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Ernest Mandel

Paging the doctor

I recently saw a young hypertensive patient who had suffered a motor vehicle accident complicated by a transected aorta that was successfully repaired several years back. He has had hypertension since then and was referred to us for…

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The urine’s the thing…

Vomiting or nasogastric tube (NG) decompression can lead to metabolic alkalosis, often associated with hypokalemia. When asked what the source of the K loss is, most people assume it is lost in the gastric fluid. However, gastric fluid…

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PD vs HD in the elderly

Patients over 65 tend not to choose peritoneal dialysis for a host of reasons, not the least of which is PD is underutilized in the US in general. However, a recent study suggests that PD may be preferable…

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HCG in Kidney Disease

That cardiac biomarkers, including Troponin and BNP, can be elevated in CKD or ESKD without necessarily having clinical significance is familiar to most of us. Whether you believe that an elevated Troponin in ESKD is due to diminished…

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Alimentary Azotemia?

I am currently a clinical fellow, slogging through another consult month. As I am sure many of you have experienced, consult questions often come in batches. At least three times this week we have been called to see…

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