Detective Nephron

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The detective sits facing the window while he awaits the arrival of his trainees.
HenleHere’s a case that is going to make you smile.
Nephron(curious): Finally. Anyone for some Coke?
HenleI shall take some Coke, thanks. By the way, it’s a case of hypophosphatemia.
Nephron(smiling): Ah, yes. Electrolyte disorders. The best part of nephrology, and phosphate stuff is always entertaining.
AldoThis is a 71-year-old woman with a phosphorus level of 1.4 mg/dL, but ranging from 1.4 to 2.4 mg/dL.
Nephron(interrupting): That would be good enough.
HenleYes, Dr. Nephron, we did want to let you know that she has a GFR >60 mL/min, and there’s no mention of any diarrhea.
NephronPlease stop!
Henle(whispering to Aldo): He likes to stop at only one electrolyte value.
NephronHow do we categorize the causes of hypophosphatemia?
AldoRenal loss, extrarenal loss, and shifting; works for all electrolytes in nephrology (almost all).

Special thanks to Dr. Helbert Rondon, associate professor of medicine, Renal-Electrolyte Division, University of Pittsburgh, PA, and Dr. Rimda Wanchoo, associate professor of medicine, Nephrology Division, Zucker School of Medicine at Hofstra/Northwell for content editing. Special thanks to Dr. Mala Sachdeva and Valerie Barta for providing the details of this case.

The concept of Detective Nephron was developed by Kenar D. Jhaveri, MD, professor of medicine at Zucker School of Medicine at Hofstra/Northwell and an attending nephrologist at Northwell Health System, New York. Send correspondence regarding this section to or