I was recently called to evaluate an obese patient with profound metabolic acidosis who was admitted to the hospital with change in mental status and poor oral intake for several days. Her admission labs revealed severe hyperglycemia (glucose…
A randomized controlled trial of loop diuretics was published in NEJM two weeks ago. The trial involved 308 patients, from 26 clinical sites. The details are below: Type: Prospective double-blind randomized controlled trial (intention to treat analysis) Inclusion:…
Happy World Kidney Day 2011! This years theme is- protect your kidneys, save your heart. World Kidney Day began in 2006 and has continued to grow each year. While every other organ system/disease has had a day/month for…
Nephron Power and Precious Bodily Fluids have nice kidney-related Top 10 lists for World Kidney Day. Here’s our list. 10. One kidney= winning, two kidneys= bi-winning 9. Most successful solid organ transplant. Living donor transplant is a…
At renal grand rounds today, we heard about a case of severe hypomagnesemia in a patient who was on chronic omeprazole therapy. While the etiology of the low Mg2+ was likely multifactorial, I was surprised to find out…
A recent post got me thinking of the differential diagnosis of blood-stained peritoneal dialysis effluent. I thought it would be interesting to share some of the differentials and to remember that the Tenchkoff catheter can truly be a…
Should patients with nephrotic syndrome (NS) be anticoagulated? Is there any level of proteinuria or albumin at which we should be especially concerned? The rates of venous thromboembolism (VTE) have ranged from 8-44% in observational studies and it…
While recently reading about hypogonadism in the dialysis population, I came across this review on the pregnancy outcomes in women on dialysis, summarizing observational studies published between 1995 and 2009. I have participated in only a few pregnancy-planning…
There are two major types of intercalated cell in the collecting duct of the nephron – the alpha and beta intercalated cells. We are probably most familiar with the alpha intercalated cells in terms of acid-base handling by…
As previously discussed on RFN, the urea Kt/V is a measure of dialysis dose that is related to patient outcome. There are several different Kt/Vs encountered in the dialysis literature. spKt/V = single pool eKt/V = equilibratedstdKt/V =…