#Nephrology department

[omegahospitals4]

Top Nephrology Doctors in Hyderabad | Omega Hospitals Care

Experience top-notch nephrology care at Omega Hospitals, Hyderabad. Consult expert nephrologists for kidney treatments, dialysis, and advanced care solutions.

[healthworldhospitals]

The Nephrology department is a state-of-the-art facility offering round-the-clock haemodialysis, with dialysis options available in each ICU. The department is equipped with 12 haemodialysis machines dedicated to managing both acute and chronic renal failure patients. In addition to haemodialysis, the department provides peritoneal dialysis facilities and offers training and counseling for patients undergoing this treatment.

For more specialized care, the department includes a kidney biopsy facility within the laboratory. It also performs interventional procedures for renal vascular problems in the hospital's modern Cath Lab, ensuring comprehensive care for various kidney-related issues.

Healthworld’s Nephrology department stands out not only for its dialysis services but also for its role in organ transplantation. As the Eastern Zonal partners of Apollo Hospitals for heart, liver, and kidney transplantation, the department is equipped to handle these complex procedures. Several cases are currently being processed, demonstrating the facility's growing expertise in this area. The department provides thorough pre-screening and post-transplant follow-up services, ensuring patients receive continuous and holistic care throughout their transplant journey.

In summary, the Nephrology department is a leading-edge facility comparable to the best in the country. Its comprehensive services, ranging from haemodialysis and peritoneal dialysis to kidney biopsies and interventional renal procedures, coupled with its integral role in organ transplantation, position it as a premier center for nephrological care.

[covid-safer-hotties]

Also preserved on our archive

Study links COVID-19 to increased risk of acute kidney disorders - Published Sept 30, 2024

Researchers from West China Hospital, Sichuan University, have conducted a study revealing a significant association between COVID-19 and acute kidney disorders (AKD), including acute kidney injury (AKI), that varies over time. The study, led by Dr. Li Chunyang and Dr. Zeng Xiaoxi from the West China Biomedical Big Data Center, was recently published in the journal Health Data Science.

COVID-19, known for its impact on the respiratory system, also affects other organs, including the kidneys. The study aimed to investigate the time-dependent effects of COVID-19 on acute kidney disorders. Using data from the UK Biobank, the researchers conducted a matched cohort study and a Mendelian randomization analysis to explore both the association and potential causality between COVID-19 and AKD.

Dr. Li Chunyang, a research associate at the West China Biomedical Big Data Center, West China Hospital, Sichuan University

The study involved 10,121 COVID-19 patients matched with 29,004 unexposed historical controls based on age, sex, deprivation index, and hospitalization status. A conditional and time-varying Cox proportional hazard regression model was used to assess the association between COVID-19 and AKD within four weeks of infection. The results indicated that the risk of AKD peaked during the second week after infection (hazard ratio, 12.77; 95% confidence interval, 5.93–27.70) and decreased by the fourth week (hazard ratio, 2.28; 95% confidence interval, 0.75–6.93).

The study also found that only patients with moderate to severe COVID-19 showed a significant risk of acute worsening of renal function. This risk was not observed in patients with mild COVID-19. A one-sample Mendelian randomization analysis further demonstrated a potential "short-term" causal effect of COVID-19 on AKD risk, primarily confined to the first week after infection.

The findings suggest that healthcare providers should closely monitor kidney function in COVID-19 patients, particularly those with moderate to severe cases, during the critical first few weeks after infection. The study provides important insights into the temporal nature of COVID-19's impact on kidney health, which may guide clinical management and follow-up strategies.

Looking ahead, the research team plans to further explore the time-varying impact of COVID-19 on the risk of incident acute kidney disorders in East Asian populations. Additionally, they aim to investigate the underlying molecular mechanisms that may link COVID-19 to subsequent acute kidney disorders to establish more definitive causal pathways.

"The molecular mechanisms behind the association between COVID-19 and kidney damage remain unclear," added Dr. Zeng Xiaoxi, an associate professor in the Nephrology Department at West China Hospital. "Our future research will focus on elucidating these mechanisms and verifying causality, which could pave the way for targeted interventions."

Source: Health Data Science

Journal reference: Li, C., et al. (2024). The time-varying impact of COVID-19 on the acute kidney disorders: A historical matched cohort study and Mendelian randomization analysis. Health Data Science. doi.org/10.34133/hds.0159.

[deelaundry]

House - "I invented the job"

Saw a lovely post about House being "at the top of his profession," and I just want you to know that House made up "Diagnostician" as a specialty. As of 2004 (and maybe still), no doctor specialized in just the diagnosis aspect of medicine. He invented the job.

House is board-certified in nephrology and infectious disease. Typically he would be in one of those departments, but he decided to create his own that would use his talents to their utmost... and let him have the extreme autonomy he needs to function.

(Oh. Does House have a very high level of demand avoidance? Wow, yes, he does, although in 2004 we called that "being a contrary pain in the ass" or more neutrally "a high drive for autonomy.")

Another way Greg House follows from Sherlock Holmes!

[bpod-bpod]

Stopping Cystic Cells

More than half the patients with the inherited kidney disease ADPKD will need a kidney transplant. This study shows that the abnormal, cystic cells can be prevented from accumulating by inhibiting clustering of their centrosomes, cell machinery required for division – a potential novel treatment target

Read the published research article here

Image adapted from work by Tao Cheng and colleagues

Department of Medicine, Nephrology Division, Washington University School of Medicine, St. Louis, MO, USA

Image originally published with a Creative Commons Attribution 4.0 International (CC BY 4.0)

Published in Journal of Clinical Investigation insight, May 2024

You can also follow BPoD on Instagram, Twitter and Facebook

[dangerously-human]

Ruled out applying for the biostatistician job; despite the job description details, it's specific to the nephrology department, and that's not what I'm looking for. If one with the biostatistics unit opens up, though, I'd consider applying for that. What I did do today is set up a job alert for any internal postings that match one of the roles I'm interested in. I should work on my CV - my resume is mostly up to date (I have a rule), but I haven't added a list of presentations I've given or updated my publications, like... ever. Not since I got this job, anyway, and maybe once at some point I added a couple posters I was on. My hope, though, is that things go really well with my annual review next week. I would accept things staying the way they are - knowing my team directors are actually working on reducing my responsibility for my teammates - if I can get a promotion. I'd be happier with a timeline and a promise for the DIY job description, but I think it's pretty clear I'm not going to get that yet. And I guess that's okay, but I'm also not going to put my professional development on hold until there's a space for me to meet my goals here. That's the ideal, but I'm not stuck where I already am, and I feel better having taken steps to make that feel more true.

[jcsmicasereports]

Sickle cell nephropathy, a complication not to be ignored, through a Moroccan case by Asmaa Biaz in Journal of Clinical Case Reports Medical Images and Health Sciences

Summary

Nephropathy is a major complication of sickle cell disease. Indeed, the kidneys are particularly sensitive organs to this disease.

We report a case of a patient with a major sickle cell syndrome; she was hospitalized in the nephrology department of Mohammed V Military Training Hospital, forend-stage renal failure. The family investigation revealed a composite S/O-Arab heterozygosity responsible for the severity of the clinical disorder.

Key words: Sickle cell nephropathy - End stage renal failure - Sickle cell major syndrome S/O-Arab.

Introduction

Sickle cell nephropathy (SCN) is a major complication of sickle cell disease. It manifest’s in various forms, including glomerulopathy, proteinuria, hematuria, and Renal tubular disorders, and frequently results in end-stage renal disease(ESRD). Hemolysis and vascular occlusion are the main factors promoting the manifestations of this disease. Dialysis and renal transplantation are the last resort for patient with SCN [1].

Through the case of a patient with a major sickle cell syndrome S/O-Arab complicated by end-stage renal failure, we will explain the pathophysiological mechanisms of this complication and emphasize the importance of biological monitoring.

Case report

The patient was 24 years old and was admitted to the nephrology department of the Mohammed V Military Training Hospital for incidental renal failure in the context of an impure nephrotic syndrome revealing sickle cell nephropathy. In his history, we retained a

follow-up since the age of 5 years in another hospital structure for a hemoglobinosis S treated by iterative transfusions with notion of acute renal failure during sickle cell crises.

The biological result showed an anemia at 7.7 g/dL, corrected serum calcium at 82 mg/L, serum phosphorus at 64 mg/L, intact parathyroid hormone 1-84 at 543 pg/L, Alkaline Phosphatase at 201 U/L.

Hemoglobin electrophoresis was ordered to this patient, but due to repeated transfusions, her electrophoretic profile remains uninterpretable. Therefore, hemoglobin electrophoresis (HBE) was performed in the parents as part of the hemoglobin phenotypic study. The HBE of both parents is performed on Capillarys (Sebia®) at alkaline pH followed by electrophoresis at acidic pH on Hydrasys (Sebia®) which showed a heterozygous Hb O-Arab variant in the mother and a heterozygous hemoglobinosis S (A/S) in the father.

Referring to the phenotypic study of Hb performed in the parents, it is concluded that the patient has a composite heterozygosity S/O-Arab explaining the severity of the renal manifestations.

The evolution was marked by the absence of improvement of her renal function and the aggravation of the uremic syndrome motivating her setting in peritoneal dialysis. The patient was treated with erythropoietin ARANESP 30µg/ per 2 weeks with a blood transfusion of 2 packed red blood cells on average every two months.

The patient died at the age of 26 years before benefiting from either a hemoglobin genotyping study or a renal transplant.

Discussion

Sickle cell disease is the most common hereditary hemoglobinopathy in the world. An estimated 300,000 children are born with this disease each year, three quarters of whom are born in sub-Saharan Africa [2]. It is characterized by extreme variability in terms of clinical manifestations, the most serious of which are renal manifestations.

The association S/O Arab is responsible for a major sickle cell syndrome, as in the case of our patient. Indeed, Hb O Arab stabilizes the intracellular polymerization of Hb S and leads to an irreversible sickle cell disease of red blood cells, thus expressing by a more severe clinical disorder. The clinical and biological manifestation of this association is similar to homozygous sickle cell disease and the association Hb S / Hb D Punjab. The onset is usually early, in infancy, and is marked by the classic triad of chronic hemolysis: anemia, jaundice and splenomegaly. Anemia is usually moderate outside of hemolytic attacks (Hb = 7 - 10 g/dL). The evolution is often marked by sickle cell complications. Osteoarticular complications are the most frequent, such as vaso-occlusive crises, septic arthritis and osteoporosis. Pneumonia, leg ulcers and vesicular lithiasis are also reported [3].

Sickle cell nephropathy is a major complication of sickle cell disease. The kidneys are particularly sensitive organs to the disease. Sickle cell disease substantially alters the structure and function of the kidneys and is the cause of several renal diseases and syndromes. Renal damage is more severe in SS homozygous patients than in other major sickle cell syndromes [4]. Approximately 5-18% of patients have SCN, thus increasing the risk of morbidity and mortality of the disease [5].

A number of studies have focused on this pathology, its evolution includes several stages; it starts with hyperfiltration, then the occurrence of microalbuminuria, then macroalbuminuria and finally the progression to renal failure. The prevalence of these complications increases with the age of the patients but can also be seen from a young age.

Two models have been proposed to explain the pathophysiology of SCN. Becker et al. showed that prostaglandin release following ischemic injury causes an increase in glomerular filtration rate (GFR). This increase leads to glomerular injury and eventually manifests as proteinuria and glomerulosclerosis [6]. Alternatively, Nath and Katusic [7] classified the manifestations of SCN into two different phenotypes: the hemolysis-endothelial dysfunction phenotype and the viscosity-vaso-occlusive phenotype. The hemolysis-endothelial dysfunction phenotype affects the renal cortex and leads to hyperfiltration and glomerulopathy; heme released due to intravascular hemolysis predisposes to proteinuria through its accumulation on the glomerular filtration barrier, which disrupts membrane selectivity by exerting cytotoxic effects on podocytes and endothelial cells [8]. On the other hand, the viscosity-vaso-occlusive phenotype is responsible for hematuria, papillary necrosis, and tubular acidosis [9].

Microalbuminuria, reflecting the early stages of renal damage, should be routinely sought in the follow-up assessment in this category of patients.

Decreased GFR, which suggests loss of kidney function, occurs with the progression of sickle cell disease and may be a sign of uncontrolled disease. Sickle cell patients have a higher risk of developing chronic kidney disease compared to the general population.

Specific treatment with an angiotensin-converting enzyme inhibitor or an angiotensin II

receptor antagonist should be considered in these patients in order to slow the progression of the renal disease. The prevention of microthrombosis and thus of renal damage requires the maintenance of a hemoglobin A level of more than 50% by regular blood transfusion as soon as sickle cell disease is diagnosed. The role of hydroxyurea in the prevention and/or treatment of renal function abnormalities in sickle cell disease remains to be studied [10].

Conclusion

Sickle cell nephropathy is a major complication of sickle cell disease. It must be systematically and early sought in all sickle cell patients to reduce the risk of morbidity and mortality of this disease.

The development of new biomarkers has become increasingly essential for the early detection of sickle cell disease in order to improve the survival of patients with sickle cell disease.

Declaration of interest:

The authors declare no conflict of interest.

[nostrem]

Apparently there's something wrong with my kidneys but the cool NHS hasn't told me what but have booked me an outpatient appointment with the nephrology department at relatively short notice. So like, that's awesome. I already had surgery for something else entirely in May. I just need to be put down now I think

[yourhealthrescue]

Discover the Best Hospital for Kidney Surgery in India

When facing a critical health issue like kidney surgery, the importance of choosing the right hospital cannot be overstated. India has emerged as a global hub for medical tourism, particularly in the field of nephrology and urology. The country boasts some of the best hospitals for kidney surgery, offering state-of-the-art facilities, highly experienced surgeons, and personalized care that rivals the finest medical institutions worldwide.

Why India?

India's healthcare system has advanced significantly over the past few decades, making it a preferred destination for complex medical procedures, including kidney surgery. The combination of world-class infrastructure, cutting-edge technology, and skilled medical professionals has positioned India as a leader in this domain. For patients, this means access to top-tier care at a fraction of the cost compared to Western countries.

What Makes a Hospital the Best for Kidney Surgery?

The best hospital for kidney surgery in India typically excels in several key areas:

Experienced Surgeons: The expertise of the medical team is paramount. India is home to many renowned nephrologists and urologists with extensive experience in performing kidney surgeries, including transplants and minimally invasive procedures.

Advanced Technology: The best hospitals are equipped with the latest technology, such as robotic surgery systems, which allow for greater precision and faster recovery times.

Comprehensive Care: Top hospitals offer a multidisciplinary approach, with teams of specialists who work together to provide comprehensive care from diagnosis through recovery. This includes not only surgeons but also nephrologists, anesthesiologists, and nursing staff who are experts in their fields.

Patient-Centric Approach: Hospitals that are patient-focused provide personalized treatment plans and ensure that patients and their families are well-informed throughout the process. They offer post-operative care and follow-up services that contribute to successful long-term outcomes.

Accreditations and Certifications: Look for hospitals that are accredited by national and international healthcare organizations, as these certifications reflect a commitment to maintaining high standards of medical care.

Leading Hospitals for Kidney Surgery in India

Several hospitals in India stand out for their exceptional care in kidney surgery:

Medanta – The Medicity: Located in Gurgaon, Medanta is renowned for its world-class kidney transplant program. The hospital is equipped with advanced robotic surgery systems and a team of highly skilled surgeons who specialize in complex kidney surgeries.

Apollo Hospitals: With locations across India, Apollo Hospitals is a leader in healthcare. Their nephrology and urology departments are known for pioneering minimally invasive surgical techniques and providing comprehensive care for kidney-related conditions.

Fortis Healthcare: Fortis is a well-established name in Indian healthcare, with a network of hospitals that offer cutting-edge treatment for kidney diseases. Their multidisciplinary teams provide personalized care and have a high success rate in kidney surgeries.

Max Super Specialty Hospital: Located in Delhi, Max Hospital is another top choice for kidney surgery in India. Their advanced technology, coupled with a team of experienced surgeons, makes them a preferred destination for both Indian and international patients.

Why Choose India for Kidney Surgery?

Patients from around the globe choose India not only for the quality of care but also for the affordability of treatment. The cost of kidney surgery in India is significantly lower than in countries like the United States, the United Kingdom, or Australia, without compromising on the quality of care. This affordability, combined with the expertise of Indian medical professionals, makes India a compelling choice for those seeking the best hospital for kidney surgery.

Moreover, India’s healthcare system is designed to accommodate international patients, with many hospitals offering dedicated international patient services. These services include assistance with travel arrangements, language interpretation, and personalized care plans to ensure a smooth and comfortable experience.

Final Thoughts

Choosing the best hospital for kidney surgery in India is a decision that can significantly impact your health and quality of life. With world-class hospitals, experienced surgeons, and a patient-centric approach, India offers unparalleled opportunities for successful kidney surgery outcomes. Whether you need a kidney transplant or other specialized procedures, India's leading hospitals are equipped to provide the highest standards of care.

For those in search of top-quality kidney surgery, India stands out as a beacon of hope and healing, offering a combination of excellence, affordability, and compassionate care that is second to none.

[studzblr]

Save what can be saved: Day 3/48

Hi.

It was a long day. I woke up very early to go to the post-internship department ( I am inventing names because I don't know what they actually do in that place) to have my papers back only to know that they aren't ready yet. I waited, in a room with more than 12 angry men and women, until midday just to give up on the cause and go back home with no extra papers in my full-of-papers pink document holder. Visiting the hospital always lifts my spirit, I have so many good memories there.

I studied what's left in nephrology then made me a quick pseudo-pizza. I needed some fuel before facing the wildest beast aka immunology.

I'm using "study with me" videos to keep me company while studying. I like it when they have no music in the background, only rain and cats. I actually got inspired from one of the videos to move my desk in front of the window. The room looks a little less aesthetic now but the desk position is top notch. I keep the window open to enjoy the breeze and hear the Adhan clearly ( hi @imspartawssem 💗). At night, a little green buddy came to visit ( honestly I'm glad it was just one, I don't want them to throw a party in my room ).

And that's it for today!

[aryasing]

Leading Health Services in Jaipur

Shalby Hospital Jaipur is a leading multi-specialty hospital in Rajasthan offering comprehensive medical care across various specialties. With advanced infrastructure and dedication to clinical excellence, the hospital provides accessible and affordable tertiary healthcare.

Facilities and Services:

Sprawls over half a million square feet with 300 beds, ICUs, emergency services, modular OTs and sophisticated diagnostic services.

Houses 40+ specialties including cardiology, cardiothoracic surgery, neurology, oncology, orthopedics, gastroenterology, urology, nephrology and organ transplants.

24x7 accident and emergency department equipped with modern ICUs and NICU. Critical care by experienced intensivists.

Advanced Cath labs, MRI, CT scan, ultrasound, mammography, nuclear medicine and other diagnostics.

Minimally invasive surgeries like arthroscopy, laparoscopy, endoscopy offered in dedicated OTs.

Robotic surgeries offered in certain specialties like urology and gynecology.

Full-fledged dialysis unit providing round-the-clock renal replacement therapies.

Facilities like in-house pharmacy, blood bank, ATM, cafeteria and ample parking space.

Quality and Safety:

Highly qualified and experienced doctors supported by skilled nurses and paramedical staff.

Stringent infection control and quality protocols followed.

Continued medical education and training to update clinical skills and knowledge.

Cutting-edge medical technology used for diagnostic and therapeutic procedures.

Part of quality accreditations like NABH to maintain excellent healthcare standards.

With advanced infrastructure, technology and clinical expertise, Shalby Hospital Jaipur is committed to delivering the highest quality of ethical and patient-centric care.

[xxxjarchiexxx]

Casualties

11,255 killed*, including 4,630 children, and 29,000 wounded in Gaza

196 Palestinians killed in the occupied West Bank and East Jerusalem

Israel revises its estimated October 7 death toll down from 1,400 to 1,200

*This figure covers the casualties from October 7 to November 14.

Key Developments

In hospital raid, Israeli forces took captive dozens of displaced people, relatives of patients and the injured inside Al-Shifa, after stripping them of their clothes, blindfolding them, and taking them to “unknown” locations.

The buildings of the nephrology and the internal medicine departments at Al-Shifa Hospital were the first to be stormed by Israeli forces overnight, Al-Jazeera reported. Israeli forces also detonated a medicine storehouse at the hospital. 

White House backs Israeli accusations of a Hamas command underneath Al-Shifa Hospital, which Hamas denied. Hospital staff have called on independent, third-party investigators to come to the hospital and investigate the claim, which they also say is false. 

Hamas: White House adoption of false claims of command center under Al-Shifa is a “green light to the [Israeli]  occupation force to commit more massacres against civilians.”

Health official: Israeli forces shot at Palestinians who left the Al-Shifa complex through the “safe corridor” which they set up.

Belize severs ties with Israel and withdraws the accreditation of Tel Aviv’s ambassador.

[mcatmemoranda]

SUMMARY AND RECOMMENDATIONS

●Triage – Among outpatients identified as having AKI, we refer to the emergency department those who have any of the following: Kidney Disease: Improving Global Outcomes (KDIGO) stage 2 or 3 AKI (table 1); stage 1 AKI with an unclear etiology, or one that cannot be rapidly reversed with simple interventions, or in the presence of a concomitant, uncontrolled comorbid condition; or stage 1 AKI if the initial diagnostic evaluation and management cannot be performed in the outpatient setting. (See 'Identifying patients for emergency department referral' above.)

Those who are managed as an outpatient should be referred for outpatient nephrology consultation if the cause of AKI is not immediately apparent, if initial interventions fail to improve the kidney injury, if glomerulonephritis (GN) is strongly suspected, or when AKI occurs as a complication of treatment of an unrelated condition and future treatment depends upon nephrology input. (See 'Indications for urgent nephrology referral' above.)

●Indications for emergency kidney replacement therapy (KRT) – Emergency KRT should be performed in patients with AKI who have one or more of the following (see 'Evaluate need for urgent kidney replacement therapy' above):

•Hypervolemia with pulmonary edema that does not promptly respond to diuretics (see 'Hypervolemia with pulmonary edema' above)

•Severe hyperkalemia (serum potassium >6.5 mEq/L or those with symptoms or signs of hyperkalemia) (see 'Severe hyperkalemia' above)

•Life-threatening uremic symptoms, such as seizures or severe pericardial effusion (see 'Life-threatening uremic symptoms' above)

•Exposure to certain toxins (see 'Toxin exposure' above)

●Initial management

•Eliminate potential insults – Additional management entails elimination of potential insults, including hypotension, iodinated contrast agents, or medications such as nonsteroidal antiinflammatory drugs (NSAIDs), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and nephrotoxins. (See 'Elimination and avoidance of potential insults' above.)

•Treat hypovolemic (if present) – Intravenous fluid therapy with 1 to 3 liters of crystalloid should be administered to patients with a clinical history consistent with fluid loss (such as vomiting and diarrhea), a physical examination consistent with hypovolemia (hypotension and tachycardia), or oliguria. However, fluid therapy should be avoided in patients with pulmonary edema or clear evidence of anuria. Additional fluid management depends upon the clinical condition and response to initial fluid therapy. (See 'Hypovolemic patients' above.)

Among patients with AKI and hypervolemia who are hemodynamically stable and not anuric, we start intravenous (IV) furosemide at 80 mg up to a single dose of 200 mg, or equivalent, to augment the urine output and relieve symptoms. Additional therapy depends upon the response to initial therapy. We typically initiate KRT for volume overload in patients who have anuria for more than 24 hours, who fail to respond to diuretics, or whose response to diuretics is insufficient to avoid worsening hypervolemia due to high obligate intake. (See 'Hypervolemic patients' above and 'Role of diuretics' above and 'Role of kidney replacement therapy' above.)

•Treat electrolyte imbalances (if present) – Electrolyte imbalances such as the following can complicate AKI and need specific management:

-Hyperkalemia (see 'Hyperkalemia' above)

-Hyperphosphatemia (see 'Hyperphosphatemia' above)

-Hypocalcemia (see 'Hypocalcemia' above)

-Hypomagnesemia and hypermagnesemia (see 'Hypomagnesemia and hypermagnesemia' above)

-Hyperuricemia (see 'Hyperuricemia' above)

•Treat metabolic acidosis (if present) – We initiate KRT in patients with oliguric or anuric AKI who are volume overloaded and have severe metabolic acidosis (a pH <7.1), unless the acidosis can be rapidly resolved by quickly correcting the underlying etiology (eg, diabetic ketoacidosis). However, in other patients who have no indications for acute KRT, bicarbonate may be administered instead of KRT to treat acidosis. Diuretics can be used in nonoliguric patients to prevent hypervolemia and to enhance excretion of acid. The goal serum bicarbonate level is 20 to 22 mEq/L and the goal pH is >7.2. Metabolic alkalosis with AKI is usually seen in volume depleted patients and responds to IV sodium chloride infusion. (See 'Managing acid-base disturbances' above.)

●Subsequent management

•Nutrition management – Patients with AKI generally benefit from dietary restrictions on potassium, phosphorous, sodium and fluid intake (1 to 1.5 L per day, except if volume depleted). Given the complexities of nutritional support in these patients and the individual needs of a given patient, we obtain a nutrition consult to best tailor therapy in hospitalized patients with severe stage 3 AKI. For patients with lesser stages of AKI, the need for consultation should be based upon an individual needs assessment. (See 'Managing nutrition' above.)

•Assess for uremia – We perform daily assessment of uremic signs and symptoms (such as anorexia, nausea, vomiting, metallic taste, altered mental status) to determine if KRT may be indicated. KRT initiation in such patients should be approached with a clear goal of monitoring whether or not putative uremic symptoms improve with therapy. Typically, several KRT sessions are required to determine if symptoms resolve with KRT. (See 'Assessing for uremia' above.)

•Assess for fluid and electrolyte imbalances – We monitor serum creatinine, electrolytes, albumin, and measures of fluid balance (weight, fluid intake, and urine output) daily in most patients, although more frequent monitoring may be warranted. (See 'Monitoring and follow-up' above.)

●Follow-up – We advise that patients hospitalized for moderate to severe AKI have an outpatient nephrology evaluation (or primary care if nephrology is unavailable) shortly after discharge. (See 'Monitoring and follow-up' above.)

[dudeshusband]

r&r, salt in the snow, and sing with robert chase! (from @murderposting)

r&r - do you and your f/o have any plans for the future together? what do those look like?

well, chase and i are married. we live in his apartment. at the end of the show, chase becomes head of diagnostics and i like that, so I've kept it. i intend that my s/i will become a department head, also, the nephrology department (because foreman doesn't want us to be in a boss-employee situation and married. plus, a position clears up. also, we all agree).

salt in the snow - what's the longest you and your f/o have been away from each other? were you able to keep in touch?

hm. my s/i might visit their siblings in california from time to time. that might be a week or so. we'd definitely keep in touch, since we have cell phones and email and all.

i think it'd just make chase sad that he and his sister haven't spoken much in years. maybe he'd make his own trip to australia to see her (if she wants him to).

sing - how does your f/o show you they love you? are they a romantic? awkward? gruff? something else? what abt you?

he's flirty but definitely more sweet and romantic than canon mostly makes him out to be. i think he's big on compliments and 'i love yous' and physical affection but he'd also get me little gifts.

my s/is are the same in that they all love acts of service and physical affection. i like to cook for my f/os and stuff.

[sparsh-multispecialty-hospital]

Best Multispecialty Hospital in Bhilai

Sparsh Multispecialty Hospital in Bhilai is a well-known healthcare facility providing comprehensive medical services across various specialties. Here's some detailed information:

Key Features

Specialties:

Accident & Emergency

Anesthesiology

Cardiology

Cardiothoracic & Vascular Surgery

Critical Care

Dental Clinic

Dermatology & Venereology

ENT (Ear Nose Throat)

General Medicine

Laboratory Medicine

Laparoscopy & General Surgery

Medical Gastroenterology

Nephrology

Neurosurgery

 Nutrition & Dietetics

Obstetrics & Gynaecology

Ophthalmology

Orthopedics

Pediatrics & Neonatology

Plastic & Reconstructive Surgery

Radiodiagnosis

Rehabilitation Services

Respiratory Medicine

Urology Urology

Facilities:

Modern diagnostic tools

Advanced treatment procedures

24x7 emergency care

Inpatient and outpatient services

Pharmacy and pathology lab

Well-equipped ICU and surgical units

Address:

Sparsh Multispecialty Hospital

Ram Nagar Supela, Bhilai, Chhattisgarh

Contact Information:

Phone: You can inquire about their contact details locally or online for appointments or emergencies.

Timings: Typically, hospitals operate 24x7, but outpatient department (OPD) timings may vary.

Sparsh is one of the best multispecialty hospital in Bhilai.

Let me know if you want assistance in reaching out to the hospital or need more information!

[bpod-bpod]

Spread on Chips

A micropatterned chip that mimics the natural conditions of tumour spread into surrounding tissue in 3D. Invasive (metastatic) potential of cancer cells can be measured, and therapeutics screened

Read the published research article here

Still from a video from work by Smiti Bhattacharya and colleagues

Barbara T. Murphy Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York; Department of Mechanical Engineering, Columbia University, New York, NY, USA

Video originally published with a Creative Commons Attribution 4.0 International (CC BY-NC 4.0)

Published in Science Advances, August 2024

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