A patient was recently seen on the consult service for evaluation of hyponatremia. She had a history of multiple myeloma and a previous bone marrow transplant and had significant cholestatic liver dysfunction related to GVHD. Her serum sodium at…
A 41 year old gentleman with no past medical history presented to ER for nausea, vomiting and abdominal pain. Abdominal CT showed bilateral renal infarcts. His labs were notable for a Cr of 1.4, LDH 500 ESR 102….
“The physicians are now constructing a machine capable of doing the work necessitated by a volume of blood circulating the a body weighing up to 20 pounds and, inasmuch as they have determined to their own satisfaction that…
Classically, we are taught to look out for an elevated anion gap in patients with a metabolic acidosis. Although much less common, a low anion gap can also be a useful sign and there are a variety of…
Recently I was involved in the care of a renal transplant recipient who was admitted with C. Difficile colitis that was complicated by a bowel perforation. He had a history of hepatitis C with relatively preserved hepatic function….
Recently in the clinic we were asked to review a patient with suspected diabetes inspidus. She had been taking lithium for more than 20 years for bipolar disorder that was very well controlled. During a routine medical examination,…
We recently discussed an excellent paper on the classification of metabolic alkalosis. The three suggested subtypes were primary and secondary stimulation of collecting duct ion transport and exogenous alkali administration. Another interesting editorial was just published in JASN…
I saw a patient in the clinic who was referred for evaluation by his PCP with CKD, a bland urine sediment and a history of hyperuricemia and gout. He had no history of diabetes or hypertension and had…
Previous posts have discussed various iterations of the cathedia study, a study comparing femoral and jugular placement of dialysis catheters in patients in the ICU. As mentioned before, the femoral route was not associated with a higher rate…
There was an interesting article and accompanying editorial in JASN this month about the role of polarity in the development of cystic renal diseases. The maintenance of epithelial cell polarity is vital for the normal functioning of the…
