Kidney Replacement Therapy – The Basics

So what is kidney replacement therapy (KRT)? As the name suggests, it is the artificial form of removal of wastes and excess fluids from the body as a proxy for the kidneys. Who needs that? Patients with acute kidney injury (AKI), as well as any patient with end stage kidney disease (ESKD) or Chronic Kidney…

(Almost) Everything You Wanted to Know about Hyper and Hypokalemia

Disturbances in serum potassium are frequently encountered on both the floors and exams, thus making it an important concept to not only be familiar with but also understand. In this post, I will describe the etiology, consequences, and management of potassium disturbances relevant for the medical student on wards and residents early in their training….

A Quick & High-Yield Breakdown of Nephritic Syndrome

Nephritic syndrome key characteristics Hypertension Hematuria, oliguria (symptoms you can see with your eyes) Disruption/inflammation of glomeruli! If bad enough, can lead to glomerular basement membrane rupture and rapid loss of kidney function. RBCs, WBCs, and RBC casts present on urine microscopy. Proteinuria can be anywhere from sub-nephrotic proteinuria to nephrotic proteinuria. Common (and testable)…

A Quick & High-Yield Breakdown of Nephrotic Syndrome

Nephrotic syndrome key characteristics Common findings include: Proteinuria (frothy urine) Hyperlipidemia Hypoalbuminemia Edema Results from injury and disruption of podocytes and their foot processes.  When podocytes lose their foot processes their special structure or detach completely, there is exposed basement membrane and free filtration of albumin and other plasma proteins. Nephrotic range proteinuria is >3.5g…

A Quick Lesson on Minimal Change Disease

If you remember one thing about minimal change disease (MCD) from your preclinical courses, it’s probably that MCD is most commonly found in children. In fact, 70-90% of children with nephrotic syndrome are found to have MCD! In adults, this number is only around 10-15%. In this post, we’ll review the diagnosis of MCD with…

The Best Resources for your Med School Pre-Clinical Nephrology Years

If you’re like me, the first introduction to kidney physiology during the preclinical years of medical school can be overwhelming. Ions, transporters, RAAS; it all comes at you very fast. While lectures serve as a good starting point for framing this information, using supplemental resources can really help you hammer in the details. I have…

Nephrotic Syndrome Made Easy

Welcome to our nephrotic syndrome series! In this first post, you’ll find a general overview of the findings of nephrotic syndrome and how to approach diagnosis. Nephrotic syndrome is the constellation of signs and symptoms that arises when the glomerular filtration membrane is damaged and protein begins passing into the urine in large quantities. It…

Basics of Diuretics

You might recognize this image from one of our videos highlighting the physiology of the different segments of the nephron. This video can be found here. Using the information from that video, I want to summarize the mechanism of action and common side effects of various diuretics. Having a good understanding of diuretics demonstrates a…

An Intern’s Guide to AKI Work-up

Brought to you by the intern asking for the consult and the first year fellow responding! It’s intern year and you are working up another patient for an AKI. You have examined the patient and sent off some labs but do not yet have a satisfying explanation for your patient’s worsening kidney function. You and…

The Skinny on Secondary Hyperparathyroidism

If you’ve ever helped take care of a patient with chronic kidney disease, you’ve probably noticed that there is always a discussion about the patient’s calcium and phosphorus levels. Take a closer look in the chart and you’ll see that someone has probably checked the patient’s parathyroid hormone (PTH) levels in the past. To understand…