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 [...]

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: 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 [...]

Background: Medical Emergency Teams (METs) are utilized in an inpatient setting to identify patients who exhibit signs of clinical deterioration. Patients, family, or staff activate the team by calling a Code MET when there is a change in clinical status. Patients with End-Stage Renal Disease (ESRD) fare worse than age-, gender-, and race-matched populations. We [...]

Case Presentation: A 15 year-old female with developmental delay presents with intermittent abdominal pain, decreased appetite, and vaginal discharge. Parents disclose a 30 lbs weight loss over 2 years, along with vaginal discharge that was evaluated by self-swab testing and deemed a “normal variant” from menses. When she presented to her PCP’s office, she was [...]

Case Presentation: Our patient is a 42-year-old male with history significant for hypertension, end stage renal disease (ESRD) on hemodialysis (HD), anemia of chronic disease, renal osteodystrophy, and right wrist calciphylaxis who presented with worsening right wrist erythema and bleeding. Patient had reported non-compliance with his dialysis schedule and noted to have multiple previous admissions [...]

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 29 year-old-woman was found to have proteinuria on routine labs that later progressed over the next few months to nephrotic syndrome with worsening lower extremity edema. Her work up revealed a positive (antinuclear antibody) ANA titer of 1:640. However, her anti-dsDNA and serum complement levels were normal, and she did not meet [...]

Case Presentation: A 22-year-old male with no past medical history presented with a three-week history of a frontal headache associated with nausea and vomiting. He denied various symptoms, including bloody diarrhea, dysuria, or hematuria. He had no history of renal calculi, recent illness, antibiotic exposure, or drug allergies. He recently traveled to Jamaica and Florida [...]

Case Presentation: A 45-year-old woman presented to our hospital for evaluation of chronic kidney disease. Three years earlier, she had been diagnosed at an outside institution with Sjögren’s syndrome after developing sicca symptoms with positive anti-Ro/SSA, antinuclear antibody, and rheumatoid factor titers. Progressive renal insufficiency was noted soon after, but she was lost to follow-up [...]