Top Tweets for #NefroGea
Happy to share our new publication:
COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study
doi: 10.1177/20543581241297369.
Congrats @Dave_Rattlehead 🥳 .
#NefroGea.
Happy to share our new publication:
Ultrasound-Guided Percutaneous Peritoneal Dialysis Catheter Insertion for Urgent-Start Dialysis: Technique Description and Experience of a Single Center in Mexico City
DOI: 10.25259/IJN_256_2024
#NefroGea @HospitalGeaMx
🥳🎊🎉
23yo♀️admitted to 🏥 with a soft tissue infection; SLE suspected.
I ask myself, does the patient have serositis? The RX looks clear.
🫁 LUS shows bilateral pleural effusion, B lines, C pattern, and thickening of the pericardium.
@KosmosLatAm @ecocritico_UTIC
#NefroGea
#GEApower
59 YO with pseudomonas + in blood cultures, AKI 3 on RRT, persisting fever🔜endocarditis were suspected.
🫀#POCUS by Internal Medicine Fellows with tricuspid valve vegetation >15mm
TTE Sensitivity 75%
Thanks
@KosmosLatAm @AvelRomanNeph @ecocritico_UTIC
#NefroGea #MIGEA
38 yo ♀️ Primary biliary cholangitis, + peritoneal tuberculosis, total bilirubin 50 mg/dl. #UrinarySediment by Internal Medicine fellows shows abundant bilirubin casts.
#InternalMedicineGea
#NefroGea
#NephTwitter
Citrate Anticoagulation on CRRT
Citrate Dose : 3-6 mmol/L
Ca dose: 2.5-6 mmol/L
🎯 Cai+
Ca Circuit ( post filter ) 2.5-5 mmol/l
Ca ( patient ) 1-1.3 mmol/l
Adjust according to protocols.
Implementing our own protocol
#NefroGea #Nephpearls @DiplomadoTrrc
Magnesium ammonium phosphate crystals (struvite)
🔴Occurs when ammonia production is increased
🔴Alkaline urine PH>8
🔴Associated to infections like proteus or klebsiella ( due to urease-producing bacteria)
#UrinarySediment #NefroGea
🔴RED EFFLUENT IN #CRRT
Causes
Intravascular Hemolysis
Hydroxocobalamin
👇 Ex. of a 40yo ♂️, wrong placement of hem cath, after placement in RA, effluent became clear.
We suspected Intravascular Hemolysis. Teaching point always check your cath @DiplomadoTrrc
#NefroGea
🚨CVC PLACEMENT
Guidewire long : 60 cm
CVC : 20 cm.
Distance from right IYV to RA🫀15 cm
Maybe we just need to introduce guidewire to second marc (20cm)
You don't hace to introduce all the guidewire for CVC placement.
#NephTwitter #NefroGea
You can also calculate FURST for water restriction
You can predict your NaS with water clearance.
if negative water clearance your Nas will ⬇️.
#NephTwitter #NefroGea #MIGEA
HYPONATREMIA GUIDELINES 🇺🇸🇪🇺
1️⃣ Discard Nonhypotonic cause
(Gluc ⬆️, trig⬆️ ,chol⬆️)
2️⃣ Real hypoNA
🚨Acute➡️ severe symptoms
NaCl3%(🥇bolus prefer)
🇺🇸100 ml bolus 🇪🇺150ml bolus
💦12.5🧪 (17.7%)+875cc SS0.9%
💦3🧪 (17.7%)+250cc SS0.9%
https://t.co/Q9woV6svnh
#NefroGea
50yo♀️🏥, hypertensive emergency, 200/100, ER started nitroprusside infusion (high dosage was used ) intoxication suspected, nephrology requested for CRRT
Teaching points
Nitroprusside it's not dialyzable.
Thanks, @DiplomadoTrrc @galindozip for your teachings
#NefroGea
AKI IN CIRRHOSIS
💦66% Pre-Renal AKI
1️⃣ ⛔ Nephrotoxic
2️⃣ Progression 👉Albumin 1g/kg (48 hrs) 65% response
3️⃣ If Failure Vasoconstrictors (We prefer Terlipresin)
🛑34% intrarenal AKI
#NefroGEA #InternalMedicineGEA
doi:10.1177/2050640620980713.
73yo ♀️🏥 with ⬆️Cr 10(baseline 1 mg/dl) #NefroGea #MIGEA requested.
Atrial fibrillation on ECG and cardiac POCUS was documented , Vexus 3
Cardiorenal syndrome was suspected, Furosemide and metoprolol were started
48 hrs after 🫀 contractility looks better , Cr 📉 #NephTwitter
Congratulations to Rafa Moreno, Internal Medicine Fellows, #NefroGea, #MIGEA, #GeaPower
@ISNkidneycare #WCN.
55 yo♀️with, pericardial and pleural effusion, leucopenia, anemia SLE suspected, #NefroGea cooperate with #UrinarySediment, 🔜dysmorphic RBC+, 🔜 rheuma team request ANA'S + 1:1000,classification criteria >10 pts Plaquenil and steroids started
#MIGEA
Always👀#UrinarySediment
50 yo ♀️ HO SLE 2 years
4 months ago 🚫MMF, HCQ, and prednisone. Admited 🏥 with dyspnea, ⬆️ SCr, Ph <7.1 HC03 10, oliguria. #POCUS pericardial and pleural effusion, #urinarysediment waxy casts and dysmorphic RBC. MP bolus Pericardiocentesis 500 ml and CRRT started #NefroGea
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