WardSpace by Mediverse

Nephrology

AKI, CKD, electrolytes, acid-base, and the urine that tells the story.

Presentations

Acute kidney injury Peripheral edema Polyuria & polydipsia Dysuria

Ward cases

Weakness and palpitations

A 58-year-old arrives too weak to climb his stairs, with a heart that feels 'wrong'.

Rigors and a loin that will not be touched

A 52-year-old arrives shaking, febrile, and guarding her left flank from the examining hand.

Interpretation drills

LabsSodium 118 in a comfortable patient LabsWeakness with a potassium of 7.1 LabsA creatinine that keeps climbing LabsFound on the floor Blood gasThe water tablet's chemistry UrineUrine electrolytes in AKI UrineThe SIADH urine UrineRed cell casts UrineFrothy urine and fatty casts UrineColic and isomorphic hematuria ECGECG changes of hyperkalemia CompareNephritic vs nephrotic

Illness scripts

Nephritic syndrome Nephrotic syndrome

Tools & pathways

CalculatorCorrected calcium CalculatorCorrected sodium in hyperglycemia CalculatorFENa / FEUrea CalculatorCreatinine clearance (Cockcroft-Gault)AlgorithmHyponatremia AlgorithmHyperkalemia AlgorithmAcute kidney injury

From the library

Urine microscopy showing several muddy brown granular casts — Muddy brown granular casts: the sediment of acute tubular necrosis. This field, in an oliguric patient with a rising creatinine, moves the diagnosis from prerenal to intrinsic.Ajay Kumar Chaurasiya, via Wikimedia Commons · CC BY 4.0 · source

Urine microscopy showing envelope-shaped calcium oxalate dihydrate crystals — Calcium oxalate dihydrate: the envelope, a square with its diagonals drawn. Common in concentrated urine and in stone formers; in numbers after an ethylene glycol ingestion.Ajay Kumar Chaurasiya, via Wikimedia Commons · CC BY-SA 4.0 · source

Urine microscopy showing a single coarse granular cast — A coarse granular cast: a tubular mould packed with degenerated cell debris. One is a hint; many, pigmented, are acute tubular injury.Ajay Kumar Chaurasiya, via Wikimedia Commons · CC BY-SA 4.0 · source

Urine microscopy showing clumps of amorphous urate crystals — Amorphous urates: granular pinkish clumps in acid, concentrated or cooled urine. Usually a red herring, unless the story is tumour lysis.Ajay Kumar Chaurasiya, via Wikimedia Commons · CC BY-SA 4.0 · source

Hyperkalemia, rendered live

Peaked T waves with a widening QRS: the ECG nephrology cannot ignore.