The word “dialysis” evokes many clinical indications and contexts. In chronic end-stage renal disease (ESRD), patients typically have some form of long-term access like an AV fistula for their scheduled sessions. In the short term, we’re taught indications for dialysis based on the vowels:
Furosemide (Lasix) is a loop diuretic that works on the Na/K/2Cl cotransporter in the thick ascending loop of Henle. It’s a medication I routinely use for patients with congestive heart failure (CHF) exacerbations who are retaining extra fluid in their distal extremities, lungs, abdomen, and other dependent areas. In the…
I’m officially finished with my first rotation as a resident… but I’m going to really miss everyone I worked with this past month on nephrology. Each day posed a new set of challenges in patient management, interesting cases during morning reports and conferences, and understanding how consult services interplay with…
Over the last month, I’ve picked up a lot of factoids on the renal consult service which I’d like to brain dump for future reference:
“Glom” (a term we toss around on the renal service) refers to the glomerulus, a nephron’s initial filtering component, which is often implicated in renal pathologies like multiple myeloma, amyloidosis, membranous disease, focal segmental glomerulosclerosis, membranoproliferate glomerulonephritis, etc. In the workup of patients with renal disease, sometimes all the lab…
The best part about working over the weekend (hah, what a grown-up thing to say) is that parking is easy, there aren’t any conferences to pause workflow, and I have an excuse to eat Fruit Loops at the hospital “because nothing else is available.” :-)
After all the patients I’ve seen with ascites secondary to hepatic cirrhosis, I wondered why we tend to start them on 100 mg Aldactone (spironolactone) with a 40 mg Lasix (furosemide) adjuvant. What’s the rationale behind this ratio? What’s the added benefit of using two different kinds of diuretics to…
