Category: Nephrology

The dangerous medical liaison

She placed the stack neatly aside with all forms diligently signed and dated. The inbox was cleared. Being finally rested, her tasks of staying on top of duties and focusing on executions became briefly easier. A few patient callbacks, an eight-page di…

What’s the biggest lesson of intern year?

Even during medical school, there was always the running joke about getting kidney stones. With the frenetic pace of many rotations, it was always difficult to squeeze in bathroom time, and I suspect many of us adopted the same solution – drink less wa…

Pay people for their kidneys? It’s time.

These are trying times for health care optimists. Despite all the hype surrounding breakthroughs in clinical practice and technology, American medicine is stuck in in neutral. Though the engine is revving loudly, little progress is being made. This unf…

Kidney disease patients deserve better, and so do their doctors

World Kidney Day reminds us of the 850 million people globally affected by kidney diseases. It draws attention to the 1 in 7 American adults managing Chronic Kidney Disease (CKD) and the 660,000 Americans with end-stage renal disease (ESRD). It also re…

Every physician will kill a patient

How did I miss his hypokalemia? Two weeks into my intern year and my patient’s potassium returned at 2.9. Minutes later, he coded. And I felt responsible. As I explained to my partner how my patient had become pulseless after diuresis of his heart fail…

A shortage of Kayexalate leads to an ER visit

Last week I had a patient with mild kidney disease and a high potassium. I thought that it would be easy to take care of. We called around to all the pharmacies from Bangor to Ellsworth to Belfast, and nobody had Kayexalate, the time-tested antidote, i…

In medicine, what’s in a name?

Before I could see her, I could hear her. My patient, a young woman with messy braided hair, was grunting with every effort to breathe. The noises quieted slightly when I reached her bedside, but her tears continued to fall between gasps. Her body move…

Nocturia: the underdiagnosed condition patients find extremely distressing

As a family physician, I treat patients of all ages – children to those nearing 100 years old. One issue that plagues young and old alike is lack of sleep. In fact, according to the Centers for Disease Control and Prevention’s (CDC) 2016 Morbidity and …

MKSAP: 53-year-old woman with hypertension and chronic active hepatitis B infection

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 53-year-old woman is evaluated during a routine follow-up visit. Medical history is significant for hypertension and chronic active hepatit…

A surgeon mistakes a kidney for a tumor. How can this happen?

A number of media outlets recently featured a story about a Florida general surgeon who removed a normal kidney from a woman who was undergoing spine surgery. How could this have occurred? The 51-year-old patient who had been injured in a car crash was…