Posts filtered by tags: Nephrology[x]


 

Kidney disease patients deserve better, and so do their doctors

World Kidney Day reminds us of the 850 million people globally affected by kidney diseases. It draws attention to the 1 in 7 American adults managing Chronic Kidney Disease (CKD) and the 660,000 Americans with end-stage renal disease (ESRD). It also reminds us that kidney disease is the 9th leading cause of death in the United […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, United, Conditions, PA NP, Nephrology, CRNA


Every physician will kill a patient

How did I miss his hypokalemia? Two weeks into my intern year and my patient’s potassium returned at 2.9. Minutes later, he coded. And I felt responsible. As I explained to my partner how my patient had become pulseless after diuresis of his heart failure, she looked at me and said, “Physicians kill patients, it’s […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Physician, PA NP, Nephrology, Hospital-Based Medicine, CRNA


A shortage of Kayexalate leads to an ER visit

Last week I had a patient with mild kidney disease and a high potassium. I thought that it would be easy to take care of. We called around to all the pharmacies from Bangor to Ellsworth to Belfast, and nobody had Kayexalate, the time-tested antidote, in stock. It happened to be on a Tuesday night […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Belfast, Bangor, Ellsworth, Meds, PA NP, Nephrology, CRNA, Kayexalate


In medicine, what’s in a name?

Before I could see her, I could hear her. My patient, a young woman with messy braided hair, was grunting with every effort to breathe. The noises quieted slightly when I reached her bedside, but her tears continued to fall between gasps. Her body movements were exaggerated, rooted in the rhythm of her labored breathing […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Physician, PA NP, Nephrology, Hospital-Based Medicine, CRNA


Nocturia: the underdiagnosed condition patients find extremely distressing

As a family physician, I treat patients of all ages – children to those nearing 100 years old. One issue that plagues young and old alike is lack of sleep. In fact, according to the Centers for Disease Control and Prevention’s (CDC) 2016 Morbidity and Mortality Weekly Report, more than one-third of American adults do […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, PA NP, Nephrology, CRNA, Centers for Disease Control and Prevention 's CDC


MKSAP: 53-year-old woman with hypertension and chronic active hepatitis B infection

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 53-year-old woman is evaluated during a routine follow-up visit. Medical history is significant for hypertension and chronic active hepatitis B infection. Her hepatitis B infection has been treated with tenofovir for the past 5 years with suppression of her serum […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, American College of Physicians, Conditions, PA NP, Nephrology, CRNA


A surgeon mistakes a kidney for a tumor. How can this happen?

A number of media outlets recently featured a story about a Florida general surgeon who removed a normal kidney from a woman who was undergoing spine surgery. How could this have occurred? The 51-year-old patient who had been injured in a car crash was scheduled for an anterior lumbar interbody fusion (ALIF) of the fifth […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Florida, Surgery, Conditions, PA NP, Nephrology, CRNA


A CT scan for kidney cancer? It may depend on where you live.

About one in fifty people reading this essay will be diagnosed with kidney cancer at some time in their life. In fact, one out of one people writing this essay has already been diagnosed with kidney cancer. (I had a small tumor removed from my left kidney not long after I turned 50.) But how many people […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, PA NP, Nephrology, Oncology/Hematology, CRNA


Medicine is a calling and being on call is medicine

Late one Friday night while walking the long and lonely hallways of my hospital, my mind wandered back several years. I recalled my first weekend call as an eager, newly minted nephrology attending. I had met one of my colleagues earlier that morning in the doctors’ lounge, whereupon I had been handed a clunky, black weekend pager. “Welcome to being on call every fourth weekend for the rest of your life,” he had said as the pager ceremoniously exchanged hands. Many things have changed since then...
Tags: Health, Physician, Nephrology


It’s the physician’s job to think of worst-case scenarios

I saw two patients with a chief complaint of bubbles in their urine this month. One middle-aged woman had eaten some wild mushrooms she was pretty sure she had identified correctly, but once her urine turned bubbly a few days later, she came in to make sure her kidneys were OK. Even though she was feeling quite well, they were not, and she ended up going straight to Cityside hospital for IV fluids, a kidney biopsy, and dialysis. We don’t know yet how much her kidney function will recover and we ...
Tags: Health, Primary Care, Conditions, Nephrology


Cardiologists and nephrologists – the importance of collaboration

Bridging the gap between health problems of the heart and kidneys continues to be a talking point amongst specialists. Across both fields, there is clear evidence and recognition that kidney function can affect cardiac health. Kidney patients are vulnerable to a higher level of cardiovascular events as a risk factor and vice versa. Over half of all heart failure patients have moderate or severe chronic kidney disease. Both conditions are connected to similar risk factors, including obesity, diab...
Tags: Books, Featured, Health & Medicine, European Society of Cardiology, European Heart Journal, European Society of Cardiology ESC, Science & Medicine, Cardiology, Pixabay, Nephrology, Cardiovascular Research, Nephrology Dialysis Transplantation, Cardio renal care, clinical Kidney Journal, Wikimedia Commons Congestive, European Renal Association


Opioid cheating is a billion-dollar industry

If you search for “how to pass a urine drug test” on the internet, you will get several million results. As physicians, we see and manage the national opioid crisis every day. We see the impacts of this in our practices and our lives. The crisis frankly shows no signs of abating or becoming a less critical issue. Unfortunately, one major reason for our inability to control this issue might be in the testing. Most patients in the throes of addiction or recovery require regular urine testing as pa...
Tags: Health, Medications, CPT, SAMHSA, Conditions, Nephrology, Giri Venkatraman


MKSAP: 25-year-old man with dark-colored urine

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old man is evaluated for dark-colored urine for 2 days, swelling of the face and hands for 1 day, and severe headaches this morning. He reports having an upper respiratory tract infection 1 week ago with fever, sore throat, and swollen glands, but had otherwise felt well. Medical history is otherwise unremarkable, and he takes no medications. On physical examination, temperatu...
Tags: Health, Infectious Disease, American College of Physicians, Conditions, Nephrology, Albumin


A physician’s personal crisis with pain

Six months ago, I had severe right flank pain. In the ER, I had an ultrasound showing a possible kidney stone. I deferred a CT scan and went home with medication. I fit the textbook picture: I had abnormal imaging, and I was given a treatment and discharged. I was advised to return if the pain worsened or failed to resolve. I briefly improved, but then the pain returned much worse. Ten days later, I returned to the ER. I was given ketorolac and had a CT, which showed no stone. The ER attending a...
Tags: Health, Emergency Medicine, Pain Management, Physician, Nephrology


MKSAP: 28-year-old man with lower-extremity edema

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for a 2-month history of progressive lower-extremity edema, weight loss, and fatigue. Medical history is significant for recreational use of inhaled cocaine; he denies injection drug use. He has no other known medical issues and takes no medications. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 130/90 mm Hg, pulse rate is 90...
Tags: Health, Infectious Disease, American College of Physicians, Conditions, Nephrology


The unintended meaning behind medical schools’ pass-fail system

In recent years, there has been a push across medical schools to change the grading scale towards that of a pass-fail system. The appeals of a pass-fail system to me were obvious. Instead of worrying about my grades as I had in college to maintain an adequate enough GPA to get into medical school, I believed that merely passing would lessen much of the pressures I faced as an undergrad. Those romantic notions about the medical school academic experience were quickly eviscerated on the first day ...
Tags: Health, Education, GPA, Medical School, Nephrology


Watch what you say around patients

I always warn my medical students to be careful what they say in front of patients, or patients’ families or friends. “You never know who’s listening!” I add. They may think that I’m exaggerating — but I have my reasons. Early in my career as an internist/nephrologist, if I had a free moment, I’d head for the emergency room. I might get a referral, and the coffee and conversation were usually entertaining. As I chatted with the ER doctor one morning, a cardiac-arrest victim came in, and the doct...
Tags: Health, Emergency Medicine, Milton, Physician, Nephrology


The difficult conversations physicians have with patients

A 60-year-old lady came for follow-up after a recent stay in the hospital. She was diabetic — horribly uncontrolled — the result of which was that she had already been on dialysis for four years. She ended up in the emergency room with chest pain. Diabetic patients are at higher risk than the general population of having heart attacks. She underwent studies to evaluate for blockages in her heart. The cardiologist found a significant blockage, but a stent could not be placed because of tricky ana...
Tags: Health, Physician, Nephrology, Hospital-Based Medicine


Medicine: How can you not be fascinated by this job?

“Any recent antibiotics? Steroids?” I asked my last patient of the day, a healthy looking young woman with what she described as a yeast infection that was driving her crazy. She’d had many of them, and they were always coming back, but she had only used over the counter topicals. I knew she needed oral medication, but I asked one more question: “Any trouble with high blood sugars?” Her answer eliminated any late day drowsiness or fatigue I might have harbored. “No, my sugars have always been fi...
Tags: Health, Primary Care, Conditions, Nephrology


MKSAP: 65-year-old man with chronic kidney disease

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 65-year-old man is evaluated during a follow-up visit for stage G3b/A3 chronic kidney disease due to diabetic nephropathy. He reports doing well with good baseline exercise tolerance and no shortness of breath. Medical history is also significant for type 2 diabetes mellitus and hypertension. Medications are basal bolus insulin and lisinopril, 20 mg/d. On physical examination, tempera...
Tags: Health, American College of Physicians, Conditions, Nephrology


MKSAP: 45-year-old man with type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old man is evaluated during an annual routine health maintenance visit. History is notable for type 2 diabetes mellitus (diet controlled) diagnosed 3 months ago. Family history is significant for his father who developed end-stage kidney disease due to diabetes at age 68 years. He reports no symptoms and takes no medications. On physical examination, temperature is 37.0 °C (98...
Tags: Health, Diabetes, Endocrinology, American College of Physicians, Conditions, Nephrology


n Which Medical Specialty Are physicians Happiest?

Consider your happiness—both at and outside of work—when choosing a medical specialty. Saving lives, job security, high wages and respect among your peers are probably just a few of the many good reasons why you chose to pursue a career in medicine. But when choosing a medical specialty, your overall happiness should be at the top of your list of things to consider. You’ll know you’ve chosen the right specialty when you’re just as happy going to work as you are after you’ve left for the day. Tha...
Tags: Health, India, Neurology, Pediatrics, Medscape, Orthopedics, Cardiology, Nephrology, Anesthesiology, Ophthalmology, Dr.Murali Krishna, Murali Krishna


An ode to great clinician-educators

When asked to describe my career, I consider myself primarily a clinician educator.  Recently I have reflected on the influences that allowed me to have a successful career doing what I love.  This post is not meant to mention all those influencers, but just some that I recall often.  As I have thought about this post, I quickly realized that all the “heroes” that I recall focused on clinical education.  Students and residents show great respect and love for the great clinician educators, while ...
Tags: Health, Education, Turkey, Gastroenterology, Nephrology, Hospital-Based Medicine, Orhan Muren


A new workplace brings a new perspective

I enter the corridor of my new workplace. I’m welcomed and introduced all around. For some reason, best known to her, the human resource lady took so much of my time that I am already pissed and looking angry. I don’t feel comfortable in this different setup, and I miss my old workplace. Every single thing about it, which previously used to get on my nerves, I miss. However, I succumb to my new work because it has been over a year since I practiced medicine, and the sole reason for me to be here...
Tags: Health, Physician, Nephrology, Hospital-Based Medicine


MKSAP: 57-year-old woman with hematemesis

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old woman is evaluated in the emergency department for an episode of hematemesis that occurred 1 hour ago. She had previously felt well except for a recent knee injury, for which she has been taking ibuprofen. She currently is experiencing lightheadedness and weakness. Medical history is otherwise unremarkable. She does not smoke or drink alcohol. She takes no other medication...
Tags: Health, Emergency Medicine, American College of Physicians, Conditions, Cardiology, Nephrology


What Hurricane Harvey taught this medical student about patient care

“Apocalyptic” was the word used by my fellow volunteers at the local church, a temporary shelter for displaced families on post-hurricane-landfall day 3. Although the flooded roads harboring similarly displaced alligators, fire ants, and snakes and the black flecks in the sky representing rescue helicopters were grossly removed from the many-eyed beasts of Revelations, I agreed with their assessment. In fact, the thousands of flooding victims stranded on roofs in the dead of night as water level...
Tags: Health, Texas, Education, Emergency Medicine, Harvey, Nephrology, Hospital-Based Medicine


Inappropriate patient behavior is not OK

“OK, one more patient to go,” I said to myself with my eyes quickly scanning the patient list in my hands. I was in the elevator, going up the spanking new glass tower in the giant tertiary care hospital I call my workplace. Today was turning out to be a better Monday than usual. I had worked over the weekend, so I knew the patients. And there were no major surprises or turn of events on them. So, rather uncharacteristically for a Monday, I was on my way to see the last patient of the day at 4:1...
Tags: Health, Hospital, Sadhu, Physician, Nephrology


3 points on dialysis John Oliver forgot to make

Dear John Oliver, First of all, thank you for your recent segment on dialysis. Kidney disease deserves much more attention and discussion than it currently receives. Thank you also for your full-throated support of transplantation and the need for more kidney donors. As a practicing nephrologist, there is nothing better than hearing that one of my patients has been given a transplant. Finally, thank you for pointing out that end-stage renal disease is the lone pocket of universal health care in ...
Tags: Health, John Oliver, Taco Bell, Physician, Nephrology, John Oliver First


MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasis

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for recurrent nephrolithiasis. Medical history is significant for Crohn disease complicated by multiple small bowel strictures requiring resection. He began developing kidney stones 3 years ago following his last bowel surgery. Analysis of the stones has consistently shown calcium oxalate, and he has been adherent to a low oxalate diet, oral hydration to m...
Tags: Health, American College of Physicians, Crohn, Conditions, Nephrology


What this physician learned from being an ailing patient

I felt a gust of sharp pain a couple of centimeters to the right of my belly button. It will subside, I thought. All pain subsides. It was an easy dictum to follow as a 39-year-old pediatric eye doc who last spent a night in the hospital as a patient in 1977. I’d undergone bilateral laparoscopic inguinal hernia repair ten days earlier, so I was accustomed to brief squalls of discomfort after certain maneuvers — in this case, 30 minutes on the elliptical machine. My adherence to post-operative in...
Tags: Health, Physician, Nephrology