In this post… The paradoxical anti-diuretic effects of diuretics A general approach to nephrogenic diabetes insipidus When is a tractor not a tractor? … When it turns into a field Nephrogenic diabetes insipidus Nephrologists are often asked for advice on how to manage patients with nephrogenic diabetes insipidus (NDI). Almost always, this has been caused by current or historic lithium exposure. This is one of those referrals that invariably sends me scuttling back to review original literature, because I can never quite remember how on earth diuretics are supposed to magically transform into anti-diuretics in this context, nor the relative merits of thiazides / amiloride / acetazolamide.

In this post… PPIs are associated with hypomagnesaemia PPIs reduce intestinal Mg2+ absorption diuretics, CNIs and anti-cancer agents promote renal Mg2+ loss PPIs and Mg We had a referral recently for a case of persistent hypomagnesaemia “? cause”. As is often the case, the patient had been taking a PPI for some years. There was no obvious alternative explanation and FEMg was low - so we blamed this as the likely culprit.