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
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
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
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
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
Kidney cysts are commonly found on imaging and are a common cause of anxiety for patients. This overview will provide context with the aim of being able to minimize patient anxiety, avoid unnecessary referrals and triage patients for appropriate referral to nephrology or urology. The main question to ask yourself when a kidney
There are certain dermatologic conditions unique to ESRD that the nephrology practitioner should be aware of. These include: Uremic pruritus Calciphylaxis - calcific uremic arteriolopathy Perforating Dermatosis - Kyrle Disease Nephrogenic Systemic Fibrosis Uremic Pruritus Pruritus is a common complaint in ESRD. It may be localized or generalized. Pathogenesis. It is often attributed
When writing this article I felt a need to add more and more information, to be comprehensive. I had a fear of leaving something out. I need to stop. The intention of BCNephro is not to be an encyclopedic nephrology resource. The intention is to share my experiences in a way that makes
What is glomerulonephritis? Glomerulonephritis is inflammation of the glomerulus. This is may be manifest by: Clinical Findings: Glomerular hematuria Variable proteinuria (typically sub nephrotic may be nephrotic) Leukocyturia (variable) Impaired kidney function (variable) Hypertension (variable) May be renal limited or associated with systemic inflammation (vasculitis) Pathologic Findings: Glomerular hypercellularity Crescents (indicate more severe
Hypernatremia like hyponatremia is all about water. Hyponatremia indicates intracellular water excess (overhydration). Hypernatremia means the opposite, too little water. (At least too little water relative to sodium). This is dehydration. It indicates intracellular dehydration. This article will address: Pathophysiology Approach to Diagnosis Renal Causes of Hypernatremia Diagnostic Algorithm Treatment Pathophysiology What happens
