The decision whether to give bicarbonate (HCO3-) for metabolic acidosis can be confusing. In some conditions, such as lactic acidosis, bicarbonate has not been shown to be beneficial, may be harmful, and is reserved for very severe acidosis. In other conditions such as Chronic Kidney Disease (CKD) treatment with alkali is recommended to
Infection associated glomerulonephritis. Patient presents with Acute Kidney Injury (AKI) and active urine sediment in the context of a current or recent infection. Pathophysiology and Clinical Presentation Antigen antibody immune complexes form with the antigen from the infection and the antibody from the immune response. These immune complexes deposit in the glomeruli
Hyperkalemia can be classified as mild, moderate and severe as well as acute and chronic. Severe hyperkalemia will be acute as it will require immediate treatment. This article will address treatment strategies based on the severity of hyperkalemia. Treatment of Hyperkalemia Treatment Options Stabilization of cardiac cell membrane Redistribution from extracellular to intracellular
Nephrologists generally use the physiologic approach to diagnosing acid base disorders. Check out this article for an overview of the physiologic approach. Understanding Acid Base Disorders | BCNephro However, there are two other approaches to diagnosis of acid base disorders. Base Excess Physicochemical (Stewart) The Base Excess is routinely reported with blood gas
What is rhabdomyolysis? Rhabdomyolysis is a condition where there is muscle necrosis with release of intracellular muscle contents into the systemic circulation. Most notably: CK (creatine kinase): detected in blood Myoglobin: detected in urine Others AST/ALT If severe: Potassium, Phosphorus, Urate, Lactic acid In rhabdomyolysis the CK is markedly elevated. When is the
Treatment of Kidney Stones. Once we know or deduce the type of kidney stone, the next focus is treatment. In a patient with recurrent nephrolithiasis, treatment is secondary prevention. That is prevention of stone growth or new stone forming. Acute stones that are passing are typically managed by urology as they may require
Kidney stones are common and the incidence is increasing. Knowledge of management and prevention is imperative. This article will approach diagnosis. Not diagnosing that a patient has a kidney stone, but diagnosing the type of stone and assessing for secondary causes in patients with recurrent nephrolithiasis. Types of Kidney Stones The five most
Interstitial Nephritis is an important cause of Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD). This article will talk about Acute Interstitial nephritis (AIN) AIN may be difficult to diagnose. AIN is relatively common. 1 study found that 12.9% of renal biopsies for AKI showed interstitial nephritis. AIN may cause severe AKI
Dialyzers are where dialysis, the blood purification takes place. This article will address: Dialyzer Components Types of Dialysis Membranes Sterilization Techniques Dialyzer Reactions Dialyzer Components Dialyzers are composed of an outer capsule or shell in which the membranes are located. Capsule / Shell There are 2 components to the capsule/ shell in which
Which patients with kidney disease should be screened for monoclonal gammopathy? Assessment for paraproteins is important for the evaluation of most kidney diseases. Paraproteins can be associated with a wide spectrum of renal manifestations including: Acute Kidney Injury Chronic Kidney Disease Proteinuria +/- Nephrotic syndrome Proximal Tubulopathies (i.e. Fanconi syndrome) Patients should be
