Great question I think it’s a little bit of all three

Hard to say. Probably not properly diagnosing the cause of CKD

I have not been giving furosemide more than once daily. If I increase I increase the dose. If 40 mg isn’t working then 40mg bid won’t work either. Furosemide is a threshold drug

Back in 1975 I was taught to first check a urine Na and K. If the urine K was greater than Na - start spironalactone at 100 and recheck. Until the urine Na was greater than the urine K, increase the spironalactone. Once urine Na > K, then start 40 mg furosemide each day. I still use this model.

I was asked to host Annals on Call in 2018. Loving podcasts myself, I wanted to see if I could do this well. Continued positive feedback has encouraged me to record (over 150 episodes).

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