Intravenous fluids in septic shock: should we be content with the blanket approach?
Recently, the findings of CLASSIC trial were published in the NEJM, which demonstrated that among adult patients with septic shock in the ICU, intravenous fluid (IVF) restriction did not result […]
Point-of-care ultrasound in Hyponatremia
Nephrologists are often consulted for evaluation of hyponatremia. While there can be a lot of causes, the basic approach to diagnosis is simple. First, look at serum osmolality. Serum sodium […]
Hemodynamic phenotypes in Nephrology
This table (from our KI reports article) summarizes common POCUS findings in various hemodynamic phenotypes that we encounter in day-to-day nephrology practice. Basic POCUS (without cardiac Doppler) cannot differentiate between […]
Multi-parametric POCUS approach in heart failure
Suggested pre-reading: Pump-pipes-leaks approach and VExUS review. A patient with known systolic heart failure (left ventricular ejection fraction ~20%) presented with shortness of breath after missing diuretics for a few […]
Do Sono-auscultation findings change with ultrafiltration?
An elderly patient on hemodialysis presents with worsening shortness of breath. His blood pressure at presentation is 195/110 mmHg. He did not miss any dialysis sessions but says that he […]
‘Pump Pipes Leaks’ model of fluid status assessment by the nephrologist
Fluid status assessment is very complex and currently, there is no gold standard to do this at the bedside. Over-reliance on a single parameter, whether a an element of history […]
ESRD patient with shortness of breath
A middle-aged patient on maintenance hemodialysis presents with shortness of breath. Patient was undergoing chemotherapy for a hematologic malignancy and compliant with dialysis sessions. Had normal ejection fraction on cardiology-performed […]
An intriguing tale of B-lines in a dialysis patient
Dr. X is rounding on an ESRD patient who initially presented with dyspnea after missing a dialysis (HD) session; underwent dialysis in the hospital. Pt asymptomatic at the time of […]
A case of cardiogenic pulmonary edema
Nephrology was consulted for acute kidney injury and hypervolemia in a chronically ill nursing home resident. You decide to perform lung POCUS to assess extravascular lung water. Multiple B-lines per […]