Hypercalcemia in patients in the burn intensive care unit.

Although patients with burns are known to develop hypocalcemia, the development of hypercalcemia has also been reported in a few patients in the burn intensive care unit. Here, the incidence of hypercalcemia in the burn unit of a single institution is reviewed. The records of all patients admitted to the burn intensive care unit over a period of 4 years of a single institution were reviewed.

Failure of sonography to visualize a kidney affected by emphysematous pyelonephritis.

We describe a diabetic patient who presented with acute renal failure as a result of acute bilateral emphysematous pyelonephritis. Initially, both an abdominal X-ray examination and a renal sonogram were unremarkable. Two days later, however, the previously visualized right kidney could not be demonstrated again by a repeat renal sonogram.

Bilateral emphysematous pyelonephritis in a patient with no known risk factors.

Emphysematous pyelonephritis (EPN) is a rare life-threatening necrotizing infection of the kidney and perirenal space with gas formation. It is usually unilateral and affects patients with a risk factor such as diabetes or urinary obstruction. In the past, most patients required nephrectomy, and in bilateral cases long-term dialysis was inevitable.

Idiopathic hypocomplementemic immune-complex-mediated tubulointerstitial nephritis.

Background: A 42-year-old man presenting with flank pain was found to have renal failure with severe hypocomplementemia and eosinophilia.

Investigations: Physical examination, laboratory testing, renal ultrasonography, and renal biopsies.

Diagnosis: Acute immune-complex-mediated tubulointerstitial nephritis.

Composition and clinical use of hemodialysates.

A thorough knowledge and understanding of the principles underlying the preparation and the clinical application of hemodialysates can help us provide exemplary patient care to individuals having end-stage renal disease. It is prudent to be conversant with the following: (a) how each ingredient in a dialysate works, (b) the clinical circumstances under which the concentration of an ingredient can be altered, and (c) the special situations in which unconventional ingredients can be introduced into a dialysate. The potential to enrich dialysates with appropriate ingredients (such as iron compounds) is limited only by the boundaries of our imagination.