General Internal Medicine

Chronic kidney disease

Questions discussed in this category

What are some practical tips in distinguishing between metabolic bone disease due to chronic kidney disease and osteoporosis?

1 Answer available

How do you use NT-proBNP in patients with chronic kidney disease or end-stage kidney disease, given that these conditions can affect NT-proBNP levels?

1 Answer available

Do you have a preference between an ACEI and ARB when initiating therapy for a patient with diabetic kidney disease, albuminuria, and hypertension?

7 Answers available

What are some practical tips for when a patient's consistently stated goals of care do not correlate with their actions?

For example, what do you do when someone requests aggressive, life-prolonging treatments but then is not receptive to elements of day-to-day care in t...

4 Answers available

Do you recommend vitamin C supplementation with PO iron in patients with iron deficiency?

Is this recommendation given to all patients or only certain patients, and if so, which patients?

2 Answers available

What is your approach to bisphosphonate use in patients with advanced chronic kidney disease and osteoporosis?

1 Answer available

What is the maximum diuretic regimen recommended in patients with end-stage kidney disease who have residual renal function and volume overload?

4 Answers available

How would you approach management of retroperitoneal fibrosis causing ureteral compression that has already caused irreversible loss of kidney function?

Renal perfusion scan shows 14 % perfusion on affected side.

3 Answers available

Under what circumstances would you hold an ACE inhibitor or ARB prior to surgery in a patient with CKD?

2 Answers available

How do you approach consults regarding clearance of patients with chronic kidney disease for surgery?

4 Answers available

Would you stop an ACE inhibitor/ARB or instead initiate a potassium binder to manage hyperkalemia in a patient with proteinuric CKD stage 5 who is on an ACEi/ARB?

5 Answers available

How do you approach hematuria in a patient with diabetic nephropathy?

3 Answers available

What is your approach to patients with chronic kidney disease who are found to have pelviectasis without hydronephrosis on renal ultrasound imaging?

1 Answer available

What are some indications that might lead you to pursue a kidney biopsy in a patient with presumed diabetic kidney disease?

3 Answers available

What is the role for iothalamate clearance testing for glomerular filtration estimation in patients with chronic kidney disease?

4 Answers available

For patient with polycystic kidney disease and proteinuria who are on maximum dose of ACEi/ARB, what are other anti-proteinuric medications that should be considered?

1 Answer available

How would you approach pursuing a kidney biopsy in a patient with suspected lupus nephritis who is on warfarin for antiphospholipid antibody syndrome?

2 Answers available

Would you recommend starting an SGLT2 inhibitor in a proteinuric CKD patient with chronic asymptomatic bacteriuria?

2 Answers available

Do you prefer cinacalcet or etelcalcetide for patients with hyperparathyroidism in the setting of kidney disease?

3 Answers available

Are there instances when you recommend against a kidney biopsy in a patient with a single kidney who otherwise has indications for a biopsy, consents, and has no medical contraindications for the procedure?

1 Answer available

Do you rule out active urinary tract infections prior to performing a kidney biopsy?

2 Answers available

Do you check EPO levels in patients with anemia of chronic kidney disease?

2 Answers available

How do you choose between spironolactone and finerenone for patients with proteinuric diabetic kidney disease and heart failure?

2 Answers available

Do you avoid ESAs in patients with anemia and chronic kidney disease who also have Factor V Leiden?

1 Answer available

When do you recommend testing for APOL1 variants in patients with proteinuric chronic kidney disease?

2 Answers available

Do you recommend patients temporarily hold cilostazol prior to and after a kidney biopsy?

1 Answer available

Are there instances when you prefer serum creatinine over cystatin C when estimating GFR in a patient with CKD?

1 Answer available

What are your management strategies for patients with chronic kidney disease attributed to deferasirox use who require frequent blood products for a hematologic disorder?

1 Answer available

Do you avoid ESA use in patients with anemia and chronic kidney disease who also have APLS and risk for thrombosis?

2 Answers available

For patients with microscopic hematuria, do you prefer a lab submitted urinalysis sample undergoes automated urine analysis or microscopic analysis by laboratory staff for quantification of red blood cells?

1 Answer available

How do you dose apixaban in patients with CrCl <30 mL/minute?

1 Answer available

Is there a kidney length for which you would no longer recommend attempting a kidney biopsy due to safety concerns and lack of diagnostic yield?

1 Answer available

Do you stop tolvaptan below a certain eGFR in a patient with autosomal dominant polycystic kidney disease?

1 Answer available

Papers discussed in this category

Circulation, 2022 Nov 06

A Randomized Controlled Trial Comparing Apixaban With the Vitamin K Antagonist Phenprocoumon in Patients on Chronic Hemodialysis: The AXADIA-AFNET 8 Study.

Circulation, 2022 Nov 06

Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial.

Ann Intern Med, 2019 Jul 30

Sodium-Glucose Cotransporter-2 Inhibitors and the Risk for Severe Urinary Tract Infections: A Population-Based Cohort Study.

Am J Kidney Dis, 2021 Mar 08

Assessing Risk of Rapid Progression in Autosomal Dominant Polycystic Kidney Disease and Special Considerations for Disease-Modifying Therapy.

Kidney international, 2001 Mar

Role of diuretics in the preservation of residual renal function in patients on continuous ambulatory peritoneal dialysis.

American journal of nephrology, 1992

Acute and long-term effects of therapy with high-dose furosemide in chronic hemodialysis patients.

Kidney research and clinical practice, 2019 Mar 31

Efficacy of triple diuretic treatment in continuous ambulatory peritoneal dialysis patients: A randomized controlled trial.

AJR. American journal of roentgenology, 2015-08

Management of Anticoagulant and Antiplatelet Medications in Adults Undergoing Percutaneous Interventions.

Journal of vascular and interventional radiology : JVIR, 2019 Jun 20

Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions-Part II: Recommendations: Endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe.

Clinical journal of the American Society of Nephrology : CJASN, 2019 Nov 18

Genetic Testing for Genetic Variants in Clinical Practice: Finally Starting to Arrive.

Kidney international, 1978-07

Use of computerized tomography to diagnose complications of percutaneous renal biopsy.

Annals of clinical and laboratory science, 1982

Perinephric abscess: an unusual late infectious complication of renal biopsy.

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2019 Jan 17

Update on the Native Kidney Biopsy: Core Curriculum 2019.

The Journal of urology, 1964 Apr

DEATH DUE TO SEPTICEMIA FOLLOWING PERCUTANEOUS NEEDLE BIOPSY OF THE KIDNEY.

Transplantation direct, 2021 Sep 07

Significance of Asymptomatic Pyelonephritis Found on Kidney Transplant Biopsy.

Mayo Clinic proceedings, 1995 Mar

Nephrology (Carlton, Vic.), 2019 Oct 23

KHA-CARI Guideline recommendations for renal biopsy.

Medicine (Baltimore), 2018 Oct

Rituximab for idiopathic and IgG4-related retroperitoneal fibrosis.

BMC Rheumatol, 2020

Use of rituximab in idiopathic retroperitoneal fibrosis.

Kidney international. Supplement, 2002 Dec

Comparative effects of ACE inhibition and angiotensin II receptor blockade in the prevention of renal damage.

JAMA internal medicine, 2014 May

Effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on all-cause mortality, cardiovascular deaths, and cardiovascular events in patients with diabetes mellitus: a meta-analysis.

JACC. Heart failure, 2024 Aug 31

Natriuretic Peptides, Kidney Function, and Clinical Outcomes in Heart Failure With Preserved Ejection Fraction.

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