#226

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium.

Listeners can claim Free CE credit through VCU Health at curbsiders.vcuh... (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [e-mail] | Free CME!

Credits Written (including CME questions) and Produced by: Cyrus Askin, MD Infographic by: Cyrus Askin, MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Joel Topf, MD
Sponsors Pediatrics On Call podcast by the American Academy of Pediatrics If you provide medical care to children, Pediatrics On Call - the new podcast from the American Academy of Pediatrics - will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here.

VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps 00:00 Sponsors - VCU Health CE and Pediatrics On Call podcast by APP 00:30 Intro, disclaimer, guest bio 03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame); 08:45 Sponsor - Pediatrics On Call podcast by APP 09:15 Definition of acute kidney injury (AKI) and fundamentals 11:00 Cardiorenal syndrome 12:24 Schema for AKI 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities 21:22 AKI in the otherwise-healthy patient; 32:20 Rhabdomyolysis38:21 Vancomycin 41:43 Acute interstitial nephritis (AIN) 44:52 Contrast induced nephropathy (CIN) 50:37 Gadolinium in AKI and/or CKD 52:53 Timing of dialysis 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors; 62:01 Is Ultrasound necessary in AKI 64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology 68:45 Outro and Sponsor - VCU Health CE
Links* Dr. Topf: Nephrology & Social Media - May 2020, Vol 50, Issue 3, p 247-328 of Seminars in Nephrology Dr. Topf: Zoe Keating - cellist & composer Dr. Topf: Mrs. America a miniseries which dramatizes the women’s movement and fight for and against the Equal Rights Amendment in the 1970s Dr. Williams: Last of Us 2
*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will develop a rational approach to the diagnosis and management of the patient with acute kidney injury (AKI).

Learning objectives After listening to this episode listeners will…
… be facile with the definition of AKI … have a framework for approaching AKI including an understanding of what features in a patient’s history may shed light on the diagnosis … appreciate prerenal azotemia and the relationship with ATN … develop an approach to rhabdomyolysis and AKI … be able to discuss the various types of AKI likely to be seen in the critically ill patient ... recognize the paradigm shift related to the safety when using iodinated contrast and gadolinium with regards to renal function … know common medications implicated in AKI … appreciate common AKI-related issues in the outpatient setting and have a head-start on how best to deal with them
Disclosures Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures.

Citation Topf J, Askin CA, Williams PN, Watto MF. “#226 Kidney Boy on Acute Kidney Injury: Myths & Musings”. The Curbsiders Internal Medicine Podcast. thecurbsiders..... Original Air Date: July 20th, 2020.

[@fadyhananias9760]

Great tips! Thank you so much!