Today in my city (Tobruk/Libya) we started the first CRRT and it was a successful experience for the ICU and Nephrology team. I’m grateful for what I learned in USA 🇺🇸
After 7 weeks of treatment with cyclophosphamide for primary membranous nephropathy my patient developed a very rare side effect of cyclophosphamide “bluish discoloration of nails”
@OchsnerNephro
After 20 days of respiratory distress from COVID19 my Mom today is being discharged home , thanks for all the medical staff , I can’t be more happier .
#Tobruk
#libya
I never seen this degree of severity for obstructive nephropathy . 4.3L of urine came out after Foley’s placement followed by gross hematuria. US showed B/L hydronephrosis . Patient presented to ED c/o extensive pruritus
#Tobruk
medical center
My dialysis patient who I saw today for the first time, I asked him do you have any questions for me ? he replied with “ let me see how good you are then I’ll have questions for you “. Fair enough 😁.
When a clinic patient says I think my back pain is kidney related , schedule his appointment with nephrologist by himself and the he is right 😬. No trauma. Perinephric hematoma, embolization was done for the active bleeding
correcting hypoNa in CRRT by using D5W as post filter RF to avoid over correction
D5W rate=[(140-target Na)/140]x desired clearance
e.g-pt wt.100kg & Na 115
Desired clearance is 25ml/kg/h =2500ml/h (2.5L/h),target Na 123
D5W rate=[(140-123)/140]x2.5= .303L/h(300ml/h)
Imagine this patient was referred to nephrology at the first presentation with hematuria before going through unnecessary cystoscopy and CT. Acanthocyte seen in the
#UrinarySediment
. GN work up in progress
Today we had a septic patient on high doses of pressors with AKI requiring SLED. SLED could not be continued as the dialysis machine started triggering the blood leak alarm, which persisted despite changing the dialysis machines multiple times.
Quick reminder on ANCA-associated vasculitis
* RTX or CYC are standard for renal AAV
* Plasma exchange considered in patients at greatest risk of ESKD
* Clinical trials support lower dose steroids regimens
* Avacopan is steroids sparing & improves renal outcomes
Great day
@OchsnerHealth
, Ochsner Kidney care open its first dialysis center with 36 beds. I like the interface device which is connected to each machine that can transfer all the dialysis treatment information to your EMR & the FaceTime room for sub specialty virtual visit .
COVID-19 cases in Tobruk/Libya, unfortunately they were unvaccinated. only one young patient survived and currently he is dependent on oxygen.
1. Is normal x ray
@doorva207
His name is Carl Girouard . Please stop spreading hate and getting to conclusions before the police . We are all against these acts regardless of the religions .
Tobruk German War Cemetery was built in the Shape of fortress. It contains 6,026 German burials from the Second World War.
Tobruk/Libya
Photo by : Sami Brydan
My recommendation for the trainees is: keep refreshing your skills of reading the basic of imaging findings by looking to the imaging slides
@OchsnerNephro
Patient with Proteinuria of 1 g , hematuria, positive MPO and elevated sCr post COVID-19 vaccine. kidney biopsy done today
@OchsnerNephro
#UrinarySediment
showing dysmorphic RBC with blebs from many sides . 👇🏽
Spinning the urine & looking to it under the microscope can dramatically change your management specially if you find something unexpected like in this patient with long history of DM & CKD found to have proteinuria, dysmorphic RBCs in the urine
#urinarySediemnt
#UrineMicroscopy
Glitter cells in the urine are viable and pale staining WBCs with cytoplasmic granular motility that depends on the low cytoplasm viscosity as occurs in hypotonic urine . Patient of
@SarahRosenbloo3
أخواني وزملائي في أمريكا .سأقوم بجمع التبرعات شخصيًا لأهلنا المتضررين في ليبيا .كل من يريد التبرع يتواصل معي للمعلومات البنكية .سأقوم يوميا بنشر المبلغ الذي وصلنا لتجميعه وبأذن الله في نهاية الحملة سيتم إيصال المبلغ إلى أخوة في طبرق لا أزكيهم على الله لتوزيع المبالغ للمتضررين