musings of a salt whisperer
Nobel Prize When I was a resident UpToDate was still incomplete and work in progress. I was an early convert and fan. l had become a disciple of Rose of the Yellow Book. I remember talking with Sarah Faubel and she would convincingly argue that UpToDate is so important to medicine that Rose deserved the …
A randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes. F Perry Wilson, et al. Nature Communications 2023. Diagnostic Performance of Fractional Excretion of Sodium for the Differential Diagnosis of Acute Kidney Injury. Abdelhafez, Mohammad Et al. CJASN 2022. And the editorial by Seethapathy H, and Fenves AZ CJASN …
Today I was honored to give Medicine Grand Rounds at MedStar Health in Baltimore. Here is a wlk through and bibliography for this talk. Title slide. Slides are available for download at: Keynote What’s New in Nephron Town (31.7 MB) PowerPoint What’s New in Nephron Town (16.9 MB) Note: I create, rehearse and deliver the presentation in Keynote. The …
I have been workshopping this one for awhile in my mind and today I carved out a few hours to create it. It starts here Part of the inspiration for this came from an epic message on the Channel Your Enthusiasm back channel by Roger Rodby Here is the draft of the script. Diffusive vs …
Continue reading “New Tweetorial: Comparing diffusive versus convective clearance”
If you are taking the M2 renal class and are looking for a way to study while cleaning, exercising, walking the dog, or commuting, allow me to suggest a few podcasts that may be of interest. Curbsiders Podcast on rapid interpretation of ABGs Curbsiders #104: Renal Tubular Acidosis The Curbsiders: Hyponatremia Curbsiders: Hypernatremia Hyperkalemia with …
A number of years ago, I was invited to write a chapter introducing sodium and water for a new medical text book under the Scientific American brand. I remember being disappointed that I didn’t get hypo- or hypernatremia and being stymied for awhile before I figured out how I wanted to the topic. Ultimately, I …
I often get a call from a nurse saying something to the effect of, “Dr. Smith is ready to discharge this patient home as long as he is cleared by nephrology.” I will tell you, that the pre-test probability that I will “clear” the patient for discharge is high. I want patients to go home …
One of my favorite podcasts was Joane Robinsons and David Chen’s Game of Thrones recap podcast, A Cast of Kings. As I listened to it I wondered if the same idea could be used for medical textbook. To have people read the book together and have a monthly podcast that summarized and commented on each …
I received this DM today (my DMs are open. I was nervous about opening DMs but a year later I would rate the experiment as a delightful success. It has opened up Twitter to many new discussions that otherwise would not have occurred). Hi Dr. Topf, I’m a final year medical student from the UK. …
Continue reading “What books or resources should I use to learn nephrology?”
My team was consulted for acute kidney injury (AKI) and hyperkalemia. Before we saw the patient they had already been given the standard, calcium, bicarb, and insulin/glucose cocktail. This had no effect. Potassium went from 6.4 to 6.4. The patient was still making urine. The AKI was due to emergency surgery with an impressive estimated …