Concept Map: Cryoglobulinemia

 Here is a summary via pics on Cryoglobulinemia. Check out a review on this in NEJM.

Top 10 things Nephrologists Wish every Primary Care and Hospitalists Knew

1. A “Normal” Serum Creatinine Level May Not Be Normal

2. Patients With Decreased GFR or Proteinuria Should Be Evaluated to Determine the Cause; Positive Urine Dipstick Test Results for Protein Should Be Followed Up With a Spot Urine Protein or Albumin to Urine Creatinine Ratio.

3. A low Potassium level -- please check a magnesium level as well as hypomagnesemia leads to hypokalemia

4. Know the Medications That Spuriously Elevate the Serum Creatinine Level. A cystatin C-based GFR may help in this matter.

5. Do Not Automatically Discontinue an ACEI /ARB or SLGT2i Solely Because of a Small Increase in the Serum Creatinine or Potassium Level.

6. Not all elevations in Potassium are real- in the right context make sure you rule out hemolysis, hyperglycemia and pseudohyperkalemia before freaking out!

7. Although Most Patients With Hypertension are essential, a simple urinalysis may help diagnose a renal cause. HTN may be a symptom of underlying renal disease in many cases.

8. PPIs cause heart burn for the Nephrologists. Stop if no strong indication as they cause AKI and CKD.

9. Do not change dialysis schedule for ESKD patients for a contrast study( they are end-stage already).

10.If the Na is low, make sure the patient is not getting antibiotics or other meds in D5W and if the Na is high, make sure the patient is not getting meds in normal saline.