Background: Patients with end stage renal disease (ESRD) are at significantly increased risk for both thrombosis and bleeding relative to those with normal renal function, which makes anticoagulation particularly challenging. Evidence suggests that rivaroxaban and dabigatran are associated with a higher risk of bleeding in ESRD patients. To date, no large national cohort studies have […]

Background: Since the start of the coronavirus disease 2019 (COVID-19) pandemic, millions have succumbed to the infection worldwide. The virus is most well-known for its devastating pulmonary and cardiovascular manifestations, but acute kidney injury (AKI) has been frequent as well (reported incidence ranging from 0.5% to 56.9%), and has been repeatedly observed to be associated […]

Case Presentation: A 73-year-old woman with past medical history of metastatic endometrial adenocarcinoma previously treated with Pembrolizumab (stopped 4 months prior) presented with six weeks of persistent fatigue, myalgias, nausea, and vomiting. On presentation, she was noted to be hypotensive with labs notable for hyponatremia and hypomagnesemia. She appeared lethargic with dry mucous membranes and […]

Case Presentation: A 35-year-old woman with a history of congenital renal dysplasia complicated by end stage renal disease (ESRD) on hemodialysis, chronic macrocytic anemia, and malnutrition with folate, vitamins B12 and A deficiencies, presented with fatigue, dyspnea, and new rash. One week prior to presentation, the patient started experiencing progressive dyspnea on exertion. At her […]

Case Presentation: A previously healthy 29-year-old woman was diagnosed with end-stage renal disease of unknown etiology and initiated on daily peritoneal dialysis. Patient reported poor compliance with this treatment regimen and, five months later, presented to the emergency department with non-productive cough and pleuritic chest pain. She was found to have left upper lobe pneumonia […]

Case Presentation: A 63-year-old male presents to the hospital with complaints of one-day history of weakness, dizziness. His outpatient blood work demonstrated a serum sodium level of 124 mEq/L, and a creatinine of 3.1 mg/dL. His medical history was significant for high-grade urothelial bladder carcinoma status post radical cysto-prostatectomy, neobladder urinary diversion, and MVAC (methotrexate, […]

Case Presentation: We present an 80-year-old female with a medical history significant for atrial fibrillation and heart failure with preserved ejection fraction. She underwent pulmonary vein isolation in 2017 and had reportedly been on flecainide 150 mg twice daily and atenolol 100 milligram twice daily since then. She presented to the emergency department with dyspnea […]

Case Presentation: An 81-year-old woman with a pertinent history of primary hypothyroidism and lung adenocarcinoma, treated with durvalumab, was admitted to the hospital in shock after being found lethargic, hypotensive, and hypoxic at home.Prior to admission, she developed weakness, fatigue, anorexia, vomiting, and diarrhea. She had recently been hospitalized with presumed septic shock attributed to […]

Case Presentation: A 68-year-old male presented to the hospital with declining mental status. His chronic medical conditions included stage IV renal cell carcinoma on nivolumab maintenance therapy, type II diabetes mellitus, chronic kidney disease, hypothyroidism on levothyroxine 150 mcg, and long-term opioid therapy for malignancy pain. He had a one-week duration of upper abdominal pain […]

Case Presentation: A 41 year-old female with a history significant for end stage renal disease (ESRD) secondary to focal segmental glomerulosclerosis (FSGS) on peritoneal dialysis for two years, uremic pericardial effusion with pericardiocentesis three years prior, and polyarticular gout on allopurinol presented as a transfer from an outside hospital for evaluation due to concerns for […]