Recently a 65-year-old female was referred to an ED in the state of Missouri complaining of fevers, chills, headache, diarrhea and vomiting occurring over the last week. 3 weeks prior she had received an orthotopic liver transplant. Her…
A 42-year-old man developed AKI during his recent hospitalization due to presumed sepsis. He was started on vancomycin and levofloxacin as empirical therapy. When renal was consulted 7 days after admission, creatinine level had peaked at 4.39 mg/dl…
Happy new year to all! I’ve been thinking about how much Nephrology content there is in non-renal journals and how much we miss by just reading the usual renal periodicals each month. You cannot be expected to read…
Although I don’t believe that many will agree that this was the most important paper of the year in the world of nephrology, I do want to give a shout out to a paper published in JCI in…
A 54 year old man was referred to the Nephrology service due to AKI after presenting with lethargy and severe thirst. He had a long history of pulmonary and hepatic sarcoidosis which had been quiescent for some time….
Patient with a history of kidney transplant s/p biopsy 2 weeks prior now undergoing chemotherapy treatment for leukemia develops acute abdominal pain, worsening renal function and hypertension. Renal US followed by CT are shown below: Renal US with…
Yet another manuscript evaluating fluids for IV replacement was published in JAMA this week underscoring the importance and controversial nature of the topic. A large meta-analysis involving 10,868 patients from 38 trials showed that hydroxyethyl starch (HES) was…
A gentleman with ESRD secondary to polycystic kidney disease comes in with vomiting and headache eight months after kidney transplantation. Brain MRI shows a small single enhancing lesion in the temporal lobe. Lumbar puncture reveals an elevated opening…
Fluid therapy is essential in ICUs and not surprisingly there is still much controversy about which fluid to use, how much and when. Nephrologists often roll their eyes at other subspecialty’s preferences, e.g. surgeon’s preferences for Ringers, citing…
Despite the fact that the kidney ultrasound is generally obtained as one of multiple recommendations when evaluating AKI, the benefit of kidney ultrasound is not clear. The post-renal causes of AKI are not very common. It adds to…
