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
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
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
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
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
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
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
