AI Snips
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Kidney‑Focused Clinician And Educator
- Joel Topf described his dual academic and private practice life and his Twitter persona 'kidney_boy'.
- He uses teaching roles at William Beaumont Oakland and Ascension Saint John to educate students and trainees.
Systematic Initial AKI Workup
- Start the AKI workup in cirrhosis with urinalysis and urine sodium/FENa to categorize injury patterns.
- Use a volume challenge if pre-renal is suspected and escalate if no response to test for hepatorenal physiology.
Low Urine Sodium Is Not Definitive
- A low urine sodium or low FENa in cirrhosis is common and nondiagnostic by itself.
- Interpret urine tests cautiously because bilirubin and concentrated urine can stain hyaline casts and mimic ATN.