@ngiehl8 on GrepMed

Diagnosis and Management of Hyponatremia #Hyponatremia #Algorithm #Differential #Diagnosis #Management #Nephrology ** GrepMed Recommended Text: Nephrology Secrets - https://amzn.to/2Z74DhY

Hypo-osmolar Hypotonic HypoNatremia Algorithm (Serum Na+ < 135 meq/L, serum Osm < 275 mosm/kg) Assess Volume Status, Check Urine Na, Urine Osm #Hyponatremia #Algorithm #Diagnosis #Nephrology #Differential #Hypotonic

Approaches to Evaluating Kidney Disease in Patients with HIV Infection #Pathophys #Nephro #IM #HIV #CKD #AKI #NEJM

AKIKI Trial - Visual Abstract Which is the better time for Initiation Strategies for Renal Replacement Therapy (RRT) in the Intensive Care Unit? Conclusion: In a trial involving critically ill patients with severe AKI, there is no significant difference with regard to mortality between an early and a delayed strategy for the indication of RRT. https://www.nejm.org/doi/full/10.1056/NEJMoa1603017 Dr. Cristhian Muñoz @CristhianMuM #AKIKI #Trial #VisualAbstract #Nephrology #EBM #RRT #CriticalCare #Early

Core IM: Pearls on Contrast-Induced Nephropathy Definition: • no slam dunk criteria • definition in research studies typically increase in serum creatinine 25-50% within 48-72 hours after contrast exposure Pathogenesis: • no clear explanation • best data from animal models suggests hypoxic/cytotoxic acute tubular necrosis Diagnosis: • look for signs of ATN (muddy brown casts) • FENa (counterintuitive, but sensitivity —100%) #Diagnosis #Management #ContrastInduced #Nephropathy #CIN #PCAKI #Overview

Drug-Induced Acute Kidney Injury - Sites of Action Along the Nephron #DrugInduced #AcuteKidneyInjury #AKI #Nephrology #Pathophysiology #Pharmacology

Guide to Acute Kidney Injury (AKI) What to ask/look for: - HPI, PMH, full ROS - Nephrotoxins (NSAlDs, contrast, OTCs, herbals, abx, illicits, chemo, immunosuppression) - Hx of AKI/CKD - Recent hypo/hypertension? - TTE/liver fxn? - BMP, cap, CBC w/ diff - Urinalysis/microscopy/UOP/weights - Urine Na/K/Cl/urea/protein/Cr - Renal/bladder US w/ PVR - CPK, uric acid (rhabdo/TLS) Causes of Inpatient AKI (Liano 1996) - ATN - 45% - Pre-renal disease — 21% - AKI on CKD— 13% (mostly ATN and pre-renal) - Urinary tract obstruction — 10% (most often prostate related) - Glomerulonephritis or vasculitis — 4% - Atheroemboli — 1% #AcuteKidneyInjury #AKI #Nephrology #Diagnosis #Algorithm #Causes #Differential

Algorithmic Approach to the Patient with Azotemia #Azotemia #AKI #Nephrology #Diagnosis #Differential #Algorithm #Management

Acute Kidney Injury (AKI) in Patients with Cancer Cancer Related • Hypercalcemia • Intravenous contrast • Lymphomatous infiltration • Light chain (LC) cast nephropathy • LC deposition disease (LCDD) • Heavy chain DD • Proximal LC tubulopathy • Monoclonal gammopathy of renal significance (MGRS) • Secondary Membranous nephropathy • Solid tumors • Secondary Minimal change disease • Hematologic malignancies Treatment Related • Sepsis, volume depletion • Hepatic sinusoidal obstructive syndrome • Capillary leak syndrome (Interleukin-2) • Tumor lysis syndrome • Proximal tubular injury • Cisplatin • ATN: Imatinib, ifosfomide • Crystal nephropathy: Methotrexate • AIN: Sorafenib, sunitinib , PD-Ii • TMA: Gemcitabine, cisplatin, bevacizumab (VEGFi), TKi • Hemorrhagic cystitis -> bladder outlet obstruction (cyclophosphamide) #Acute #Kidney #Injury #AKI #Cancer #Oncology #Differential #Diagnosis #Classification #Nephrology

Urine Electrolyte Interpretation - AKI, Hyponatremia, Hypokalemia and Non-Gap Metabolic Acidosis #Urine #Electrolytes #Interpretation #ULytes #AKI #FENa #FEUrea #Nephrology #Diagnosis