The PRESERVE Trial, which was recently published in the NEJM was a large study of a variety of preventive measures for contrast-induced nephropathy. It used a 2×2 factorial design to test the efficacy of NaHCO3 vs. normal saline…
In the AKI bracket one team caught my eye, RIPC, Remote Ischemic Preconditioning. This is a procedure of inducing transient ischemia in the arm by inflating a BP cuff for 5 minutes x2 with an interim deflation for…
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…
As a kid growing up in the San Francisco ACT brought to mind guys in tights running around and projecting their voices at the American Conservatory Theater. Now I’ve got to adjust my association with the acronym with…
How common is contrast nephropathy in the general outpatient setting? When you send one of your outpatients to get a CT scan with iv contrast, what is the real risk? Much of the randomized, controlled trial data on…
Final results of last week’s Renal Fellow Network poll: There seemed to be general agreement that volume expansion with isotonic saline is definitely effective, and many individuals also selected the isotonic saline + N-acetylcysteine combination. Interestingly, only 23%…
“Osmotic nephrosis” is a term which describes a common form of renal tubular injury in response to hyperosmolar substances. It is especially relevant to iv contrast nephropathy, and was first observed in animals and human patients infused with…
The issue comes up all the time: you try and set up one of your ESRD patients for a procedure requiring iv contrast, such as a cardiac catheterization or a PE-protocol CT scan. You get a call from…
At the risk of offending community hospitals out there…I present to you “Outside Hospital”, a video I helped make during my residency in Internal Medicine parodying some of the outside hospitals from which we used to receive patient…
Trick Question: Which would you imagine to be lower osmolarity between “low osmolar iv contrast” and “iso-osmolar iv contrast”? The answer is, for historical reasons, “iso-osmolar contrast.” The increasing use of iv contrast agents led to the identification…
