EMCrit Podcast 242 – ED Nephrology with Joel Topf aka KidneyBoy - a podcast by Scott D. Weingart, MD FCCM
from 2019-03-09T23:30:39
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Joel Topf is a nephrologist in Detroit working for St Clair Specialty Physicians. He is faculty for the Nephrology Fellowship at St John Providence.
Blog: PBFluids.com
Twitter: @Kidney_Boy
Co-creator: NephMadness, Co-creator: NephJC, Co-creator: DreamRCT
The Case
* Tweetorial on the Case
* Slides for the Case
Hyponatremia
* Topf thoughts on DDAVP in hypoNa
* DDAVP clamp in hyponatremia
* EMCrit Intro to Hyponatremia
* Curbsiders Hyponatremia Episode
* IBCC Hyponatremia
* Taking control of severe hyponatremia with DDAVP
Joel admits elderly with Na < 130
Hypernatremia
* Make sure they are not DI and then replete their free water deficit
* Acetazolamide for Nephrogenic DI1
* Hypernatremia is a marker of poor quality ICU Care2
* EMCrit Hypernatremia Episode
* IBCC Hypernatremia
Hyperkalemia
Joel's Furosemide dose is Cr x 20
* Curbsiders on HyperK with Joel
* EMCrit HyperK
* IBCC HyperK
* Recent RCT on Kayexalate3
* The odds ratio for death was 10 at a potassium of 5.5 to 6 mEq/L. It rose to 31 for potassium above 6!4
Who Needs RRT?
* Is A,E,I,O,U still the answer?
*
AEIOU mnemonic for indications for emergent dialysis (from EM Cases)
Acidemia – pH<7.1 despite medical management
Electrolyte abnormalities – hyperkalemia refractory to medical management
Ingestion – nephrotoxic drug ingestion amenable to dialysis
Overload – volume overload resulting in respiratory failure
Uremia with bleeding, pericarditis or encephalopathy
More
* Get Joel's Free Electrolyte and Acid Base Book
Now on to the Podcast...
1.
Gordon CE, Vantzelfde S, Francis JM. Acetazolamide in Lithium-Induced Nephrogenic Diabetes Insipidus. N Engl J Med. 2016;375(20):2008-2009. doi:10.1056/nejmc1609483
2.
Polderman K, Schreuder W, Strack van, Thijs L.
Further episodes of EMCrit Podcast
Further podcasts by Scott D. Weingart, MD FCCM
Website of Scott D. Weingart, MD FCCM