Cisplatin nephrotoxicity

Cisplatin was discovered more than 40 years ago, and is still widely used in chemotherapy regimens for many different types of cancer. Its wider use has been limited by toxicities, one of which is nephrotoxicity. Nate Hellman also…

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Pitfalls with paraproteins

We were recently consulted on a patient with a history of multiple myeloma who had developed severe hypercalcemia and acute renal failure. The calcium on admission was 15mg/dl (albumin 2.6) and the patient was treated aggressively with IV…

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Hyponatremia correction; rule of 6s

Profound hyponatremia of around 100mEq/L or less is a double-edged sword- it’s got to be treated but can be terrifying to treat. The University of Rochester shared their protocol for controlled correction of severe hyponatremia with AJKD in…

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Sepsis & AKI – an insoluble problem?

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Argatroban

Critically ill patients receiving continuous renal replacement therapy are frequently given heparin to maintain circuit patency. In the presence of active HIT-II or HITT, even in the absence of clinical thrombosis, systemic anticoagulation with a direct thrombin inhibitor…

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‘Failure to thrive’ on PD

A few months ago I took care of a patient who, having been on peritoneal dialysis for a number of years, was losing weight, had poor small solute clearances and worsening edema. We transitioned her over to HD…

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