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Core IM | Internal Medicine Podcast

#203 POCUS for AKI & Dialysis | Real Cases That Changed Management

Core IM | Internal Medicine Podcast

Core IM Team

Education, Mental Health, Health & Fitness, Medicine

4.81.2K Ratings

🗓️ 23 March 2026

⏱️ 30 minutes

🧾️ Download transcript

Summary

A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded?

A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI?

A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter?

And the classic inpatient dilemma: your heart failure patient looks better after diuresis, but the creatinine is rising. Is it time to stop, or should you keep going?


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See here for Neph Madness details 

See here for the POCUS region of NephMaddness

VOTE here to build your bracket!

🔹Transcript and Shownotes:


00:52 | What is NephMadness?

02:19 | Detecting post-renal obstruction in a patient who reported normal urination

11:26 | POCUS for discharge or continue diurese

17:25 | Distinguishing COPD from volume overload in a dialysis patient using lung ultrasound

23:55 | Assessing AV fistula maturity at the bedside to potentially avoid placing a temporary dialysis line


Along the way, we discuss practical ways clinicians can use renal, lung, and venous ultrasound to clarify uncertain clinical situations and make faster decisions at the bedside.


If you’ve ever paused on rounds, wondering “what should we do next?” in a patient with kidney disease, this episode explores how POCUS can help answer that question.


Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, AKI Management, POCUS



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Transcript

Click on a timestamp to play from that location

0:00.0

I think it's something that is recognized by both internal medicine and nephrology is something that our

0:04.1

trainees should be learning. We just need to have the infrastructure to do it. And I think as, you know,

0:08.4

our generation of doctors kind of rises up, I think that infrastructure will grow further. But I honestly,

0:13.4

I can't imagine practicing without it. Welcome to Coriom. We have a special Neff Madness episode today,

0:19.5

and you just heard from Dr. Jeffrey Kot. Hi, my name is Jeffrey Kot. I'm a nephrologist and intensivist at Madler Hospital, which is part of the North Wales System on Long Island. And I'm also part of the Neffmanus Executive Committee. And I'm also here with Dr. Noah Markowitz. Hi, I'm Dr. Noah Markowitz, a PGI-Y-3 internal medicine resident at Montefiur and soon-to-be

0:39.5

Nephrology fellow at Mount Sinai. I'm personally beginning my own Pocus journey and I'm thrilled

0:45.4

to share some of the amazing teaching points we learned from Dr. Kot. Yes, and before we get started,

0:51.3

what is Neff Madness and what are we doing here today?

0:58.9

So Neff Madness is mirrored after the March Madness College Basketball Tournament.

1:03.8

And the goal is to award the topic that we think is going to be the face of nephrology in 26, the most influential or most exciting thing that's going to happen in the years to come.

1:08.8

So a bracket's going to be made of different concepts in nephrology, and these concepts will then go head to head with each other. The winner of

1:15.3

each matchup is decided by a panel of experts. I can say that I look forward to Neff Madness

1:20.7

every year because there's so much content released from it. Experts write blogs. Like I feel like

1:26.0

I go through a mini Nephrology fellowship every March.

1:28.6

And of course, there's the podcasts.

1:31.9

Yes, which is why we're here today.

1:33.6

So today we're talking about what is going head to head in the Northeast region

1:37.1

bracket, which is point of care ultrasound, Pocus.

1:40.4

And the matchup is between Pocus for Akii versusI. versus Pocus for end-stage renal disease.

1:46.0

So we're going to be going through four cases. The first two being Pocus for A.K.I. And the second two being Pocus for end-stage renal disease. So as we go through these cases, think about what you want to vote for as the future of nephrology.

2:09.6

All right. I think, Jeff, we're so excited to learn from you today and why you're so passionate about ultrasounds and kind of some of the cases that have made you think,

2:12.9

oh, I'm so glad I had these skills. And for listeners, all these cases are de-identified.

...

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