- |||||||||| lisinopril / Generic mfg.
[VIRTUAL] Is This Primary or Secondary Membranous Nephropathy? () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3780;
Labs are consistent with nephrotic syndrome, and he is subsequently started on Furosemide and Lisinopril...In the absence of a biopsy, a mutual decision is made to treat the patient with rituximab...The patient is offered an alkylating agent based therapy, but has opted to enroll in an ongoing clinical trial on anti-CD 38 therapy. He remains under surveillance for possible secondary etiologies due to his biopsy findings, while awaiting his response to anti CD-38 therapy.
- |||||||||| furosemide / Generic mfg.
[VIRTUAL] Renal Lymphatic Pumping Involves Interstitial Sodium Regulation of NKCC1 Transporter (Simulive) - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3548;
Conclusion High sodium within the renal interstitium following proteinuric injury impairs the pumping function of renal lymphatic vessels through SPAK-NKCC1-eNOS pathway that may contribute to sodium and water retention and reduces lymphatic responsiveness to furosemide. We propose this dysfunctional pathway in lymphatic vessels is a novel mechanism of progressive edema in proteinuric kidney disease.
- |||||||||| spironolactone / Generic mfg.
[VIRTUAL] A Salty Goodbye to Diuretic Resistance: Hypertonic Saline () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3258;
She was initially treated with high dose furosemide but did not improve...She was then changed to a bumex drip and high dose spironolactone (200mg) with some improvement (via objective urine electrolyte assessment) she was still inadequately diuresed...The NaCl load directly inhibiting RAAS through distal NaCl delivery (salt load also increases salt wasting), this causes decreased afferent arteriolar constriction and thus further improving GFR. It also stimulates ANP in the RA to inhibit RAAS and ADH indirectly.
- |||||||||| tolvaptan / Generic mfg.
[VIRTUAL] Use of Tolvaptan to Maintain Eunatremia in Acute Brain Injury-Induced SIADH () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3254;
However, salt tablets increases fluid retention; which increases blood pressurre, and leads to recurrent hemorrhage and poor outcomes. The use of Tolvaptan increases free water excretion to achieve eunatremia, thereby decreasing the risk of brain edema and controls blood pressure, especially in this patient population.
- |||||||||| furosemide / Generic mfg.
[VIRTUAL] Severe Hypermagnesemia: A Potential Cause of Acute Hyperkalemia () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3249;
Hyperkalemia improved to 5.3 with IV Lasix, bicarbonate, and NS but persisted until Mg infusion was discontinued and Mg levels normalized to 2.5 leading to normalization of K (4.3)...Additionally, ROMK is an important pathway for potassium secretion in the distal nephron. Therefore, potassium levels should be closely monitored in patients who receive high dose magnesium infusions and are at high risk of hypermagnesemia and subsequent hyperkalemia.
- |||||||||| furosemide / Generic mfg.
[VIRTUAL] Cerebral Salt Wasting in a Renal Transplant Patient () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3219;
In SIADH a combination of fluid restriction, lasix, and salt tabs are used...We believe we met the burden of proof to diagnose this patient with CSW. Though there may still be debate about the existence of CSW, we believe that with the difference in treatment approach it should always be considered in the differential in patients with CNS injury.
- |||||||||| Spikevax (elasomeran) / Moderna, Takeda
[VIRTUAL] Nephrotic Syndrome Secondary to Minimal Change Disease Following Moderna COVID-19 Vaccine () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3069;
In the COVID-19 era, 3 cases of new-onset MCD and one case of MCD relapse have been reported following the Pfizer-BioNTech COVID-19 vaccine...Patient was started on oral prednisolone and furosemide...More studies are needed to determine the incidence and pathophysiology of this adverse event post COVID-19 vaccine. It is not clear in this case if or when the second dose of the COVID-19 vaccine should be administered.
- |||||||||| hydroxychloroquine / Generic mfg.
[VIRTUAL] Nephrotic Syndrome in a Patient with Systemic Lupus Erythematous: Is it Lupus Podocytopathy? () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3068;
Case Description A 73-year-old female with a history of SLE (on Hydroxychloroquine), and nephrolithiasis presented with left flank pain for 2 weeks...She was started on high-dose prednisone, simvastatin, ACE inhibitor, and furosemide with potassium supplementation for significant pedal edema...There is mild mesangial matrix expansion. _x005F_x000D_ B. Electron microscopy showing diffuse podocyte foot process effacement with no mesangial or glomerular basement membrane immune-type electron-dense deposits identified.
- |||||||||| furosemide / Generic mfg.
[VIRTUAL] Distal Renal Tubular Acidosis in Patients with Autoimmune Diseases () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_2921;
Conclusion Incomplete DRTA was found in 11 out of 48 patients with autoimmune diseases. None of the patients developed severe hypokalemia or metabolic alkalosis or any other side effect after Furosemide and Fludrocortisone test.
- |||||||||| lisinopril / Generic mfg.
[VIRTUAL] Primary Membranous Nephropathy Flare After COVID-19 Vaccination () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_2435;
We present a patient with MN and metastatic breast cancer who developed nephrotic syndrome after receiving her second mRNA-1273 COVID-19 vaccine with positive PLA2R Ab by ELISA suggesting MN flare...She was diagnosed with metastatic breast cancer and started anastrazole transiently...She was treated with lisinopril and furosemide followed by rituximab in May 2021...Our case of primary MN flare after COVID-19 vaccine adds support to a potential association between SARS-CoV-2 antigens and loss of tolerance to the PLA2R antigen. Close follow-up of patients with primary MN and other glomerular diseases after COVID-19 vaccination is warranted.
- |||||||||| Lokelma (sodium zirconium cyclosilicate) / AstraZeneca
[VIRTUAL] Hyperkalemia: Medical Management vs. Hemodialysis () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_2263;
Further studies are necessary to confirm these findings. Nationally standardized treatment algorithms ought to be developed; a randomized trial would be conducive to that end.
- |||||||||| furosemide / Generic mfg.
[VIRTUAL] Furosemide Alleviates Hypercalciuria and Hypomagnesemia in Claudin 16-Deficient Mice () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_2221;
Evaluation of distal Ca 2+ and Mg 2+ transport proteins by immunoblotting and immunofluorescence showed furosemide-dependent increases of TRPV5 and calbindin levels in Cldn16 -/- kidneys along with signs of hyperthrophy of the distal nephron. Conclusion The present results suggest that loop diuretics bear potential to alleviate symptoms of Cldn16-deficiency due to compensatory stimulation of electrolyte reabsorption in DCT, CNT, and CCD.
- |||||||||| hydrochlorothiazide / Generic mfg., aspirin / Generic mfg., furosemide / Generic mfg.
[VIRTUAL] Will the Real Creatinine Please Stand Up? Elevated Creatinine in a Patient with Smoldering Myeloma () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_1421;
Both nephrologists and oncologists should be aware of this phenomenon in the care of patients with all types of paraproteinemias, so that alternative means of kidney function assessment (such as measurement of cystatin c) can be employed when creatinine assays are unreliable. Serum creatinine and kappa/lambda free light chain ratios
- |||||||||| acetazolamide / Generic mfg., furosemide / Generic mfg.
[VIRTUAL] A Case of Extreme Metabolic Alkalosis () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_763;
We corrected his metabolic alkalosis and AKI with cautious use of IV fluids and Acetazolamide without needing dialysis, although metabolic alkalosis relapsed until the G-J tube was changed. Daily PH and Cr
- |||||||||| nifedipine immediate release / Generic mfg., spironolactone / Generic mfg.
[VIRTUAL] Primary Hyperaldosteronism And Resistant Hypertension In Pregnancy (ePosters) - Oct 14, 2021 - Abstract #AHA2021AHA_7240;
She was taking carvedilol, spironolactone, and furosemide at pregnancy diagnosis...Her regimen was uptitrated to nifedipine 90 mmHg, carvedilol 50mg BID, hydralazine 50mg TID and furosemide 80mg BID...During admission, she developed resistant hypertension requiring nicardipine and esmolol drips and severe headache, concerning for superimposed preeclampsia (SIPE)...This information is crucial as PA is an increasingly recognized cause of resistant hypertension in young adults. Both PA and preeclampsia involve pathophysiologic mechanisms in the RAAS pathway and deserve further attention and research.
- |||||||||| Jardiance (empagliflozin) / Eli Lilly, Boehringer Ingelheim
[VIRTUAL] Effects of Empagliflozin on Diuresis and Renal Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF) (Live) - Oct 14, 2021 - Abstract #AHA2021AHA_6954;
P2
No difference in safety events occurred between groups.CONCLUSION The use of the SGLT2 inhibitor empagliflozin in patients with ADHF is safe and increases urine output without affecting renal function. Thus, addition of SGLT2 inhibition to standard diuretic therapy is a promising strategy to improve cardiorenal recompensation of patients admitted with ADHF (NCT04049045, EUDURA-CT: 2018-003692-35).
- |||||||||| diltiazem / Generic mfg., furosemide / Generic mfg., apixaban / Generic mfg.
[VIRTUAL] REFRACTORY HYPOXEMIA IN A NONAGENARIAN WITH PATENT FORAMEN OVALE MANAGED MEDICALLY () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2300;
CASE PRESENTATION: We present a 96 year old female with heart failure with preserved ejection fraction, chronic respiratory failure secondary to moderate persistent asthma, on 4L of O2 at baseline, recurrent venous thromboembolic disease on apixaban, severe untreated OSA, initially admitted for septic shock due to acute cholecystitis requiring percutaneous cholecystostomy and broad spectrum antibiotics...Instead, the patient was treated with short acting diltiazem every 6 hours and furosemide daily with the goal of reducing pulmonary pressures and R to L shunting of deoxygenated blood... To summarize, hypoxia due to intracardiac shunting is an important cause of hypoxia, not to be missed on our list of differential diagnoses, with timely identification and appropriate therapy being the key to positive outcomes.
- |||||||||| cetirizine oral / Generic mfg., spironolactone / Generic mfg., epoprostenol intravenous / Generic mfg.
[VIRTUAL] SEVERE THROMBOCYTOPENIA DUE TO IV EPOPROSTENOL: DON'T MUCK WITH THE PLATELETS () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2256;
It appears to have a dose-dependent relationship and may improve with changing to an alternative prostacyclin. It is critical to recognize this phenomenon as profound thrombocytopenia can not only be dangerous, but also preclude lung transplant candidacy, should it become necessary
- |||||||||| paracetamol / Generic mfg.
[VIRTUAL] AN UNCOMMON CONCURRENCE OF BABESIOSIS AND ACETAMINOPHEN OVERDOSE: CASE REPORT () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2223;
SARS-CoV-2 RNA was negative.Patient was admitted and received Acetylcysteine for acetaminophen toxicity, atovaquone, azithromycin, doxycycline for Babesia and borreliosis coverage...Patient received IV Lasix, symptoms improved and the CXR on day 6 showed pulmonary edema resolved.In the following days, patient continued to receive treatment for babesiosis, blood parasitemia cleared but Hgb decreased to 6.7 g/dL, patient received transfusion and Hgb level remained 7.9 g/dL on the day of discharge... ARDS can be an early onset manifestation after initiation of treatment for babesiosis and usually resolves with supportive treatment.
- |||||||||| sildenafil / Generic mfg.
[VIRTUAL] A UNIQUE MUTATION IN AN INFANT WITH PULMONARY HYPERTENSION AND MITOCHONDRIAL DISEASE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2056;
Pulmonary vasodilator therapy was initiated with Bosentan, Sildenafil and subcutaneous Treprostinil...The patient is currently stable on a PH regimen of subcutaneous Treprostinil, sildenafil, and furosemide... To our knowledge, this is the first reported case of PH associated with WARS2 mutation.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma
[VIRTUAL] ATYPICAL COMPLICATION OF COVID-19: BUDD-CHIARI SYNDROME CAUSING A HEPATIC HYDROTHORAX () - Oct 13, 2021 - Abstract #CHEST2021CHEST_1697;
To our knowledge, there has only been one other reported case of Budd-Chiari syndrome associated with COVID-196 and no prior report of hepatic hydrothorax associated with COVID-19. It is important to recognize the mechanisms behind COVID-19 complications as well as recognize the possible atypical presentations of COVID-19.
- |||||||||| remdesivir / Generic mfg., dexamethasone / Generic mfg.
[VIRTUAL] REMDESIVIR THERAPY AND ITS ASSOCIATION WITH SINUS BRADYCARDIA () - Oct 13, 2021 - Abstract #CHEST2021CHEST_1489;
RDV therapy should not be withheld in patients at risk of developing bradycardia. CLINICAL IMPLICATIONS: Remdesivir therapy did not increase the risk of developing bradycardia in our patient population.
- |||||||||| losartan potassium / Generic mfg., furosemide / Generic mfg., hydrocodone/paracetamol / Generic mfg.
[VIRTUAL] OPIOID MISUSE AND A BROKEN HEART: PULMONARY EDEMA AND TAKOTSUBO CARDIOMYOPATHY POST NALOXONE USE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_1187;
On day 3 of admission, she was noted to have decreased responsiveness, pinpoint pupils & an empty bottle of Hydrocodone/acetaminophen was found at bedside...She was discharged on daily metoprolol 25mg, losartan 25 mg, ASA 81 mg & lasix 20mg... Being postmenopausal combined with physiological stressor of anxiety in absent CAD in the setting of naloxone appeared to have been a direct precipitant of the development of TCM in our patient.
- |||||||||| thyroxine / Generic mfg., furosemide / Generic mfg.
[VIRTUAL] NOT ALL THE PATIENTS PRESENTING WITH SHORTNESS OF BREATH HAVE HEART OR LUNG DISEASES () - Oct 13, 2021 - Abstract #CHEST2021CHEST_750;
Signs and symptoms of diaphragmatic paralysis can mimic heart failure. Physicians should maintain a high index of suspicion to workup for hypothyroidism and paralysis of the diaphragm in patients with typical presentation in the absence of cardiac or pulmonary etiology, as early diagnosis and treatment have good outcomes.
- |||||||||| gabapentin / Generic mfg.
[VIRTUAL] COCAINE-INDUCED COMPLETE HEART BLOCK THAT WAS REVERSED BY NALOXONE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_683;
CASE PRESENTATION: 49-year-old woman with history of coronary artery disease, mechanical mitral valve, heart failure, anxiety, and depression on aspirin, warfarin, furosemide, gabapentin, citalopram, quetiapine, and clonazepampresented with 3 days history of abdominal pain, diarrhea, and vomiting...Patient was started on IV fluids, IV antibiotics for acute colitis and morphine for pain...Patient underwent permanent pacemaker placement due to persistent CHB and during the procedure, patient received fentanyl... In conclusion, naloxone might be a possible treatment for cocaine induced CHB, but further studies are required to further elicit this observed effect.
- |||||||||| furosemide / Generic mfg.
[VIRTUAL] ACUTE RIGHT VENTRICULAR DYSFUNCTION FIXED IN A HEARTBEAT () - Oct 13, 2021 - Abstract #CHEST2021CHEST_676;
Our patient manifested with acute RV failure in the setting of her septic physiology. Most cases of RV failure have gradual recovery; however, our case demonstrates an instance of varying RV function with significant rapid improvement in cardiac function.
- |||||||||| spironolactone / Generic mfg.
[VIRTUAL] BRASH SYNDROME: A DOWNWARD SPIRAL () - Oct 13, 2021 - Abstract #CHEST2021CHEST_534;
Treatment is tailored to correcting the individual abnormalities. Many of these case reports had favorable outcomes.
- |||||||||| losartan potassium / Generic mfg., captopril / Generic mfg., furosemide / Generic mfg.
Preclinical, Journal: Sodium palatability in male spontaneously hypertensive rats. (Pubmed Central) - Oct 13, 2021
Losartan (AT1 receptor antagonist, 100 ng/1 μl) injected intracerebroventricularly in SHRs abolished 0.3 M NaCl intake induced by water deprivation + partial rehydration, whereas only transiently (first 30 min of the 60 min test) reduced hedonic responses, without changes in aversive responses to intra-oral NaCl...The results also suggest that central AT1 receptors are part of the mechanisms activated to increase NaCl intake and palatability in SHRs. A partial dissociation between NaCl intake and palatability in SHRs is also suggested.
- |||||||||| furosemide / Generic mfg.
Journal: Association Between Adaptive Servo-Ventilation Therapy and Renal Function. (Pubmed Central) - Oct 13, 2021
A reduction in furosemide equivalent dose following the initiation of ASV therapy was independently associated with increases in eGFR with an adjusted odds ratio of 13.72 (95% confidence interval 3.40-55.3, P < 0.001). In conclusion, short-term ASV therapy was associated with the preservation of renal function, particularly when the dose of loop diuretics was concomitantly reduced.
- |||||||||| furosemide / Generic mfg.
Enrollment open, Trial initiation date: LAPP: Lasix for the Prevention of De Novo Postpartum Hypertension (clinicaltrials.gov) - Oct 8, 2021
P3, N=82, Recruiting,
In conclusion, short-term ASV therapy was associated with the preservation of renal function, particularly when the dose of loop diuretics was concomitantly reduced. Not yet recruiting --> Recruiting | Initiation date: Mar 2021 --> Oct 2021
- |||||||||| furosemide / Generic mfg., bumetanide / Generic mfg.
Journal: DRESS syndrome following furosemide administration: An unusual association. (Pubmed Central) - Oct 8, 2021
Not yet recruiting --> Recruiting | Initiation date: Mar 2021 --> Oct 2021 We add to the literature another case of furosemide-induced DRESS with the particularity of cross reactivity with bumetanide.
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