Acute Kidney Injury - Classification Prerenal: • Dehydration • Heart failure (a.k.a. cardiorenal syndrome) • Liver failure (a.k.a. hepatorenal syndrome) Intrarenal: • Intrinsic renovascular disease - Hypertensive emergency - Small vessel vasculitis - TTP/HUS • Glomerular disease - Post-infectious glomerulonephritis • Tubulointerstitial disease - Acute tubular necrosis (causes: sepsis, meds, contrast, rhabdo, prolonged prerenal AKI) - Acute interstitial nephritis (AIN) Postrenal: • Ureteral obstruction (usually requires bilateral obstruction) • Neurogenic bladder • Urinary tract infection • Medications • Benign prostatic hypertrophy (BPH) - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/ #AKI #Acute #Kidney #Injury #Classification #diagnosis #nephrology

Stages in the development of HF and recommended therapy by stage. ACEI indicates angiotensin-converting enzyme inhibitor; AF, atrial fibrillation; ARB, angiotensin-receptor blocker; CAD, coronary artery disease; CRT, cardiac resynchronization therapy; DM, diabetes mellitus; EF, ejection fraction; GDMT, guideline-directed medical therapy; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; HRQOL, health-related quality of life; HTN, hypertension; ICD, implantable cardioverter-defibrillator; LV, left ventricular; LVH, left ventricular hypertrophy; MCS, mechanical circulatory support; and MI, myocardial infarction. #CHF #Congestive #HeartFailure #Staging #Stages #ACCAHA #Algorithm #Management #Cardiology

Hepatitis B Serology Interpretation HBsAg HBcAb HBsAb - BIDMC Infectious Diseases Fellowship @BIDMC_IDFellows #HepatitisB #HBV #HepB #Serology #Interpretation #hepatology #diagnosis

Acid Base Disorders - Blood Gas Interpretation Steps for Blood Gas Interpretation: 1. Acidemia or Alkalemia? 2. Respiratory or Metabolic? 3. Compensated? Acute or chronic? 4. Anion gap? Delta-delta? 5. Differentials? ABG And BMP Normal Values • pH: 7.35-7.45 • PaCO2: 35-45 mmHg • PaO2: 80-100 mmHg • HCO3 (on BMP): 22-26 mmol/L Step 1 - Acidemia or Alkalemia: • pH <7.35 = Acidemia • pH >7.45 = Alkalemia Step 2 - Respiratory or Metabolic: pH pCO2 ↓ ↓ Metabolic Acidosis ↑ ↑ Metabolic alkalosis ↓ ↑ Resp Acidosis ↑ ↓ Resp Alkalosis Step 3 - Compensation, Acute vs Chronic: • Metabolic compensation • Respiratory compensation Step 4 - Anion gap, Delta-delta: Anion Gap (AG) = {Na - (Cl + HCO3)} Normal = 12 +/- 2 Corrected Anion Gap = AG + 2.5(4-albumin) Delta: Delta = (AG-12) / (24-HCO3) Delta: Delta Interpretation For Metabolic Acidosis <0.4 Pure Normal AG metabolic acidosis 0.4-0.8 Normal + High AG metabolic acidosis 0.8-2.0 Pure High AG metabolic acidosis >2.0 Metabolic acidosis with superimposed Metabolic alkalosis/Resp acidosis Step 5 - Differential Diagnosis: Causes of High Anion Gap Metabolic acidosis: G Glycols - ethylene glycol “antifreeze” and propylene glycol (present in IV benzodiazepines) O Oxoprolin (associated with acetaminophen dosing) L L-lactate (common form of lactate) D D-lactate (short bowel syndrome, intestinal bacterial overgrowth, propylene glycol) M Methanol A Aspirin (salicylates) R Renal failure (uremia) K Ketoacidosis (starvation, diabetic) Causes of Normal Anion Gap Metabolic acidosis: - Diarrhea - Renal tubular acidosis/Chronic renal failure - Adrenal insufficiency - Rapid saline infusion - Acetazolamide Causes of Metabolic Alkalosis: - Vomiting, NG suction - Volume depletion (diuresis) - Mineralocorticoid excess Causes of Respiratory alkalosis: - Hyperventilation (Anxiety, pain, fever, hypoxia) - “Classically” noted with pulmonary embolism (with associated hypoxia) - Salicylates Causes of Respiratory acidosis: - CNS depression (sedation, narcotics, CVA) - Neuromuscular weakness (GBS, Myasthenia gravis) - Obstructive or restrictive lung disease (COPD, OSA, Asthma, Obesity hypoventilation) - Airway obstruction (foreign body, aspiration) M. Daniyal Hashmi, MD @MDaniyalHashmi1 #AcidBase #disorders #Interpretation #Diagnosis #Summary #Nephrology #ABG #bloodgas #Acid #Base #Gas #VBG #differential

Phosphate Binders - Pros and Cons Calcium carbonate (TumsTM) - Most inexpensive, antacid properties useful for reflux and peptic ulcer disease Calcium Acetate (PhosLo) - Relatively inexpensive, less GI calcium absorption compared to Ca carbonate Aluminum hydroxide (Amphogel) - Most effective, potent binder, inexpensive Sevelamer-HCI (RenageI) - Calcium and metal-free binder; may have ancillary benefits such as lipid lowering, uric acid lowering, anti-inflammatory effect. Sevelamer Carbonate (Renvela) - Calcium and metal-free binder; may have ancillary benefits (see above), no metabolic acidosis. - Improved GI tolerance. Lanthanum Carbonate (Fosrenol) - No calcium load. Low pill burden. Magnesium based (MagneBind) - Minimal calcium load. - Anti-constipating. Trivalent iron containing binders (sucroferric oxyhydroxide Velphoro, ferric citrate Auryxia) - No calcium load. Low pill burden - May supply additional Fe, decrease ESA Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ #Phosphate #Binders #Table #Comparison #Pharmacology #Nephrology