beautiful, very well explained.

[@anupsingh436]

Great work guys, thank you

[@PediaTricks007]

Thank You

[@gracelyntan4615]

thank you for this!

[@sujithakatari]

Thank you so much

[@nephondemand]

You're most welcome

[@ninaa3389]

great explenation!!

[@lansvacer5181]

thank you and god bless you for all the wonderful videos! could you explain some point (from harrison's internal medicine - algorithm of HYPOKALEMIA) - after establishing a renal cause for hypokalemia (Urine K>15mmol/d), TTKG is measured - if TTKG>4 => distal K secretion is elevated (next steps is evaluating aldosteron etc). so far makes sense.... if TTKG Tubular flow is elevated (?!?!) and a suggested cause to that is 'osmotic diuresis' (!!?!?) Im having hard time how to interpret this low TTKG and what it means all together, i would so much appreciate if you could shed light...

[@nephondemand]

+Tomer C In the setting of hypokalemia, is is conventional thinking to believe that there are limited renal losses of K when the TTKG < 2.

[@sathishkumar-xy3pi]

My doubt is, How or in what way the water reabsorption affects urine potassium? If the urine potassium is, say 60meq it should be so whether the urine is 1000mosm or 300mosm right? Is it not an absolute quantity? If it isn’t, then does it mean that other ions like Measurement of urine sodium also vary with amount of water being reabsorbed???

[@nephgeo6311]

In hypokalemia ttkg should normally be less than 3..not 6..i guess

[@darshanjani5502]

great lecture! just wanted to clear on 2 things... whether or not the urine and serum k mentioned here are to in mmol/lit (or mg/DL) for a spot sample... and are the urine and serum ormolalities measured or calculated? thanks!!

[@nephondemand]

+Darshan Jani In my example I use mg/dL because I am in the US. It is preferred to use measured SOSM and UOSM.

[@darshanjani5502]

+Nephrology On-Demand In my center we don't have the facility to measure Serum osmolality... so would calculated osm be OK?

[@nephondemand]

+Darshan Jani yes

[@sansomayaji]

Can you please help me how to normalize this value to amount of water thats been reaborbed

[@nephondemand]

let me get back to you on that because I've never had to do that before. Thanks.