Clinical Quiz

A Young Woman With Elevated Creatinine and Uric Acid

A 22-year-old Vietnamese woman was referred to the nephrology clinic for evaluation of elevated creatinine that was incidentally found on a laboratory check. She had a history of papillary thyroid cancer treated with a left thyroid lobectomy in 2017. She was currently in remission. She was found to have had hyperuricemia since high school. She said…

Surgical Management of a Male Patient With LUTS

A 48-year-old White man presented with chronic voiding problems. He was evaluated and found to have high urinary residuals ranging up to 1000 cc. He was started on alpha blockers but had persistent urinary retention. The upper urinary tracts were normal on ultrasound. Office cystoscopy showed no obvious pathology. Video-urodynamics were performed (see Figure 1…

Renal-biopsy-microscopy-glomerular-mesangial-proliferation-cellular-crescent

HIV and Edema in a 34-Year-Old Man

A 34-year-old Hispanic man with HIV presented with gradual onset lower-extremity edema over the past 2 months. He was diagnosed with HIV 10 years earlier. What is the cause of his nephropathy?

Ultrasound showing the left kidney which is echogenic and small

A Case of Severe Uremia in a 26-Year-Old Man

A 26-year-old male patient with chronic kidney disease (CKD) of unknown etiology presented to emergency room with multiple complaints. He has felt unwell for at least 1 month. For the previous 2 weeks, he experienced nausea, vomiting, and profound fatigue. He was told a year ago that dialysis was needed, but he has not received medical…

Hyponatremia in a Thyroidectomy Patient

A 68-year-old woman with recent history of papillary thyroid cancer (Figure 1) underwent bilateral neck dissection and total thyroidectomy 3 months previously. Due to concern for residual cancer, she received radioactive iodine ablation (RAIA) therapy 1 week prior. Prior to RAIA, she was weaned off levothyroxine for several weeks. She had been observing a “low…

Heterogeneous Mass Right Adrenal Gland

A Localized Advanced Adrenal Mass in a 61-Year-Old Woman

A 61-year-old white woman experienced progressive right flank pain over a 6-month period. Cross-sectional imaging (computed tomography [CT] of the abdomen and pelvis; MR venogram) demonstrated a 10.9 x 9 x 8.4 cm right adrenal mass with concern for liver invasion and inferior vena cava involvement. Her metastatic workup was negative. She underwent an adrenal…

An ESRD Patient With Arm Swelling

A 52-year-old woman with type 2 diabetes mellitus (DM2), hypertension, and end-stage renal disease (ESRD) due to diabetic nephropathy has been on renal replacement therapy (RRT) for the past 5 years. She was recently transitioned from peritoneal dialysis to hemodialysis (HD) because of frequent peritonitis and subsequent peritoneal membrane failure. There is a tunneled HD catheter…

Microscopic examination revealed the presence of brown crystals

Cryptic CKD in a Man With a Kidney Stone History

A 47-year-old man presented with slowly progressive chronic kidney disease (CKD) of unknown cause. He has a history of passing a kidney stone at age 30. A stone analysis was not performed at that time, and he has had no further stones.  At age 40, his serum creatinine was 1.15 mg/dL; at age 47, the…

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