Mahmud Saqib, MD; Gregory Capelli, DO; Abhilash Koratala, MD – Point of care ultrasonography can be a valuable adjunct to conventional physical examination in patients with hyponatremia that aids in clinical decision making. It can address the shortcomings of traditional volume status assessment such as the inherent low sensitivity of ‘classic’ signs such as lower extremity edema.
Abhilash Koratala, MD – Point of care ultrasonography (POCUS) is a non-invasive bedside diagnostic tool that aids in clinical decision-making process. In addition, it allows to monitor the efficacy of therapeutic interventions in real time. As such, nephrologists can enhance patient care by adopting this skill, especially in those with simultaneous cardiac dysfunction and difficult to manage fluid status.
Abhilash Koratala, MD – In patients with heart failure and cardiorenal syndrome, lingering congestion is associated with worse outcomes. As such, titrating diuretic or ultrafiltration therapy based on objective assessment of volume status plays a crucial role in the management of these patients. Conventional physical examination findings and parameters such as daily weight measurement are not always reliable in this setting. Recently, point of care ultrasonography (POCUS) has emerged as an attractive enhancement to bedside clinical examination in assessing fluid volume status.
Harini Bejjanki, MD; Kawther F. Alquadan, MD; Abhilash Koratala, MD – nsplantation. While small collections resolve spontaneously, larger, symptomatic ones may cause obstructive nephropathy requiring percutaneous or laparoscopic drainage.
Liann Abu Salman, MD; Nathaniel Reisinger, MD – A 63-year-old man with past history of multiple myeloma recently started on a regimen of daratumumab, carfilzomib, and dexamethasone was referred to our emergency department for a rapidly rising serum creatinine as high as 10 mg/dL. He complained of fatigue, nausea, and poor appetite. Exam revealed hypertension, but no edema or rales.
Ira Blau, MD; Behdad Besharatian, MD; Nathaniel Reisinger, MD – A radiographic incidental finding (sometimes called an incidentaloma) is defined as a structure that is unintentionally found during an exam for an unrelated indication. The increased use of routine abdominal imaging is associated with a rising incidence in incidentalomas of the kidney.
Natalie N. McCall, MD; Anna Burgner, MD, MEHP – A 32-year-old male presented with hypertensive emergency and features of thrombotic microangiopathy. He underwent a kidney biopsy after renal dysfunction persisted despite clinical improvement otherwise. The kidney biopsy was performed with direct ultrasound guidance.
Andrew A. Moses, MD MA; Hilda E. Fernandez, MD – Advances in the use of ultrasonography can enhance our ability to better characterize acute kidney injury (AKI). AKI is a clinical syndrome characterized by a rapid decrease in kidney excretory function with the accumulation of products of nitrogen metabolism and other clinically unmeasured waste products, and may proceed to include clinical manifestations including decreased urine output, development of metabolic acidosis, and electrolyte abnormalities.
Vineet Veitla, MD; Bhavna Bhasin, MD – Point of care ultrasonography (POCUS) is considered to be a very useful and informative extension of the bedside physical exam. The information obtained from POCUS allows for real time assessment for expedited decision making to improve efficiency in patient care and management.
Randi Connor-Schuler, MD; Jonathan Suarez, MD – Acute kidney injury (AKI) is a significant problem for patients admitted to the intensive care unit (ICU), both due to the high incidence and associated mortality with rates of AKI requiring renal replacement therapy (RRT) of over 5%, and mortality rates with AKI of over 60%.