Background: Many end stage renal disease (ESRD) patients present with complaints related to missed or incomplete hemodialysis (HD). Inpatient HD units often are not credentialed for outpatient use which results in extra cost and consumes additional resources for a standard outpatient procedure. Delays in patient throughput in emergency departments (ED) can cause boarding in the [...]

Case Presentation: A 66-year-old Hispanic male with a history of primary hypertension and type 2 diabetes mellitus presents to hospital with 3 months of progressive fatigue, poor appetite, watery diarrhea, dizziness, and vomiting. Vital signs were notable for postural hypotension (BP 146/84 sitting, BP 118/72 standing). Physical examination was normal with no skin or mucous [...]

Case Presentation: A previously healthy 4-year-old female born in Mexico was sent to the emergency department for elevated blood pressures noted at her routine outpatient clinic visit. On arrival, her blood pressure was 161/126. The patient reported polydipsia, polyuria, and weight loss. Her initial physical exam was unremarkable and her vitals were otherwise within normal [...]

Background: Acute kidney injury (AKI) following cardiac surgery occurs in 30% of cases with 1% requiring dialysis resulting in significant morbidity and mortality.  HMG-CoA Reductase Inhibitors (“statins”) have been postulated to be of benefit in this population, however results from existing clinical studies have been inconsistent. Since there is abundance of evidence showing that short-term [...]

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 [...]

Background: The novel coronavirus disease 2019 (COVID-19) has demonstrated a range of presentations and outcomes affecting multiple organ systems. Acute kidney injury (AKI) associated with hospitalized patients with COVID-19 and related outcomes vary widely according to early reports. This study aimed to determine the prevalence of AKI, AKI in the setting of chronic kidney disease [...]

Background: Paracentesis is a common procedure for patients with decompensated cirrhosis. In patients with cirrhosis and superimposed renal impairment, clinicians may hesitate to perform a large volume paracentesis, given concerns of intraabdominal fluid shifts resulting in further renal dysfunction. In this study, we aimed to answer whether greater ascites fluid removal was associated with 48-hour [...]

Background: End Stage Renal Disease carries a poor prognosis. Only half of dialysis patients are still alive three years after the initiation of renal replacement therapy. Furthermore, dialysis patients are hospitalized more often compared to the general population, averaging two admissions per year. We hypothesized that outcomes in dialysis patients are worse when they require [...]