Hematuria: Deep on the DDx
Recently at our biopsy conference we had the case of a healthy middle aged man presented who had come to medical attention with episodes of painless gross hematuria. He had consistent rbcs on UAs, normal renal imaging, a…
Urine Microscopy and the Camera Phone
I had a breakthrough with my iPhone 3G camera. I’ve tried unsuccessfully several times in the past to take pictures of urine microscopy fields through the lens of the microscope and had just about given up until I…
Seldinger Technique
One of the many pleasures of nephrology fellowship is learning how to put in temporary hemodialysis lines safely and efficiently using the Seldinger technique (the Swede is seen to the left). As an intern I constantly said to…
Linked: Sodium and Potassium
Emily mentioned in her recent post on the Rule of 6s that potassium administration needs to be taken into account when correcting the plasma sodium in cases of hyponatremia. Why is this the case? When potassium is given…
ASN In-Training Exam: ASN and RFN Review Material
I took the MCAT with pencil and paper. Over 500 nervous sweaty pre-meds in one giant auditorium. Everyone was so tense I’m surprised there wasn’t a spontaneous combustion. Ever since, it’s been electronic standardized testing were you often…
eKt/V
As previously discussed on RFN, the single pool Kt/V (spKt/V) was developed by Gotch and Sargent in a reanalysis of the NCDS data in an attempt to distinguish the dose of hemodialysis associated with improved outcomes. The spKt/V…
Measures of dialysis dose
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 =…
Try this in clinic…
It was the usual sort of day in clinic and the team was seeing a middle aged woman with stable diabetic nephropathy and subnephrotic proteinuria. Her blood pressure and blood sugars had been well controlled since the last…
Alimentary Azotemia Redux: A Quantitative Approach
The issue of whether a marked elevation in the BUN when compared with the creatinine might represent gastrointestinal bleeding was nicely covered previously on RFN. One of our attendings recently had our group of first year fellows review…
Intradialytic hypertension
I’ve recently had a few calls from our outpatient dialysis unit about patient’s with rises in their blood pressure during and after dialysis. Intradialytic hypotension is a very common phenomenon and it’s been interesting to learn that intradialytic…