Category Archives: Renal

Urinary catheter not needed for THA with spinal anesthesia

This trial randomized patients undergoing spinal anethesia for THA to indwelling urinary catheters or none. Of 200 patients, 9 in the no-catheter group and 3 in the catheter group needed a single in-out cath (the latter group after the catheter … Continue reading

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Predicting contrast induced nephropathy

A new easy-to-use online calculator can help predict the risk of contract induced nephropathy before cardiac catheterization (calculator here).

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Synthetic marijuana associated with acute renal failure

Synthetic marijuana, or “spice” has been linked to at least 16 cases of acute renal failure, according to the CDC. Unexplained renal failure in young otherwise healthy patients should prompt questioning about synthetic marijuana use (CDC site).

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ACE and ARBs associated with contrast-induced kidney injury

In this case-control study, patients on ACE/ARBs were significantly more likely than those not on ACE/ARBs to experience contrast-induced acute kidney injury (odds ratio 1.4, CI 1.1 to 1.8). However, this does not prove causality, and it is not clear … Continue reading

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Risk of CVA and bleeding in afib patients with ESRD

In this large administrative database analysis of patients with non-valvular afib, patients with ESRD were significantly more likely to suffer stroke, system thromboembolism, and bleeding than those without ESRD; the risk of stroke/embolism was significantly lower for those on warfarin … Continue reading

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Antibiotic dosing difficulties with CVVHD

In this small prospective cohort of critically ill patients on antibiotics and CVVHD, researchers found wide variability in trough levels of various antibiotics, which did not appear to correlate with effluent flow rates; 15% were below minimum therapeutic levels, and … Continue reading

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7 as good as 14 days of cipro for acute pyelonephritis

In this trial of women with acute pyelonephritis, randomized to 7 or 14 days of ciprofloxacin, clinical cure was the same in both groups (96% and 97%). This should be a reasonable duration of treatment for women with pyelonephritis with … Continue reading

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New guidelines for lupus nephritis

The American College of Rheumatology has recently published guidelines on the screening, treatment, and management of lupus nephritis. A few of the key findings include the need for a biopsy for all new diagnosis, the use of ACE/ARBs with proteinuria, … Continue reading

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NaCl better than Hco3 for reducing contrast nephropathy, but duration matters

In this randomized trial of patients with renal insufficiency undergoing procedures with IV contrast, they were randomized to normal saline (1cc/kg/hr for 12 hours before and after procedure), or Hco3 (2 different regimens; 3cc/kg an hour before and 1cc/kg/hr for … Continue reading

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Fibrates and renal failure

This large cohort study of patients >age 65 found those with a new outpatient prescription for a fibrate were >2 times more likely to be hospitalized with an increased creatinine within 90 days, which was most pronounced in those with … Continue reading

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