Yup, and yet CKD is a major risk factor for AKI!

True, improving pre-renal can also be clinically hard to tell apart from recovering ATN depending on when they present.

Ha, I did think of that and downgraded my language to "most" :)

Hang on let me write this down:
"prescribe more ACEi, fewer snakebites." OK, got it!

With the PTH not super elevated I imagine there's less risk for adynamic bone dz with a bisphosphonate. Although, I'm unsure of the target iPTH when using it for 1°HPT. Looks like I'm d/t do some reading. :)

Either way would be risk/benefit discussion with the patient about the unclear risk and benefit and make the decision together.

My $0.02: your patient doesn't fit neatly into any trials. Benefit unclear but maybe a 24h uCa & see if the hypercalciuria is resolved?

Figure if high bonr turnover...Ca has to go somewhere, right?

If PTH still overly active I'd favour cinacalcet but PO bisphos probably reasonable (& titratable)?

What's the weather like up there?

I'm curious if the CKD4 patients had a higher eGFR Cr-Cys C? Would be nice to see new safety data with updated assessment methods!

Egophony is just sound. I wonder if there's a Doppler equivalent on POCUS?

Dad jokes are pretty benign.

I swear the word "spellcheck" was in there somewhere

What I can't seem to do is my posts prior to posting them...

It's been a long time comung, but at our lab we just implemented a cystatin C panel. It adds a Cr automatically and outputs a calculated eGFR Cr-Cys C automatically!

Since the Cr is the cheaper test it makes sense to add it on in most cases.

Done. Let me know your thoughts.

(6) The authors proposed comparing ABG/BMP might help diagnose equipment errors.

My conclusion: both methods have potential pitfalls For bizarre results, checking against the *other* method might help confirm that it's real (both directions!).

Oh and definitely check an ABG in a lipidemic pt :)

(4, cont'd) the agreement between chem panels and ABGs seems to vary by device and lab methods used, but in the quoted study they agreed in ~95% & ~99% for ±2 & ±3 mmol/L (respectively).
(5) Common pre-prep errors were trialed and it didn't seem to effect the results by much.
(6) →

(3) This covers the case where there are ↑triglycerides, but doesn't really say which is more accurate in general.

*** many pubmed searches later ***

I came across this article (see excerpt):

academic.oup.com/clinchem/art...

(4) After getting access to the article (finally), I learned this →