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…
Renal
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…
If you were on a tea & toast diet, how much water would you need to drink before you develop hyponatremia? I haven’t seen anyone work out the numbers before so here are my calculations. And the key to understanding hyponatremia is…
As alluded to in the first post, don’t be fooled by a “normal” potassium in the setting of DKA because osmotic diuresis and H+/K+ exchange means that total body potassium is actually LOW. You all know this, but don’t…
the first symptom of hyperkalemia is death Earlier post covered temporizing measures to counter hyperkalemia — namely, intracellular shift, increasing cardiac myocyte threshold potential. Give furosemide if the patient still urinates…
Previous post reviewed the safety of balanced crystalloids in hyper K. But what was up with serum bicarbonate decreasing with saline administration? This post introduces a new way of looking at the anion gap to possibly answer this phenomen…
Is it safe to give LR or plasmalyte to a hyperkalemic patient (these balanced crystalloids have 4-5 mEq/L K as opposed to 0 mEq/L K in normal saline)? Postponing the discussion of renal handling of potassium to review the physiology of flui…
You’ll likely encounter hyperkalemia on your next Resus / Cardiac shift, and you’ll instinctively treat it. But take a moment to review the fascinating physiology behind the “cocktail”! First, consider how K+ is buff…
