Today we’ll be discussing acute kidney injury (AKI). How often are you looking at the Bun/Cr thinking ‘Patient has an AKI’…and then not much more? I’ve done this. While ascertaining the unde…
You’re at Sinai – and your patient is a renal transplant patient. What do you do? “Don’t you just call renal transplant?” Yes, you should definitely call them. But there’s other things to consider – see below for today’s TR pearls.
If you’re like me, when you treat hyperkalemia, you make things easy on yourself and open up that HyperK orderset, or think about the mnemonic C BIG K DROP (Calcium, beta-agonist/bicarb, insulin, glucose, Kayexalate (Lokelma actually)…
This deep dive came from a question posed during a morning report by Jackson. Jackson presented the case of a patient presenting with a swollen penis at MSBI, found to have low albumin and diagnosed with nephrotic syndrome. These patients a…
A CT abd/pelvis without contrast is one of our go-to studies when evaluating for nephrolithiasis in a patient with acute flank pain. And it’s a really good one too–a recent meta-analysis of CT for suspected renal stone showed a sensit…
When a patient presents with hyperkalemia, in addition to the initial steps of obtaining an EKG and treating with calcium, insulin, glucose, albuterol, and furosemide if indicated, consultants will often ask us to also administer sodium pol…
You have a patient who is in acute renal failure. You have sent an ER-venous panel that shows a Cr of 4.6, a BUN of 95, and a K of 6.5. You discuss these findings with your nephrology colleagues who request you get the “more accurate” basic…
Current FDA dosing for Toradol is 30mg IV and 60mg IM in patients < 65 years old. But is that necessary? Let’s look at this randomized controlled trial: Motov S et al. Comparison of intravenous ketorolac at three single-dose regim…
What do all these EKGs have in common? They are all hyperkalemia! How hyperK+ are they? Turns out it is probably hard to say…there’s a Basic Rubric: P…
A 29 y/o F 20 weeks pregnant presents with fever, dysuria, and left flank pain. She has some CVA tenderness on the right. WBC is elevated to 15. UA shows both blood and leukocytes in the urine. You are concerned about pyelonephritis vs. and…
52 y/o female with a PMH of HTN and HLD presents with mental status change over the past 12 hours. She is non-compliant with medications and her initial BP is 252/130. Physical exam shows pt is A&Ox1, with an otherwise normal neuro exam…
CASE: 45F h/o ESRD on dialysis presents ped struck. Pt is obtunded, intubated for airway protection. CT head shows subdural hematoma with midline shift. Neurosurgery is activated. No antiplatelets or anticoagulants. Is this person coagulopa…
Metformin has been known to be associated with increased incidence of lactic acidosis. Metformin is renally excreted. Increased Metformin concentration leads to increased risk of lactic acidosis. IV contrast causes nephropathy leading to in…
A 66 year old female patient presents to the ED with a transient episode of dizziness and SOB earlier today. PMH notable for stage III CKD, DM, HTN. She takes valsartan, metformin, and is currently on TMP-SMX (Bactrim) for a UTI. Her EKG sh…
