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How to Calculate Creatinine Clearance

Why Calculate Creatinine Clearance? Creatinine clearance is an estimate of Glomerular Filtration Rate (GFR).  It is a useful estimate of GFR because: Creatinine is produced by the body in relatively stable amounts Creatinine is eliminated by the kidneys. The majority of this renal clearance is by glomerular filtration, a small amount is eliminated

By |2023-12-28T13:51:07+00:00December 28th, 2023|Kidney Disease|0 Comments

The Solitary Kidney: Living with One Kidney

What happens if you only have one kidney? Causes of a Solitary Kidney First, what are the reasons that someone would have only one kidney?  These can be broken down to congenital or acquired. Congenital Some are born with only one or one functional kidney.  This can be because: The kidney never formed

By |2023-12-20T14:02:00+00:00December 20th, 2023|Kidney Disease|0 Comments

Continuous Renal Replacement Therapy Ultrafiltration Models

Continuous Renal Replacement Therapy (CRRT). Slow dialysis for critically ill hemodynamically unstable patients.  The main benefit of CRRT is that it is better at treating and preventing volume overload in these patients. The main benefit of CRRT.  Volume management.  It allows for ultrafiltration at a slower rate. How do we decide on ultrafiltration

By |2023-12-13T14:56:13+00:00December 13th, 2023|Dialysis|0 Comments

Continuous Renal Replacement Therapy – What is it and Why is it Used?

Continuous Renal Replacement Therapy (CRRT) is a form of slow dialysis for critically ill hemodynamically unstable patients.  Why is it used? CRRT has NOT been shown to be associated with improved outcomes (mortality or renal recovery) then intermittent hemodialysis. CRRT is considered to be better tolerated than intermittent hemodialysis hemodynamically unstable patients. CRRT

By |2023-12-06T14:30:38+00:00December 6th, 2023|Dialysis|0 Comments

Use of Renin Angiotensin System Blockers in Chronic Kidney Disease

Renin Angiotensin System (RAS) blockers are renoprotective and often used in chronic kidney disease (CKD).  RAS blockers include: Angiotensin Converting Enzyme (ACE) Inhibitors Angiotensin Receptor Blockers (ARB) These medications have proven benefits in proteinuric CKD  Proteinuria: What is it and How I Treat | BCNephro , including microalbuminuria in patients with diabetic kidney

By |2023-11-29T13:54:20+00:00November 29th, 2023|Kidney Disease|0 Comments

Chronic Kidney Disease – Approach to Diagnosis

This article will provide a framework for evaluation of the patient with abnormal kidney function (elevated serum creatinine/ decreased estimated Glomerular Filtration Rate (eGFR). When evaluating a patient with Chronic Kidney Disease (CKD),  I have the following considerations: Is there something bad? Is it chronic? What is the underlying cause? Is There Something

By |2023-11-29T15:56:46+00:00November 22nd, 2023|Kidney Disease|0 Comments

Creatinine, Cystatin C and GFR

The main test to indicate kidney function is the serum creatinine.  Why is this? First, what are we talking about when we talk about kidney function?  We’re talking about how well the kidneys filter the blood.   This is the glomerular filtration rate (GFR). Creatinine is a marker for kidney function because it is

By |2023-11-15T15:14:52+00:00November 15th, 2023|Kidney Disease|0 Comments

ANCA Associated Glomerulonephritis

ANCA associated Glomerulonephritis is the most common Rapidly Progressive Glomerulonephritis (RPGN) and it occurs in older patients. What is ANCA Associated Vasculitis? ANCA associated vasculitis is a small vessel vasculitis.  It is an idiopathic autoimmune condition that manifests as necrotizing inflammation of small vessels with little/no immune complex deposition.  As there is little

By |2023-12-07T13:52:22+00:00November 8th, 2023|Kidney Disease|0 Comments

Counseling Patients with CKD about Dialysis

Talking to patients and families regarding initiation of dialysis can be complex.  Typically shared decision making is recommended.  This involves more than simply asking if the patient “wants” dialysis. There are two settings where this counseling is necessary.  Each has different questions and concerns.  The first is a patient with chronic kidney disease

By |2023-12-07T13:52:49+00:00November 1st, 2023|Dialysis|0 Comments

Acute Kidney Injury – Indications for Dialysis

What are the indications for Renal Replacement Therapy (RRT) with dialysis in Acute Kidney Injury (AKI)? The common indications: Uremia Life threatening volume overload refractory to medical treatment Life threatening hyperkalemia refractory to medical treatment Life threatening metabolic acidosis refractory to medical treatment Life threatening intoxication with a dialyzable drug This leaves the

By |2023-12-07T13:58:08+00:00October 25th, 2023|Dialysis|2 Comments
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