Morning Report – Renal Failure
Determine AKI on CKD vs CKD AKI: Cr > 0.3 BL in 48hrs, >1.5x BL in 7 days, UO dec by 3cc/kg over 6hrs CKD: GFR 60-90 AND evidence kidney dysfunction, or GFR <60 Before consulting renal get UA, urine…
Tolvaptan, a Selective Oral Vasopressin V2-Receptor Antagonist, for Hyponatremia
Dig deep for that kidney knowledge! Let's quickly review: Arginine vasopressin, otherwise known as antidiuretic hormone (ADH), acts on V2 receptors in the renal distal convoluted tubules to concentrate the urine to maintain water homeostasis. It is implicated in the…
Effects of Losartan on Renal and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Nephropathy
Clinical Question: As compared to placebo, does the angiotensin-II-receptor agonist (ARB) losartan delay progression to ESRD and improve mortality in patients with type 2 diabetes and nephropathy?
Correction of Anemia with Epoetin Alfa
Anemia is a common complication of chronic kidney disease which is typically treated with recombinant human erythropoietin. However the ideal goal hemoglobin is not well established. This study looks to answer if a lower-goal hemoglobin CKD patients shows decreased adverse…
A Randomized, Controlled Trial of Early versus Late Initiation of Dialysis (IDEAL)
Patients with progressive chronic kidney disease are typically initiated on hemodialysis at CKD Stage 5. But is there benefit to starting it earlier versus later in Stage 5. This studies compares initiation of hemodialysis at eGFR 10-15 versus 5-7. Here…