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Medical Monday Case Challenge: What's Going On Here?⠀
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A 32 year old with end-stage renal disease (ESRD) on dialysis presents with an arm fistula and an intracerebral hemorrhage. There is dilatation of the AVF and right heart. ⠀
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What's the diagnosis? And most importantly, what's your first step to treat? ⠀
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Leave your answer in the comments below. We'll post the discussion of this real case tomorrow in the comments as well.

#physician #medstudent #medicalschool #medicalstudent #nurses #futuredoctor #medicalmonday #medicalmondays #casechallenge #doctor #doctorslife #medstudentslife #healthcare #medicalmystery #nephrology #nephrologist #cardiology #cardiologist #medicalresident
Medical Monday Case Challenge: What's Going On Here?⠀ ⠀ A 32 year old with end-stage renal disease (ESRD) on dialysis presents with an arm fistula and an intracerebral hemorrhage. There is dilatation of the AVF and right heart. ⠀ ⠀ What's the diagnosis? And most importantly, what's your first step to treat? ⠀ ⠀ Leave your answer in the comments below. We'll post the discussion of this real case tomorrow in the comments as well. #physician  #medstudent  #medicalschool  #medicalstudent  #nurses  #futuredoctor  #medicalmonday  #medicalmondays  #casechallenge  #doctor  #doctorslife  #medstudentslife  #healthcare  #medicalmystery  #nephrology  #nephrologist  #cardiology  #cardiologist  #medicalresident 
Zoe and her doctor looking at her urine sample through the microscope. So cool that she offered to do this. #myzoe #STEM #nephrologist #henochschonleinpurpura #hsp
Tenía rato q no usaba bata 🙈#doctor #nephrologist
#LongDay at Work. #doctors life #nephrologist
รับวุฒิบัตรจร้า #Nephrologist#RCPT2016
This doctor is loading..#imsoimpatient #nephrologist #doctor #iphone #beat
With my #mentor Dr. Kenar Jhaveri. What an incredible person, #nephrologist and educator. #NorthwellLife #Northwell
#doctors #urologist #nephrologist 👨🏻‍⚕️👨‍⚕️ )))
Tenía rato q no usaba bata 🙈#doctor #nephrologist
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#microsiddindia #microsidd #doctor #doctors #surgery #surgeryday #surgical_instruments #surgeon #generalhospital #gaenechologist #Nephrologist #urologist #orthopaedic #medical_college #hospital #medical_equipment #surgical_instruments
Before my kidney transplant, this was my reality. Three nights a week (after working eight hour days) I was hooked up to a machine for four hours. BUT GOD!! My doctor thought I was the ideal candidate for at home dialysis. After being thoroughly trained and comfortable with the process, I made the transition to dialyzing in the comforts of my home. I strongly encourage those who are able, to try home dialysis. I enjoyed the independence and increased health benefits that came from dialyzing at home. 
Benefits of kidney dialysis at home: - Flexible treatment times that fit your schedule
- More flexible diet
- More time to spend with family and friends
- Travel and going to work can be easier
- Increased independence can improve your quality of life
- Avoids transportation issues to and from the center three times per week
- Greater feeling of well-being
- May preserve remaining kidney function
- Better control of fluids
- Fewer medications
- Better regulation of blood pressure and toxin build-up
- Less fatigue and nausea

#lifeline #God #healed #kidneys #transplant #donatelife #organdonation #nephrologist #life #dialysis #advocacy #empowerment #courage #takecontrolofyourlife #health #healthbenefits #morelife #freseniuskidneycare #freseniusmedicalcare #davitadialysis #kidneydisease
Before my kidney transplant, this was my reality. Three nights a week (after working eight hour days) I was hooked up to a machine for four hours. BUT GOD!! My doctor thought I was the ideal candidate for at home dialysis. After being thoroughly trained and comfortable with the process, I made the transition to dialyzing in the comforts of my home. I strongly encourage those who are able, to try home dialysis. I enjoyed the independence and increased health benefits that came from dialyzing at home. Benefits of kidney dialysis at home: - Flexible treatment times that fit your schedule - More flexible diet - More time to spend with family and friends - Travel and going to work can be easier - Increased independence can improve your quality of life - Avoids transportation issues to and from the center three times per week - Greater feeling of well-being - May preserve remaining kidney function - Better control of fluids - Fewer medications - Better regulation of blood pressure and toxin build-up - Less fatigue and nausea #lifeline  #God  #healed  #kidneys  #transplant  #donatelife  #organdonation  #nephrologist  #life  #dialysis  #advocacy  #empowerment  #courage  #takecontrolofyourlife  #health  #healthbenefits  #morelife  #freseniuskidneycare  #freseniusmedicalcare  #davitadialysis  #kidneydisease 
Dear Doctors now Medical equipment are more easier to by from US at 0% down payment and up to 36months instalments* 
#microsiddindia #microsidd #easybuy #installment #emi #medical_college #medicalstudent #doctor #physician #Nephrologist #urologist #surgeon #gaenechologist
Nephrocalcinosis and acute phosphate nephropathy with intratubular calcium phosphate crystals, tubular atrophy and interstitial fibrosis (hematoxylin and eosin stain).
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Nephrocalcinosis, the deposition of calcium phosphate crystals within renal tubules and sometimes within interstitium, may occur at any age. Acute phosphate nephropathy typically occurs due to a large load of oral sodium phosphate as part of colonoscopy preparation, and presents as acute kidney injury (AKI), developing in 1 in 1,000 to 5,000 of such patients. Risk factors include dehydration, pre-existing chronic kidney disease (CKD), concomitant use of ACE inhibitors or diuretics, older age, and female sex. Recognition of this entity and change in colonoscopy preparation have markedly decreased incidence of acute phosphate nephropathy. Nephrocalcinosis can also be due to excess calcium, due to either hypercalcemia or hypercalciuria, and may occur at any age. The prognosis depends upon the underlying cause. CKD and even end-stage kidney disease (ESKD) can develop if deposits are extensive and the underlying cause cannot be treated. In patients with acute phosphate nephropathy, serum calcium levels are typically normal, in contrast to nephrocalcinosis caused by hypercalcemia.
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AJKD Atlas of Renal Pathology: Nephrocalcinosis and Acute Phosphate Nephropathy (free; link in profile)
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DOI: 10.1053/j.ajkd.2017.01.005 (March 2017)
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#AJKD #AtlasofRenalPathology #nephrology #kidneydiseases #renal #renalpath #renalpathology #kidney #microscopy #medicine #nephrologist #kidney #CKD #AKI #CKD #ESKD #nephrocalcinosis #nephropathy
Nephrocalcinosis and acute phosphate nephropathy with intratubular calcium phosphate crystals, tubular atrophy and interstitial fibrosis (hematoxylin and eosin stain). . Nephrocalcinosis, the deposition of calcium phosphate crystals within renal tubules and sometimes within interstitium, may occur at any age. Acute phosphate nephropathy typically occurs due to a large load of oral sodium phosphate as part of colonoscopy preparation, and presents as acute kidney injury (AKI), developing in 1 in 1,000 to 5,000 of such patients. Risk factors include dehydration, pre-existing chronic kidney disease (CKD), concomitant use of ACE inhibitors or diuretics, older age, and female sex. Recognition of this entity and change in colonoscopy preparation have markedly decreased incidence of acute phosphate nephropathy. Nephrocalcinosis can also be due to excess calcium, due to either hypercalcemia or hypercalciuria, and may occur at any age. The prognosis depends upon the underlying cause. CKD and even end-stage kidney disease (ESKD) can develop if deposits are extensive and the underlying cause cannot be treated. In patients with acute phosphate nephropathy, serum calcium levels are typically normal, in contrast to nephrocalcinosis caused by hypercalcemia. . AJKD Atlas of Renal Pathology: Nephrocalcinosis and Acute Phosphate Nephropathy (free; link in profile) . DOI: 10.1053/j.ajkd.2017.01.005 (March 2017) . #AJKD  #AtlasofRenalPathology  #nephrology  #kidneydiseases  #renal  #renalpath  #renalpathology  #kidney  #microscopy  #medicine  #nephrologist  #kidney  #CKD  #AKI  #CKD  #ESKD  #nephrocalcinosis  #nephropathy 
I am so grateful for this opportunity to get to know all of you. Thanks a million for being very nice to me. Hope to see you again someday. #nephrologist #renalunit #elective #ชาวไต #workmode #มาทำงานจริงๆนะ
Carter greeted Professor Craig yesterday the same way he did 6 months ago(pictured) 😫😂 He’s the man who was there from the beginning. The man who saved Carter’s life together with his incredible team of doctors and surgeons.The man who we still see regularly for follow ups . The man who himself can’t believe that this is the same little baby boy. That little baby boy who had small chances at life in those early days. That little boy who’s now not so little anymore , full of energy , thriving and looking as big as a 3yr old when he’s not even 2. 
Carter may not realise or show much gratitude to this man yet, but there will come a day where he’ll greet him with a strong handshake and admiration as his real life hero 🙏🏻 #thankyoudoc #forevergrateful #reallifehero #lifesaver #Cartersdoctor #kidneybaby #kidneybabymomma #ckd #nephrologist #nephrectomysurvivor #onekidneybaby #toomanybattlescars #fighter
Carter greeted Professor Craig yesterday the same way he did 6 months ago(pictured) 😫😂 He’s the man who was there from the beginning. The man who saved Carter’s life together with his incredible team of doctors and surgeons.The man who we still see regularly for follow ups . The man who himself can’t believe that this is the same little baby boy. That little baby boy who had small chances at life in those early days. That little boy who’s now not so little anymore , full of energy , thriving and looking as big as a 3yr old when he’s not even 2. Carter may not realise or show much gratitude to this man yet, but there will come a day where he’ll greet him with a strong handshake and admiration as his real life hero 🙏🏻 #thankyoudoc  #forevergrateful  #reallifehero  #lifesaver  #Cartersdoctor  #kidneybaby  #kidneybabymomma  #ckd  #nephrologist  #nephrectomysurvivor  #onekidneybaby  #toomanybattlescars  #fighter 
Nothing like a little doggie bag from quest to go with my matcha latte? Matcha latte-Almond milk, one sweet and low and no additional sugars about 18-20g of carb but please check it for yourself. There is sugar in their matcha powder. Current blood sugar is 73➡️ My mom and I call this "73 steady." So that arrow on my dexcom means I'm holding that blood sugar. Not for long though I need to eat...
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So back to the doggie bag. Since my kidney doctor (nephrologist) is at Cedar Sinai over an hour away from my house I decided to switch it up. Usually I go and give urine and blood at my doctors office and he calls me the next day with the results. I asked the nurse if I could get the blood work done and then talk to him. She says "Oh sure! We usually do that for our established patients!" (She's always super happy😃😃😃) And I'm thinking...I've been coming here over a year so wasn't I established awhile ago? lol I didn't say anything I'm like okay good to know. I get to Quest and show them my email from my nurse and the front office girl says "oh, we don't take personal emails." For the love of god, fine! So my nurse sent it over and they took 5 vials from me. The phlebotomist was good so I'll definitely request her again. But because my kidney disease is so advanced I don't urinate very often. Once when I wake up and twice at night. Hence my doggie bag. So if I can't pee by 4pm then I refrigerate it and bring it back in the am. I'll see the kidney doctor next week on the 19th to go over my labs and see if I'm holding 22% kidney function or if my decline is continuing.  I have reached a point of acceptance for where I'm at.  I feel less scared then before. I'm like okay. I'll be okay. I'll get through this.Lets do this! 🙋✌🏼💙⭐️
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#kidneys #kidneydisease #kidneytreatment #kidney #nephrologist #ckd #kidneydisease #stage4 #pancreas #diabetic #diabetes #type1 #typeone #diabetesawareness #diabetescomplications
Nothing like a little doggie bag from quest to go with my matcha latte? Matcha latte-Almond milk, one sweet and low and no additional sugars about 18-20g of carb but please check it for yourself. There is sugar in their matcha powder. Current blood sugar is 73➡️ My mom and I call this "73 steady." So that arrow on my dexcom means I'm holding that blood sugar. Not for long though I need to eat... . . . So back to the doggie bag. Since my kidney doctor (nephrologist) is at Cedar Sinai over an hour away from my house I decided to switch it up. Usually I go and give urine and blood at my doctors office and he calls me the next day with the results. I asked the nurse if I could get the blood work done and then talk to him. She says "Oh sure! We usually do that for our established patients!" (She's always super happy😃😃😃) And I'm thinking...I've been coming here over a year so wasn't I established awhile ago? lol I didn't say anything I'm like okay good to know. I get to Quest and show them my email from my nurse and the front office girl says "oh, we don't take personal emails." For the love of god, fine! So my nurse sent it over and they took 5 vials from me. The phlebotomist was good so I'll definitely request her again. But because my kidney disease is so advanced I don't urinate very often. Once when I wake up and twice at night. Hence my doggie bag. So if I can't pee by 4pm then I refrigerate it and bring it back in the am. I'll see the kidney doctor next week on the 19th to go over my labs and see if I'm holding 22% kidney function or if my decline is continuing. I have reached a point of acceptance for where I'm at. I feel less scared then before. I'm like okay. I'll be okay. I'll get through this.Lets do this! 🙋✌🏼💙⭐️ . . #kidneys  #kidneydisease  #kidneytreatment  #kidney  #nephrologist  #ckd  #kidneydisease  #stage4  #pancreas  #diabetic  #diabetes  #type1  #typeone  #diabetesawareness  #diabetescomplications 
Today I completed my third and last physiology exam for the fall semester. This exam covered the Kidneys and all their wonderment.  Just a reminder for optimal kidney health: exercise regularly, monitor blood pressure , keep blood sugar ❌ 🍬 🍭 in control, maintain a healthy fluid intake, keep your OTC 💊 to a minimum and 🚫🛑 smoking . Be good to your body and it will be good to you #urinemythoughts #medicalhumor #cornyjoketime
Today I completed my third and last physiology exam for the fall semester. This exam covered the Kidneys and all their wonderment. Just a reminder for optimal kidney health: exercise regularly, monitor blood pressure , keep blood sugar ❌ 🍬 🍭 in control, maintain a healthy fluid intake, keep your OTC 💊 to a minimum and 🚫🛑 smoking . Be good to your body and it will be good to you #urinemythoughts  #medicalhumor  #cornyjoketime 
Dr.Anastasiia,a pediatrician and nephrology resident from Russia😊 
#doctor #doc #nephrologist #medstudents #medical #instafollow #resident #docsclub #indtagood #instagramers #kidney #kidneyteam #residency #nephrology
Cuando el Nefro se junta con gente decente #doctors #nephrology #nephrologist #surgery #surgeon #traumatology
At my favorite doctor's office!!! I love him so much. We have the best Patient/Doctor relationship.👨🏻‍⚕️
At my favorite doctor's office!!! I love him so much. We have the best Patient/Doctor relationship.👨🏻‍⚕️
Good health and good sense are two of life’s greatest blessings. 
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#nephrology #nephrologist #health #maxhospital #apollohospitalsdelhi #novahospital #medantahospital
#progresspic From 3k mg per day to 1k of #cellcept (#mycophenolate) 🙌🏾🙌🏾. This med is an #immunosuppressant that has aided in returning my #kidneys back to full functionality. This gift is also a curse that comes with very frequent vomiting, nausea and diarrhea. My #nephrologist wants to continue it’s use past our initial end date 😔. I’m not ok with that. It’s my desire to be prescription drug free sooner than later.  Stay tuned... (not pictured: #plaquenil #vitamind) #lupusawareness #kidneydisease
#progresspic  From 3k mg per day to 1k of #cellcept  (#mycophenolate ) 🙌🏾🙌🏾. This med is an #immunosuppressant  that has aided in returning my #kidneys  back to full functionality. This gift is also a curse that comes with very frequent vomiting, nausea and diarrhea. My #nephrologist  wants to continue it’s use past our initial end date 😔. I’m not ok with that. It’s my desire to be prescription drug free sooner than later. Stay tuned... (not pictured: #plaquenil  #vitamind ) #lupusawareness  #kidneydisease 
How to guide at CureComms.com/medical-content-steps/
How to guide at CureComms.com/medical-content-steps/
#doctor #nefrologo #nephrologist #beard #barba #oso #bear Noche de trabajo...todo por lograr las metas.
This study by Charmaine E. Lok (@uoft) et al of non−dialysis-dependent and dialysis-dependent patients requiring vascular access found that an upper-extremity ateriovenous fistula (AVF) can be reliably and safely created using a minimally invasive radiofrequency magnetic catheter−based system. 98% of endovascular AVFs were successfully created, 87% were deemed physiologically suitable for dialysis (within 3 months), and 64% were functionally used for dialysis (within 12 months).
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Visual Abstract by @jtopf for Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis Access (#OpenAccess; link in profile)
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DOI: 10.1053/j.ajkd.2017.03.026 (Oct 2017)
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#AJKD #visualabstract #nephrology #renal #kidneydiseases #medicine #nephrologist #hemodialysis #kidney #ESRD #AJKDvisualabstract #endovascular
This study by Charmaine E. Lok (@uoft) et al of non−dialysis-dependent and dialysis-dependent patients requiring vascular access found that an upper-extremity ateriovenous fistula (AVF) can be reliably and safely created using a minimally invasive radiofrequency magnetic catheter−based system. 98% of endovascular AVFs were successfully created, 87% were deemed physiologically suitable for dialysis (within 3 months), and 64% were functionally used for dialysis (within 12 months). . Visual Abstract by @jtopf for Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis Access (#OpenAccess ; link in profile) . DOI: 10.1053/j.ajkd.2017.03.026 (Oct 2017) . #AJKD  #visualabstract  #nephrology  #renal  #kidneydiseases  #medicine  #nephrologist  #hemodialysis  #kidney  #ESRD  #AJKDvisualabstract  #endovascular 
"I enjoy developing strong, long-term relationships with #patients and improving the #kidney care we deliver while reducing the time spent in #hospital." - Albert Power, #Consultant #Nephrologist and Strategic Director for #Vascular, #Renal and #Transplant.

#NBTproud

#NHS #hospital #SouthmeadHospital #Bristol #BristolIGERS
👨🏼‍⚕️🚑🏨💉 #work #hospital #doctor #nephrology #nephrologist #dialisys #white #health #life #kidney #mylife #happy
#LongDay at Work. #doctors life #nephrologist
#doctor #nefrologo #nephrologist #beard #barba #glasses ¡último día de la semana, y el mas pesado del año, pero a darle con una sonrisa!
Heyy Guys! Today was Appointment number 2. My Rheumatologist. This appointment went alright. As far as the pain goes I can’t do much. He is going to take a look at my right hip so that my surgeon can take a look and see if we can hold off and not have to do the right hip anytime soon. Because of the prednisone, you never know what damage it has really left. We changed or rather added a Med, one I had taken before for a long time. 
Here’s too a steady, health winter, until I see him again. New video up on my youtube channel, link in Bio 
#nephrology #nephrologist #kidneyspecialist #kidneys #rheumatology #rhuemotolgist #rheumatoidarthritis #lupus #lupusawareness #livinglupie #lupussle #lupusnephritis #sle #nephritis #achilliestendon #avascularnecrosis #hipreplacement #prednisone #myfortic #hydroxychloroquine #plaquenil
#independentscentsyconsultant 
#walkforlupusontario #walkforlupusontario2018
Heyy Guys! Today was Appointment number 2. My Rheumatologist. This appointment went alright. As far as the pain goes I can’t do much. He is going to take a look at my right hip so that my surgeon can take a look and see if we can hold off and not have to do the right hip anytime soon. Because of the prednisone, you never know what damage it has really left. We changed or rather added a Med, one I had taken before for a long time. Here’s too a steady, health winter, until I see him again. New video up on my youtube channel, link in Bio #nephrology  #nephrologist  #kidneyspecialist  #kidneys  #rheumatology  #rhuemotolgist  #rheumatoidarthritis  #lupus  #lupusawareness  #livinglupie  #lupussle  #lupusnephritis  #sle  #nephritis  #achilliestendon  #avascularnecrosis  #hipreplacement  #prednisone  #myfortic  #hydroxychloroquine  #plaquenil  #independentscentsyconsultant  #walkforlupusontario  #walkforlupusontario2018 
Who say when you're on #dialysis you can't stay fit? Well... You could! Just make sure that your fistula is matured and you do regular fist exercise and you may just be able to start with your regular #bicepscurls. Remember to only do 1kg or below, any more than that please consult your #nephrologist. 
#stillgoingstrongmy #fistula #gym #workout #physicalexercise #asians #asianboy #hemodialysis
Our amazing Transplant team of Surgeons, Nephrologists, Social workers and Nurses at the University of Michigan Hospital🏨💚♻️👩‍⚕️👨‍⚕️.
As a recipient I couldn't be more happier with my choice of going with this Transplant center🙆‍♀️
I remember I use to make calls to other tranplant centers while I was on dialysis with my 3 days a week for three and half hours treatments to see if they accept my insurance first of all and to see their protocols on transplant process, surgery procedure and their anti-rejection med therapy💊📱
Along with my preferences I also wanted to find out how they will accommodate my donor sister since my sister lives in Texas and she would have to travel to Michigan for our transplant surgery.✈🏨
Looking back⬅️now we both can say we were very happy with our pre and post transplant surgery  experiences as kidney donor and kidney recipient patients!👭😊✌ #transplant #kidneytransplant #uofmhospital #surgeon #nephrologist #nephrology #nurse #socialworker #michigan #texas #kidneydonors #kidneyrecepient #patients #storyof2sisters
Our amazing Transplant team of Surgeons, Nephrologists, Social workers and Nurses at the University of Michigan Hospital🏨💚♻️👩‍⚕️👨‍⚕️. As a recipient I couldn't be more happier with my choice of going with this Transplant center🙆‍♀️ I remember I use to make calls to other tranplant centers while I was on dialysis with my 3 days a week for three and half hours treatments to see if they accept my insurance first of all and to see their protocols on transplant process, surgery procedure and their anti-rejection med therapy💊📱 Along with my preferences I also wanted to find out how they will accommodate my donor sister since my sister lives in Texas and she would have to travel to Michigan for our transplant surgery.✈🏨 Looking back⬅️now we both can say we were very happy with our pre and post transplant surgery experiences as kidney donor and kidney recipient patients!👭😊✌ #transplant  #kidneytransplant  #uofmhospital  #surgeon  #nephrologist  #nephrology  #nurse  #socialworker  #michigan  #texas  #kidneydonors  #kidneyrecepient  #patients  #storyof2sisters 
"As weeks passed the pediatrician noticed that Kareem was not gaining weight despite avid nursing. He had also stopped pooping. He would poop 1 time every 10 ten days, very uncommon for a newborn/infant.  I had mentioned that we had a family history of what is called diabetes insipidus (which we didn't know anything about), but I was dismissed several times because it is so rare. By 3 months old Kareem had only gained 1 lb and a couple ounces. That was when his pediatrician finally decided to admit him to the children's hospital for failing to thrive. .
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Once we were admitted I had mentioned diabetes insipidus again, and following a blood and urine test he was able to be diagnosed that night. But that was only the beginning. That hospital stay consisted of a stay in the PICU, blood tests every 4 hours for 2 weeks, a blood transfusion, and a feeding tube. Kareem was diagnosed with Nephrogenic diabetes insipidus. This is a rare genetic chronic kidney condition. The stats for people having this are about 1 in 500,000. Most Dr.'s will never see a case of it in their career unless they are a nephrologist and work primarily with the kidneys. In people with NDI the kidneys don't respond to the ADH hormone that the pituitary gland produces telling the body to hold on to fluids to avoid dehydrating. His kidneys basically flush out any fluids put into the body. Their kidneys also don't filter out excess salts and sugar from the body which causes sodium to concentrate in the blood and can cause dehydration. This condition is especially hard on babies their first year of life because their main source of nourishment is a fluid (milk). Kareem got a G tube placed at 5 months old to help aid in his nutrition and help him grow.
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One of the positive things about this specific condition is that NDI patients can naturally balance their sodium levels by drinking water. Water is literally their life line. Because of the sodium concentration in their blood, it tells the body, I am thirsty and drink more water. Kareem is 16 months old and drinks about 80-90 oz of water a day and we go through about 170 diapers a week! His condition is managed by...(continued ⤵️)
"As weeks passed the pediatrician noticed that Kareem was not gaining weight despite avid nursing. He had also stopped pooping. He would poop 1 time every 10 ten days, very uncommon for a newborn/infant. I had mentioned that we had a family history of what is called diabetes insipidus (which we didn't know anything about), but I was dismissed several times because it is so rare. By 3 months old Kareem had only gained 1 lb and a couple ounces. That was when his pediatrician finally decided to admit him to the children's hospital for failing to thrive. . . Once we were admitted I had mentioned diabetes insipidus again, and following a blood and urine test he was able to be diagnosed that night. But that was only the beginning. That hospital stay consisted of a stay in the PICU, blood tests every 4 hours for 2 weeks, a blood transfusion, and a feeding tube. Kareem was diagnosed with Nephrogenic diabetes insipidus. This is a rare genetic chronic kidney condition. The stats for people having this are about 1 in 500,000. Most Dr.'s will never see a case of it in their career unless they are a nephrologist and work primarily with the kidneys. In people with NDI the kidneys don't respond to the ADH hormone that the pituitary gland produces telling the body to hold on to fluids to avoid dehydrating. His kidneys basically flush out any fluids put into the body. Their kidneys also don't filter out excess salts and sugar from the body which causes sodium to concentrate in the blood and can cause dehydration. This condition is especially hard on babies their first year of life because their main source of nourishment is a fluid (milk). Kareem got a G tube placed at 5 months old to help aid in his nutrition and help him grow. . . One of the positive things about this specific condition is that NDI patients can naturally balance their sodium levels by drinking water. Water is literally their life line. Because of the sodium concentration in their blood, it tells the body, I am thirsty and drink more water. Kareem is 16 months old and drinks about 80-90 oz of water a day and we go through about 170 diapers a week! His condition is managed by...(continued ⤵️)
Busy, expensive and very worthwhile day so far... #doctorday #endocrinologist #nephrologist #psychiatrist
Appointment number 1 done. Nephrologist to check my kidneys. We have been keeping a close eye because I have been losing protein which isn’t good. Appointment went well. New dose seems to be working. Even with my flakiness. I will do a video update after my next appointment. So stay tuned 😉  Now for some pampering thanks to mama #nephrology #nephrologist #kidneyspecialist #kidneys #lupus #lupusawareness #livinglupie #lupussle #lupusnephritis #sle #nephritis #swollenankles #fatfeet #prednisone #myfortic #pedicure #mommyandmetime #pampered
Appointment number 1 done. Nephrologist to check my kidneys. We have been keeping a close eye because I have been losing protein which isn’t good. Appointment went well. New dose seems to be working. Even with my flakiness. I will do a video update after my next appointment. So stay tuned 😉 Now for some pampering thanks to mama #nephrology  #nephrologist  #kidneyspecialist  #kidneys  #lupus  #lupusawareness  #livinglupie  #lupussle  #lupusnephritis  #sle  #nephritis  #swollenankles  #fatfeet  #prednisone  #myfortic  #pedicure  #mommyandmetime  #pampered 
It’s that time again, had to fill that big jug of mine to check my kidneys, and blood work to follow as usual. I can wake up and my ankles will be small and normal, but as long as I have been sitting up for a couple hours they just start to swell. Have both of my follow up appointments this week, Nephrologist and Rheumatologist. Good thing, because I need to see my Rheumy, I don’t know if it is just the weather, but My Achillies Tendon hurts so bad I can barely walk on it, or I do and have excruciating pain. I hope we can cut down the prednisone as well, here’s to hoping! The Myalgia pain I am having has been pretty bad so hopefully I can get something else for that because the cymbalta was a no go for me. Stupid meds, just end up messing you up in others ways. This is why medicating naturally is the way to go.  #bloodwork #24hoururinecollection #nephrology #nephrologist #kidneyspecialist #kidneys #rheumatology #rhuemotolgist #rheumatoidarthritis #lupus #lupusawareness #livinglupie #lupussle #lupusnephritis #sle #nephritis #achilliestendon #swollenankles #fatfeet #fibromyalgia #cymbalta #prednisone
It’s that time again, had to fill that big jug of mine to check my kidneys, and blood work to follow as usual. I can wake up and my ankles will be small and normal, but as long as I have been sitting up for a couple hours they just start to swell. Have both of my follow up appointments this week, Nephrologist and Rheumatologist. Good thing, because I need to see my Rheumy, I don’t know if it is just the weather, but My Achillies Tendon hurts so bad I can barely walk on it, or I do and have excruciating pain. I hope we can cut down the prednisone as well, here’s to hoping! The Myalgia pain I am having has been pretty bad so hopefully I can get something else for that because the cymbalta was a no go for me. Stupid meds, just end up messing you up in others ways. This is why medicating naturally is the way to go. #bloodwork  #24hoururinecollection  #nephrology  #nephrologist  #kidneyspecialist  #kidneys  #rheumatology  #rhuemotolgist  #rheumatoidarthritis  #lupus  #lupusawareness  #livinglupie  #lupussle  #lupusnephritis  #sle  #nephritis  #achilliestendon  #swollenankles  #fatfeet  #fibromyalgia  #cymbalta  #prednisone 
Learn the value of very low protein diet + supplementary of ketoanalog for esrd pts....while lunch served with very high protein menu ....then we know how difficult it is....
#nephrology #nephrologist #nephrologistlife #renalnutrition #stayhealthy
Dinner with nephrologists from around🇰🇿🇨🇦🇮🇷🇨🇷🇱🇷🇱🇦🇸🇱 #nephrologist#youngnephrologists#lisbon
Myoglobin cast nephropathy with reddish globular casts in distal tubule with associated acute tubular injury (hematoxylin and eosin stain).
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Rhabdomyolysis, characterized by necrosis of muscle cells and the release of intracellular contents into the blood, is the etiology of acute kidney injury (AKI) in 7%-15% of all cases in the United States. Conversely, 15% to over 50% of patients with rhabdomyolysis develop AKI. Rhabdomyolysis is typically characterized by muscle pain, red-to-brown urine due to myoglobinuria, and elevated muscle enzymes, including creatine kinase (CK) in the blood. The severity of symptoms varies widely, and the condition may be asymptomatic in mild cases. Serum CK is usually at least 5 times the upper normal limit of normal, and is predominantly of the MM (skeletal muscle) fraction. It rises 2-12 hours after muscle injury and peaks in 1-3 days. Myoglobin has a shorter half-life than CK (2-3 hours) due to its rapid excretion and metabolism. Thus, CK levels may remain elevated in the absence of myoglobinuria. Urine dipstick is not specific, and turns positive for “blood” if myoglobinuria, hemoglobinuria, or hematuria is present. Higher levels of CK, volume depletion, sepsis, and acidosis increase the risk of AKI in patients with rhabdomyolysis. Most patients recover kidney function if the underlying cause can be treated, although kidney replacement therapy may be needed.
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AJKD Atlas of Renal Pathology: Myoglobin Cast Nephropathy (freely available online – link in profile)
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DOI: 10.1053/j.ajkd.2016.12.002 (Feb 2017)
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#AJKD #AtlasofRenalPathology #nephrology #kidneydiseases #renal #renalpath #renalpathology #kidney #microscopy #medicine #nephrologist #Rhabdomyolysis #AKI #myoglobinuria
Myoglobin cast nephropathy with reddish globular casts in distal tubule with associated acute tubular injury (hematoxylin and eosin stain). . Rhabdomyolysis, characterized by necrosis of muscle cells and the release of intracellular contents into the blood, is the etiology of acute kidney injury (AKI) in 7%-15% of all cases in the United States. Conversely, 15% to over 50% of patients with rhabdomyolysis develop AKI. Rhabdomyolysis is typically characterized by muscle pain, red-to-brown urine due to myoglobinuria, and elevated muscle enzymes, including creatine kinase (CK) in the blood. The severity of symptoms varies widely, and the condition may be asymptomatic in mild cases. Serum CK is usually at least 5 times the upper normal limit of normal, and is predominantly of the MM (skeletal muscle) fraction. It rises 2-12 hours after muscle injury and peaks in 1-3 days. Myoglobin has a shorter half-life than CK (2-3 hours) due to its rapid excretion and metabolism. Thus, CK levels may remain elevated in the absence of myoglobinuria. Urine dipstick is not specific, and turns positive for “blood” if myoglobinuria, hemoglobinuria, or hematuria is present. Higher levels of CK, volume depletion, sepsis, and acidosis increase the risk of AKI in patients with rhabdomyolysis. Most patients recover kidney function if the underlying cause can be treated, although kidney replacement therapy may be needed. . AJKD Atlas of Renal Pathology: Myoglobin Cast Nephropathy (freely available online – link in profile) . DOI: 10.1053/j.ajkd.2016.12.002 (Feb 2017) . #AJKD  #AtlasofRenalPathology  #nephrology  #kidneydiseases  #renal  #renalpath  #renalpathology  #kidney  #microscopy  #medicine  #nephrologist  #Rhabdomyolysis  #AKI  #myoglobinuria