Jennifer Pham

@VelezNephHepato Wow!! This is really great timing - inherited a patient with AKI biopsy showed ATN thought due to Valsartan but even after stopping it he continues to have fluctuating creatinine. just checked med list (short, only three meds) and one is rosuvastatin 40mg! Gonna stop and see. 🙎🏻‍♀️

15/n there is evidence of ⬇️of receptor-mediated endocytosis in renal tubules by HMG-CoA reductase inhibitors. But we still lack full understanding of the ATI pathogenesis. Maybe pharmacogenetic factors play a role. For now, be vigilant of Crestor. pubmed.ncbi.nlm.nih.gov/15339974/ Fin

1/n pt w/CKD (unknown etiology) arrives to clinic for follow up. Baseline Cr 1.7-2.1, past 🚬, base UPCR 0.4. Two months prior to the visit, Cr had ⬆️ to 4.2 and PCP stopped ARB. New labs: Cr down to 2.5. ARB was resumed at 50% reduced dose. 2 mo later, new visit: Cr back ⬆️ 3.8

Introducing the No Cost to Patient APOL1 Genotyping Program for eligible patients sponsored by @VertexPharma. See if your patients are eligible or learn more about APOL1 high-risk variants. arkanalabs.com/services/apol1…

1/n young adult presents to the ED with weakness, fatigue & LE edema. Cr 2.8 (base 1.0). Reports tarry stools. Initial clinical impression: ischemic ATN 2/2 GIB. #UrineMicroscopy is performed: crisp RBC casts and acanthocytes are identified in #UrinarySediment. Time to regroup.

@GoodishIntent I think bicarb is reasonable when pH is 6.9 or lower. It remains in the algorithm on UTD and thus I think will continue to get implemented. I don’t think a big of bicarb would hurt in severe acidosis and hyperK!

@AvrahamCooperMD @DAldeaji The way I loudly gasped 😱

MAYBE THE SCARIEST ECHO OF ALL Via @DAldeaji #MedTwitter #Halloween

As has been noted by @PD_Perls, PD stands for “Poop Daily” The backbone of PD catheter dysfunction management is addressing constipation, constipation and constipation says @nupur_nephron #HDAE22

@KelseyObGyn At 2am in the ICU my coresident was scanning through a CT and went “WTF IS THAT!? Does this young female have cancer!? That mass is huge!!” I said, “Now I’m no radiologist, but I’m pretty sure that’s her uterus.” Fun 2am laughs.

I just asked a radiologist if “that big circle on the CT is an abscess”… it was her bladder. Y’all I’m done.

It was great to catch up with former @OchsnerIMRes co-resident @NephroPotatoMD at @NBLUniv! @VelezNephHepato

Excited for @NBLUniv 2022 kicking off tonight! #nbluniv The nephrology fellows are bringing it for the Table Tennis Challenge! @ucsdnephrology Coming to NBLU? Share your travel adventures! See you soon

#NBLUniv 2022 - Hello from your #StLouis team! Introducing #ArchKidneyCare, a democratic-based renal practice based in #StLouis. Excited to see the project grow as the week goes on 🫘

Glorious view of mitosis 🤯 Via @NanoLiveLtd #MedTwitter #Biology

Introducing Team St Louis @NBLUniv 2022 Nephrology Fellows - Dr Canela @methodistdallas Dr Gudura @CleClinicKidney Dr Rehman @PITTRenal Dr Garcia @BCMKidneyHealth Dr Pham @ucsdnephrology @NephroPotatoMD Dr Chong @MayoClinicNeph Dr Philips @HurleyMedical ; @CGiordano1225

@DrMootravardhak Like a couple others who responded, have only seen this once in a muscular dystrophy patient. Definitely made me do a double take!

Ladies and gentlemen of #askrenal I present to you the undetectable baseline serum creatinine. This patient is NOT on CRRT. Has anyone seen this in adults? What conditions come to mind?

Just posted a photo @ UCSD Jacobs Medical Center instagram.com/p/CfmBoQ7L2fNO…

@EddieZitnikDO Saaaaame! 🙌🏼🙌🏼

@EddieZitnikDO I usually answer and then ask them to page on call for the rest of the night.

@AbbyCoccoDO @OchsnerID

#transplantID @IDtwitter @ochsnerID 🍄

@CatDocMD Caught a septic joint recently. As a budding nephrologist! And also a compartment syndrome as a resident on rheumatology that primary had no suspicion for. All day.

Here’s some interesting lab results: Na 282 mmol/L K 7.3 Cl 290 HCO3 3 BUN 1004 mg/dL Cr <0.1 mg/dL Glu 184 Ca 16.8 Phos 8.8 Anion gap -5.8 Osm 1094 mOsm/Kg Before you flip out & call nephrology, any guesses about what species this blood chemistry comes from?