Background: Peripherally inserted central catheters (PICCs) are associated with central vein stenosis and failure to establish a functioning arteriovenous fistula. Thus, guidelines recommend avoiding PICC placement when patients with chronic kidney disease (CKD) are likely to require hemodialysis. We sought to describe the current practice of PICC placement in hospitalized patients with an estimated glomerular [...]

Background: Constipation is a common pediatric complaint and cause of abdominal pain in the pediatric age group. Management for constipation is generally completed in the outpatient setting, but many patients may require inpatient management after failure of outpatient therapy. Methods: We utilized data from the 2012 Kids’ Inpatient Database (KID), a nationally representative sample of [...]

Background: Controversy still exists regarding the use of angiotensin axis blockade (AAB) with angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) drugs preoperatively. Multiple studies suggest the AAB results in acute kidney injury (AKI) (1,2), while other studies do not (3,4 ). Some studies suggest that the AKI associated with AAB is due [...]

Case Presentation: A 68-year-old Cambodian male with no known past medical history presented to the emergency department after experiencing three days of nausea and vomiting. The patient reported, prior to becoming ill, he went fishing for a couple of hours. Later in the day he consumed undercooked fish. Patient’s vital signs on admission were temperature [...]

Case Presentation: A 56 year-old woman with a history of untreated Hepatitis C, anal cancer status post chemotherapy and radiation, current IV heroin use, and MRSA tricuspid valve endocarditis presented with lethargy, jaundice, abdominal pain, oliguria, fevers and lower extremity swelling and rash. On arrival, she initially had fluid-responsive hypotension and fever up to 102. [...]

Case Presentation: A 64-year-old Pakistani man was referred to nephrology clinic for evaluation of progressive kidney disease. Relevant medical history included well-controlled type 2 diabetes mellitus, gout and hypertension. Six months prior to presentation his serum creatinine level was 2.9 mg/dL (eGFR 22 ml/min per 1.73m2), patient had been asymptomatic and had well-controlled co-morbidities without [...]

Case Presentation: A 46-year-old female presented for evaluation of two days of nausea and vomiting. She also described swelling in her legs and decreased urination over that time. Exam revealed blood pressure of 150/100 (baseline blood pressure 90/50), pitting lower extremity edema, taut skin of both hands, and bibasilar crackles. Labs revealed creatinine of 3.2 [...]

Case Presentation: A 66-year-old man with history of hypertension, gastroesophageal reflux disease, and hyperlipidemia presented with jaundice and one week of diarrhea with occasional hematochezia. In addition, he noted dark urine, decreased PO intake and appetite. On exam, he was jaundiced with scleral icterus. Lab work revealed acute kidney injury with initial creatinine level of [...]