Don’t forget the vitamins

In the absence of glucose, the brain requires a water-soluble, fat-derived fuel for metabolism and ketoacids serve this function. Unsurprisingly, as a result of this, the main factor controlling the production of ketoacids is the relative lack of…

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Fractional Excretion

The fractional excretion of sodium (FeNa) is a test that is often used in the setting of acute renal failure to help distinguish between pre-renal and intra-renal causes that has been mentioned in previous blog posts. In general,…

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From the RFN Archives: Drug-Induced ANCA

A subset of patients with ANCA-associated vasculitis have drug-induced ANCA disease. There are a few features of drug-induced ANCA disease which set it apart from “idiopathic” ANCA disease, but overall the clinical symptoms are similar. Drug-induced ANCA almost always involves…

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AKI and Fluid Overload

Even in my limited experience as a first year fellow, it seems that the decision to institute RRT seems to hinge on an idiosyncratic blend of patient and center-specific parameters. I was not surprised to learn that there…

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Urine albumin and protein measurement

Continuing the theme of must knows regarding urinalysis: Urine albumin is detected by the urine dipstick via a reaction with tetrabromophenol blue. The reaction produces a colorimetric result depending on the amount of albumin present, which can be…

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Bundling Redux

Here’s an update on the recent financial upheaval in the world of dialysis reimbursement. The expanded bundling payment system was officially implemented in January 2011, and most dialysis units have now switched over to this new billing practice….

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