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Nephrology

General Primary Care   

Questions discussed in this category

In patients with an acute gout flare who have stage 3–4 CKD or are on anticoagulation, what is your preferred first-line treatment?
Do you prefer low-dose colchicine, oral steroids, intra-articular steroids, other? 
1 Answer available
In outpatient primary care settings, would you recommend routinely checking Cystatin-C as a marker of renal function in older adults?
3 Answers available
How do you approach patients who are inappropriately worried/fixated on a test result that is flagged as abnormal but not clinically significant?
(i.e., isolated elevation in MCHC, RDW.) Especially when all other lab results are normal and reassuring.
3 Answers available
Do you recommend transitioning elderly patients from thiazide diuretics to alternative agents when managing hypertension given the increased concern for hyponatremia in this patient population?
2 Answers available
How do you evaluate the etiology of hyponatremia in a patient with ESRD and baseline oliguria/anuria?
How do you subsequently monitor treatment response without the ability to monitor urine studies, urine output, etc.?
2 Answers available
When would you consider using amiloride over spironolactone for treatment-resistant hypertension (not reaching goal BP on 3 agents, including a diuretic)?
Lee et al., PMID 40366680
1 Answer available
How do you approach managing patients with diabetic kidney disease and proteinuria who develop hypoglycemia after initiation of a SGLT2 inhibitor?
2 Answers available
What is your approach to initiating spironolactone in patients with end stage kidney disease and heart failure?
5 Answers available
What is your approach to bisphosphonate use in patients with advanced chronic kidney disease and osteoporosis?
3 Answers 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
Do you take any special considerations when working up a pregnant patient for secondary causes of hypertension?
1 Answer available
What are some practical tips in distinguishing between metabolic bone disease due to chronic kidney disease and osteoporosis?
1 Answer available
At what eGFR do you typically refer for vein mapping for a patient with advanced CKD who prefers hemodialysis when indicated?
2 Answers available
How many days prior to surgery do you recommend stopping SGLT2 inhibitors and when is it safe to resume therapy?
2 Answers available
Do you counsel patients to take antihypertensives at specific times of day to maximize efficacy or minimize side effects?
2 Answers available
What is your systolic blood pressure target for patients over 80 with frailty and multiple comorbidities?
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
What factors influence your decision to start salt tablets, urea, or a vaptan first in the management of a patient diagnosed with SIADH?
3 Answers available
What is your approach to preventing exercise-associated hyponatremia?
3 Answers available
Do you recommend fluid restriction in addition to other management strategies for patients with hyponatremia due to SIADH?
6 Answers available
How do you reconcile the risk of contrast-induced nephropathy (CIN) with the diagnostic benefit of contrasted CT in patients with AKI/CKD?
Does your approach change with venous vs arterial contrast?
1 Answer available
Would you start an SGLT2 inhibitor in patients with diabetic kidney disease who also have a history of prior toe amputation?
4 Answers available
Do you recommend initiating an ACE inhibitor or ARB in a patient with proteinuric CKD Stage 5?
2 Answers available
Would you recommend starting an SGLT2 inhibitor in a proteinuric CKD patient with chronic asymptomatic bacteriuria?
2 Answers available
Should GLP1 R agonists be used as first line glucose lowering agents in patients with ESKD and DM2?
1 Answer available


Papers discussed in this category

Ann Intern Med, 2019 Jul 30
Sodium-Glucose Cotransporter-2 Inhibitors and the Risk for Severe Urinary Tract Infections: A Population-Based Cohort Study.
Kidney international, 2019-04
Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (SPin-D): a randomized, placebo-controlled, multiple dosage trial.
Kidney360, 2023 Feb 10
Effects of Spironolactone on Arrhythmias in Hemodialysis Patients: Secondary Results of the SPin-D Randomized Controlled Trial.
Frontiers in medicine, 2022 Mar 17
Safety and Efficacy of Spironolactone in Dialysis-Dependent Patients: Meta-Analysis of Randomized Controlled Trials.
The international journal of cardiovascular imaging, 2021 Feb 05
The effect of spironolactone on diastolic function in haemodialysis patients.
Journal of clinical hypertension (Greenwich, Conn.), 2015 Jul 30
Long-Term Effects of Low-Dose Spironolactone on Chronic Dialysis Patients: A Randomized Placebo-Controlled Study.
Kidney international, 2019 Jan 31
A randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients.
N Engl J Med, 2015 Nov 09
A Randomized Trial of Intensive versus Standard Blood-Pressure Control.
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.
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2021 Feb 08
Safety of Oral Bisphosphonates in Moderate-to-Severe Chronic Kidney Disease: A Binational Cohort Analysis.
Current opinion in nephrology and hypertension, 2022 Jun 10
Clinical utility of bone turnover markers in patients with chronic kidney disease.
JAMA, 2025 Dec 02
Discordance in Creatinine- and Cystatin C-Based eGFR and Clinical Outcomes: A Meta-Analysis.
Drugs & aging, 2001
Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.
Circulation research, 2019 Mar 29
Hypertension Management in Older and Frail Older Patients.

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