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So far BCNephro has created 93 blog entries.

Dialysis Rounding Primer Acute Kidney Injury

It has become more common for patients with dialysis requiring acute kidney injury (AKI) to be dialyzed in the outpatient setting.   With more medically complex patients and the incentive to decrease length of hospitalizations it is not uncommon for patients with dialysis requiring AKI to be discharged from the hospital prior to recovery

By |2023-12-27T16:43:35+00:00March 29th, 2023|Dialysis|0 Comments

Contrast Nephropathy does it exist? How to make it not happen

So some people don’t think contrast nephropathy is real (Don’t look up). The American College of Radiology and National Kidney Foundation looked at the data: Use of Intravenous Iodinated Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation It is also reviewed

By |2023-12-27T16:45:24+00:00March 22nd, 2023|Kidney Disease|0 Comments

Pituitary Gland Disorders – A Cause of Hyponatremia

Endocrine disorders are in the differential diagnosis of hyponatremia.  These need to be distinguished from SIADH (Syndrome of Inappropriate Antidiuretic Hormone). In the article on the laboratory evaluation of hyponatremia read here and watch here, we learned that in hypotonic hyponatremia if the urine osmolarity is > 100 ADH is present and that

By |2023-12-27T16:48:34+00:00March 8th, 2023|Hyponatremia|0 Comments

Causes of Nephrotic Syndrome, Evaluation of Nephrotic Proteinuria

What is your differential for nephrotic proteinuria? First: Nephrotic proteinuria > 3.5 grams/ 24 hrs or random urine protein creatinine ratio >3.5 grams per gram Nephrotic syndrome: Nephrotic proteinuria with associated clinical manifestations of hypoalbuminemia, edema, hyperlipidemia As mentioned here: Proteinuria What it is and How I Treat Begin considering these diagnoses when

By |2023-12-27T16:51:45+00:00March 1st, 2023|Proteinuria|0 Comments

High K – What’s the Deal? How to think about Hyperkalemia

A fundamental principle of nephrology is this:  What comes in has to go out.  If more comes in than goes out or more goes out than comes in sooner or later you're going to be in trouble. This is how I think out too much potassium in the blood - also known as

By |2023-12-27T23:02:22+00:00February 22nd, 2023|Hyperkalemia|0 Comments

Dialysis Rounding Primer – Introduction

Primer for rounding on dialysis patients in the outpatient clinic.  Intended for physician extenders, new fellows, and any other provider who wants to understand the mystery of dialysis. Topics: Acute Kidney Injury without recovery requiring continued outpatient dialysis Adequacy of dialysis Dialysis access Catheter Arteriovenous Access Anemia management Nutrition Mineral Bone Disease HTN/

By |2023-12-27T23:05:34+00:00February 12th, 2023|Dialysis|0 Comments

What? I have Stage 3 Kidney Disease!! Talking to patients about GFR and CKD

What is normal GFR? GFR is the glomerular filtration rate. It is the amount of blood filtered by the glomeruli per unit time. We are born with about a million glomeruli. It is reported in milliliters per minute. From the age of 2 to the age of 25 a normal GFR is 125

By |2023-12-27T23:07:58+00:00February 8th, 2023|Kidney Disease|0 Comments

How not to mess up a Kidney Transplant

Community Hospital Management of Renal Transplant Patients Kidney transplants are good.  Messing up a kidney transplant is bad.  As a nephrologist at a non transplant hospital this is an issue I fear.  Maybe I fear it too much, more than necessary, but I fear it nonetheless.  Here is my opinion. Going to break

By |2023-12-27T23:10:22+00:00February 1st, 2023|Kidney Transplant|0 Comments

Hypertension – A Nephrologist’s Approach

As a nephrologist I get sent patients with resistant or difficult to control HTN.  Here’s an approach, why I do it and what it tells me. 24 hour ambulatory BP monitoring What it tells me: Is it really HTN or is it pseudo resistance? White coat syndrome, white coat effect Technique of measurement.

By |2023-12-27T23:17:37+00:00January 25th, 2023|Hypertension|0 Comments

Dialysis Access: Fistula or Graft? How to figure it out

First of all, what’s the difference between a fistula and a graft? To do dialysis you need to be able to consistently insert two large bore needles, 3 times a week.  This is typically done via a fistula or graft. Fistula: An artery is redirected to directly connect to a vein.  Over time

By |2023-12-27T23:20:39+00:00January 18th, 2023|Dialysis|0 Comments
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