Life, a transient process of creating and maintaining, within discrete boundaries, an ordered environment within an ultimate sea of entropy, is a reflection of complex biochemical interactions.
Proteins, replete with titratible histidine residues, exhibit conformational changes and altered functioning with changes in local proton availability. Cellular function, upon which are built tissues, organs, and organ systems, is possible only within a rather narrow range of concentrations of essential electrolytes such as sodium and potassium.
The kidneys are responsible for maintaining the proper "soup" so that proteins, enzymes, and cellular function can work efficiently to maintain the homeostasis which is life.
kidneyatlas.org - once covered almost all aspects of renal physiology and pathology but doesn't seem to be active in 2013.
Structure & Function
Renal Pathology Tutorial by J. Charles Jennette, MD of UNC, focusing on the histology of the normal kidney contrasted with that of the kidney with different types of chronic renal failure
Very detailed information is available on HDCN.com - the hypertension, dialysis and clinical nephrology site - requires registration first.
Pre-renal azotemia: differentiation of hyperureagenesis from renal hypoperfusion using urea nitrogen data, an abstract from HDCN (requires registration first)
Body Fluid Compartments
See the Fluid Book
This FRCA article summarises common fluid and electrolyte abnormalities.
FFP, Cryo Indications and Risks, from the British Committee for Standards in Haematology.
Hyponatremia after "ecstasy," an abstract from HDCN (requires registration first). Basically party-goers sweat a lot and only drink plain water. They should drink something with a sodium content similar to sweat (70mM/l).
Bartter's syndrome - an e-Medicine overview.
Increasing info that hyperchloraemic acidosis isn't good.
The section on hypercalcemia from the NCI CancerNet Supportive information for physicians site is a very comprehensive, annotated reference including an overview of hypercalcemia associated with malignancies, and discussions of etiologies, manifestations, clinical assessment, and management.
Mildred S. Seelig, MD, MPH, at the New York Medical College and the American College of Nutrition, provides a comprehensive extravaganza on magnesium effects on cardiovascular physiology, with links.
Lots of interest in this area. This editorial summarises the latest view that there is little difference between crystalloids and colloids in ICU, perhaps some subgroups may benefit. The FRCA has notes on this. Older articles from anaesthetist.com (2000). Starches may be suitable plasma substitutes.
Alan 'Grog' Grogono has a huge website - acid-base.com - with lots of useful information, diagrams, etc.
Kerry Brandis from Queensland, Australia has provided this concise, clear and thorough explanation of acid-base physiology. Dave Sainsbury from Adelaide has written (in Java) a graphical (java) acid-base interpreter.
Peter A Stewart takes a 'modern' approach with his 'Basic approach to body pH'. Paul Elbers provides Stewart's 1981 "How to Understand Acid-Base" book in html form on acidbase.org. Another substantial review, more traditional and philosophical in nature, is Michael Bookallil's treatise on Acid-Base - the frames version is best.
Basic pharmacy info on bicarbonate.
Also notes from QldAnaesthesia.