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The Curbsiders Internal Medicine Podcast

REBOOT #145 Hepatorenal Syndrome

The Curbsiders Internal Medicine Podcast

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.83.1K Ratings

🗓️ 28 March 2022

⏱️ 69 minutes

🧾️ Download transcript

Summary

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.



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

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Transcript

Click on a timestamp to play from that location

0:00.0

What is the animal loving the phrologists favorite hobby? I don't know collecting ducks

0:15.3

To of you to create that that was a two person operation

0:21.4

I've never been angry

0:23.4

I love Paul's reaction totally worth it

0:30.2

All right, and now on to the episode

0:36.9

The curbsiders podcast is for entertainment education and information purposes only and the topics discussed should not be used

0:41.3

Daily diet of street cure or prevent a disease or conditions for the more the views and statements expressed on

0:44.6

The podcast are solely those that should not be interpreted for official policy or position of any entity aside from possibly cash

0:48.5

Like more hospital and affiliate outreach programs if indeed there are any in fact

0:51.1

There are not pretty much we aren't responsible if you should always be your own homework and let's know

1:04.7

You know Paul I just haven't quite figured out how to start the show

1:08.2

Welcome back to the curbsiders. I'm Dr. Matthew Wato here with my great friend Dr. Paul Nelson Williams

1:13.9

Paul how are you doing tonight? I'm great, Matt and just in terms of feedback. I think that was good

1:18.2

That felt right it was a little bit of energy

1:20.2

Thank you. I need constant

1:22.7

Reinforcement that I'm doing a good job like like we all do Paul on tonight's show Paul

1:28.3

This is this is a repost of a curbsiders classic from Neff madness

1:33.3

2019 back when we were brand new in this Neff madness game of course

1:38.0

We had a great pun to open the show here and that was brought to us by

1:42.8

Hannah Abrams who just did this wonderful pun cat contest if you can remember way back when and I Paul

1:48.4

You're a huge fan of puns aren't you? Yeah, no wonderful pod contest is an oxymoron if ever there was one

1:53.3

But these were as good as they get probably and for the audience Paul doesn't like to say puns

...

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