Would love to be added

Thanks for clarifying! Would you then rely on urinary sodium to differentiate CHF from SIADH? Also, do you find fractional uric acid excretion useful in these cases?

Thanks for sharing, Joel and Sarah! At my institution, we use xipamide and high-dose furosemide, and if these fail, we escalate directly to CVVHD as we have no experience with 3% NaCl in this setting. How do you decide when to use hypertonic saline?

Thanks, Joel. Sequential nephron blockade sounds comprehensive! Have you had experience combining proximal, loop, and distal tubule blockers simultaneously (e.g., acetazolamide, loop diuretics, and thiazides)? Curious how effective and safe you’ve found this approach

Great point. Do you think there’s ever a scenario where the albumin-furosemide combo is justified, or is it best avoided entirely? Would love to hear your approach in these tough cases