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…
If your looking for something new and interesting in the online Nephrology world check out Dr Ajay Singh’s The Kidney Doctor. Since starting up last month there has already been some great content including a post from the…
While performing an electronic chart biopsy prior to examining a consult patient, I noticed a “nephrologic no-no,” which can be seen on the patient’s chest x-ray coursing under the right clavicle (see image). This finding was confirmed on…
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,…
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…
Back in 1999, UCSF researchers strapped some high tech motion detectors onto about 30 patients on dialysis and compared one week’s worth of activity to that of matched controls. Mind you, these control patients were selected to be…
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…
The “Rule of 6s” describes an easy way to evaluate the maturity of a recently-placed arteriovenous fistula for dialysis access–and is even mentioned by name in the most recent KDOQI Guidelines for Dialysis Access. The Rule of 6s…
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…
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….