REBOOT #145 Hepatorenal Syndrome

Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and produced by: Justin Berk MD, Nora Taranto MD Infographic by: Alex M @nephroguy Host: Matthew Watto MD Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials) Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD Show Segments NephMadness Kidney Pun Contest Disclaimer Intro, guest one-liners Case of acute kidney injury in a patient with cirrhosis Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium) History and physical in cirrhosis and AKI Fluid choice Diuretic therapy in cirrhosis and volume overload Is a Renal Ultrasound useful in AKI? Recap: the initial approach to AKI in cirrhosis Therapeutic trials when volume status is uncertain Hepatorenal physiology revisited Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine Type 1 versus type 2 hepatorenal syndrome Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?! Diagnostic criteria or HRS NephMadness matchups including bile cast nephropathy Outro Sponsors  Grammarly. Visit grammarly.com/curb for 20% off. Panacea Financial. Visit panaceafinancial.com a bank for doctors, by doctors.