Background: Our region has the lowest hospital bed per capita of any metropolitan area in the United States. Additionally, during the COVID-19 pandemic there have been outpatient dialysis chair shortages due to workforce staffing issues. This has led to many patients waiting weeks or even months in the hospital to secure a new chair for […]

Case Presentation: Our patient is a 65 year old male with history of end stage renal disease on hemodialysis, peripheral arterial disease complicated by bilateral below knee amputations, and type 2 diabetes mellitus admitted with limited flow on his right AV fistula. An IR fistulagram revealed moderate stenosis of the basilic vein outflow, and mild […]

Case Presentation: A 45 year old woman with a past medical history of ESRD on hemodialysis, antiphospholipid syndrome on warfarin, and type 2 diabetes presented with severe, diffuse, intermittent abdominal pain. Physical exam was notable for tender subcutaneous nodules in the lower abdomen associated with overlying violaceous patches and central necrosis. Labs were notable for […]

Case Presentation: A 20-year-old female with systemic lupus erythematosus and end stage renal disease (ESRD) secondary to lupus nephritis on hemodialysis via left upper extremity arteriovenous graft presented to the emergency department for pain, erythema, and swelling of the right inferior breast. She was initially treated for cellulitis with resolution of erythema and warmth of […]

Case Presentation: A 48-year-old female with a past medical history of opioid dependency and right hip arthroplasty presented with complaints of fevers and purulent drainage at her surgical site. Pertinent exam findings included fever, tenderness, and erythema on her right hip. Initial creatinine, bicarbonate, and magnesium were within normal limits. She underwent irrigation and debridement […]