Nephrology Commons^™

Significance Of Chronic Kidney Disease On Morbidity And Mortality In Hospitalized Patients With Covid-19, Varsha Suresh, Alexis Finer, Aarushi Varshney, Kay Thi Khine, Ishak Mansi, Abdo Asmar

HCA Healthcare Journal of Medicine

Background

Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19.

Methods

We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, …

Metformin-Associated Lactic Acidosis: A Case Report, Joshua Santoli, Jamie Lee Aldakkour, Hossein Tohidi, Yizhi Lin

HCA Healthcare Journal of Medicine

Introduction

Metformin is considered a first-line therapy for patients with diabetes secondary to its cost efficiency, minimal side effects, and marked improvement in one’s hemoglobin A1c; however, metformin is avoided in patients with renal insufficiency out of concern for drug accumulation and lactic acidosis. In fact, there is a black box warning for metformin, identifying lactic acidosis as the inciting trigger for fatal arrhythmias and death.

Case Presentation

A 62-year-old male presented with multiple episodes of nausea, vomiting, abdominal pain, and decreased urine output for 3 days after working on a roof, all day in the summer heat. He did …

Calciphylaxis, A Case Series: The Importance Of Early Detection, Nikita Sijapati, Suy Sen Hung Fong, Omar Ansari, Subhasis Misra, Edgar Mercado, My Myers, Vijay Narasimha

HCA Healthcare Journal of Medicine

Introduction

Calciphylaxis is a rare disorder that involves the formation of cutaneous, subcutaneous, and vascular calcifications. Although it is predominantly seen in patients with end-stage renal disease (ESRD), it has also been reported in patients without chronic kidney disease. The presence of multiple risk factors, a poorly understood mechanism, high mortality, and the lack of standardized treatment make calciphylaxis an important subject.

Case Presentation

We describe the clinical presentation, disease course, and management of 3 patients with calciphylaxis and also provide a literature review. In all 3 patients, the diagnosis was confirmed histologically, and the management involved the continuation of …

Free Silicone-Induced Granulomatosis And Hypercalcemia In A Transgender Female, Brian L. Pando, Benjamin Goldsmith, Adam Lane Webb, Komal Kinger, Brian Helmly

HCA Healthcare Journal of Medicine

Introduction

Vitamin D derangements are a rare but important cause of hypercalcemia. Granulomatous disease is a primary cause of vitamin D derangements and is frequently associated with sarcoidosis, tuberculosis, and in the present case, foreign body granulomatosis. Liquid or injectable silicone is used as a filler for cosmetic body contouring. Transgender patients may seek silicone injections as part of gender affirmation surgeries. Granuloma formation is a rare but well-described complication of injectable silicone.

Case Description

A 40-year-old, assigned male at birth (AMAB) transgender female patient, with a history of HIV and chronic kidney disease (CKD) stage 3b, was admitted to …

A Rare Case Of C3 Glomerulonephritis Presenting As Pulmonary Renal Syndrome, Gerardo Mederos, Harsh Patel, Menalee Hapuarachchi, Machaiah Madhrira, Ranjit Nair, Dana Ciobanu

HCA Healthcare Journal of Medicine

C3 glomerulonephritis (C3GN) is a rare disease that falls under the umbrella of C3 glomerulopathy (C3G). Classic manifestations of C3G include acute renal failure, proteinuria, and hematuria. In some cases, extrarenal manifestations can include ocular drusen. Until recent reports, C3G manifesting with pulmonary symptoms has not been reported. In this report, we describe a patient that initially presented with hemoptysis and acute renal failure, eventually leading to a diagnosis of pulmonary renal syndrome. Renal biopsy showed C3GN. The patient’s symptoms improved with pulse dose steroids, plasmapheresis and mycophenolate mofetil. C3G presenting with pulmonary symptoms is rare. Further research is needed …

Comparison Of The Performance Of The Ncdr Cathpci Score And Mehran Score To Predict Acute Kidney Injury Post-Percutaneous Coronary Intervention, Michelle Nguyen, S. Mustajab Hasan, Steven Quach, Sai Guduru, Faisal Rahim, Aiham Albaeni, Khalid Abusaada

HCA Healthcare Journal of Medicine

Background: A comparison of acute kindney injury (AKI) post-percutaneous coronary intervention (PCI) prediction models is lacking. In this study, we aim to compare the National Cardiovascular Data Registry (NCDR) CathPCI score to the Mehran score in acute coronary syndrome (ACS) vs non-ACS patients.

Methods: We included patients who received PCI at our facility between July 2015 and December 2017. We excluded patients without a pre- and/or post-PCI serum creatinine, patients on dialysis at the time of PCI and patients with missing variables required to calculate the predictive scoring model. The primary outcome of this study was AKI post-PCI. Performance of …

Systematic Survey Of Creatinine-Based Versus Cystatin C-Based Estimated Gfr In People With Diabetes, Sadik Acaralp, Hossein Akhondi

HCA Healthcare Journal of Medicine

Background: Diabetes is a common cause of kidney failure, and most anti-diabetic agents are excreted through the kidneys. Therefore, it is critical to adjust medication dosage and anti-diabetic agents based on kidney function. There are different methods to estimate kidney function, but the common practice is to use creatinine to estimate the glomerular filtration rate.

Objective: In this systematic review, we identify and review publications in order to assess differences between creatinine-based and cystatin C-based estimated glomerular filtration rates in diabetic patients.

Method: The articles were identified using 3 databases and were assessed for eligibility. A total of 4 articles …