Hello and welcome back to AckRack, I'm Jed Wolpa and I'm thrilled to have with me today

a guest who is not an anesthesiologist but someone very involved with critical care

who I have to say I've been trying to get on the show for quite some time and I'm thrilled

that I finally roped him in. Dr. Derek Fein is an associate professor of medicine and

the division of nephrology here at Johns Hopkins. He's a nephrologist who does a lot of work

and he'll tell us a little bit about it, but certainly I've met him and gotten to know him

through his work with patients in the ICU when I'm on service there. And we're going to talk today

about continual renal replacement therapy in the ICU, something that we experience quite a

lot, but they can be a little confusing and I think it's going to be a really great discussion.

Derek, thank you so much for coming on the show.

Yeah, thanks for having me. It's great to be here.

So let me start by just asking a little bit about you. Tell us about you, your background and

how you got where you are and what your career, what your job looks like, how you spend your time.

Sure, so I, as you can hear from my accent and the South African by birth,

came to the United States more than 30 years ago and did most of my training here. I went to

med school at Johns Hopkins and did residency fellowship and I've been on faculty here and

I've never left 30 years later. So this is sort of my home.

Currently an associate professor and I'm the clinical director of the division of nephrology.

I spend probably 60, 70 time in patient care and it really involves everything.

Outpatient dialysis, outpatient clinical care, particularly interesting lupus and HIV kidney disease

and rounding on inpatient services, probably 20 weeks of the year.

Much of that in the ICU and the cancer center and on the floor is different services.

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