Reboot - Diuretics, leg cramps, and resistant hypertension


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Listen to our first ever discussion with @kidney_boy, Joel Topf MD. It’s a classic episode with a fresh intro as we prepare for @NephMadness 2019 with our friends from Twitter and @AJKDonline

Dominate leg cramps, diuretic therapy, and resistant hypertension with tips from @kidney_boy, Joel Topf MD @kidney_boy, Chief of Nephrology Kashlak Memorial Hospital, co-creator @NephMadness. We start with basic renal physiology and build up to the treatment of resistant hypertension.

Corrections: Dr Topf posted the following corrections on his blog 3/22/2017

“I enjoyed the experience immensely, but in an hour of talking off the cuff I made some embarrassing mistakes:

In describing water reabsorption I said it occured in the cortical collecting duct rather than the medullary collecting duct.

In describing my cure for cramps I tell the story of Gitelman’s and say it is like congenital loop diuretics rather than congenital thiazide diuretics

I mucked up the story about the MRFIT story and how it allowed a head to head comparison of HCTZ and chlorthalidone. I really oversold what happened.”

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Written by: Matthew Watto MD

Produced by: Stuart Brigham MD and Matthew Watto MD

Cohosts: Stuart Brigham MD and Matthew Watto MD

Guest: Joel Topf MD


Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Time Stamps
  • 00:00 Sponsor - Become a member of the American College of Physicians
  • 00:28 Disclaimer, Intro, Recap of upcoming shows, Corrections and Omissions
  • 05:50 Guest one-liner, Discussion of social media in medical education, Joel’s book
  • 12:45 Twitter for medical education including NephJC and NephMadness
  • 19:50 Sponsor - Become a member of the American College of Physicians
  • 21:30 Intro to diuretics, mechanism of action and a brief review of renal physiology
  • 28:26 Use of thiazide diuretics
  • 30:18 Chlorthalidone versus hydrochlorothiazide
  • 34:47 Diuretics and hyponatremia, Monitoring electrolytes and renal function on diuretics
  • 39:05 Leg (muscle) cramps and pickle juice
  • 42:55 Thiazides, osteoporosis and fracture prevention
  • 45:32 Resistant hypertension and the workup for secondary hypertension
  • 53:36 Loop diuretics: how to choose an agent, dosing
  • 62:15 Take home points
  • 67:00 Outro

157 episodes available. A new episode about every 5 days averaging 61 mins duration .