Nephrology

This randomized clinical trial examines whether sodium bicarbonate infusion decreases day 90 all-cause mortality for patients with severe metabolic acidosis and moderate to severe acute kidney injury.

Severe acidemia commonly complicates critical illness. If unresolved or untreated, acidemia may exacerbate multiorgan dysfunction, prompt escalation in life support, and portend greater risk of adverse outcomes. Intravenous (IV) sodium bicarbonate is often used in clinical practice to buffer severe acidemia; however, existing evidence on its effectiveness remains inconclusive. The most recent iteration of the Surviving Sepsis Guidelines offers only a weak recommendation (low quality of evidence) for use of IV sodium bicarbonate therapy in patients with sepsis and shock, severe acidosis, and acute kidney injury (AKI). This recommendation was derived largely from the initial BICARICU trial, a multicenter, open-label, randomized clinical trial suggesting reduced mortality at 28 days and lower use of kidney replacement therapy (KRT) with IV sodium bicarbonate therapy in a prespecified subgroup of patients with severe acidemia (pH ≤7.20) and moderate to severe AKI.

Severe acidemia commonly complicates critical illness. If unresolved or untreated, acidemia may exacerbate multiorgan dysfunction, prompt escalation in life support, and portend greater risk of adverse outcomes. Intravenous (IV) sodium bicarbonate is often used in clinical practice to buffer severe acidemia; however, existing evidence on its effectiveness remains inconclusive. The most recent iteration of the Surviving Sepsis Guidelines offers only a weak recommendation (low quality of evidence) for use of IV sodium bicarbonate therapy in patients with sepsis and shock, severe acidosis, and acute kidney injury (AKI). This recommendation was derived largely from the initial BICARICU trial, a multicenter, open-label, randomized clinical trial suggesting reduced mortality at 28 days and lower use of kidney replacement therapy (KRT) with IV sodium bicarbonate therapy in a prespecified subgroup of patients with severe acidemia (pH ≤7.20) and moderate to severe AKI.

This randomized clinical trial examines whether a personalized hemodynamic resuscitation protocol targeting capillary refill time was more effective than usual care in patients with early septic shock.

This randomized clinical trial examines whether sodium bicarbonate infusion decreases day 90 all-cause mortality for patients with severe metabolic acidosis and moderate to severe acute kidney injury.

This study evaluated whether a personalized hemodynamic resuscitation protocol targeting capillary refill time normalization improves outcomes in adults with early septic shock compared with usual care.

This study uses US national data to examine Epstein-Barr virus–seronegative donor kidney use among Epstein-Barr virus–seronegative children.

A 66-year-old man presented with a persistent cough, multiple bilateral pulmonary nodules, intrathoracic lymphadenopathy, a partially calcified left supraclavicular lymph node, a left thyroid nodule, and left level IV neck lymph nodes with calcifications. What is your diagnosis?

This economic evaluation characterizes trends in Medicare reimbursement for thyroid surgery and provides evidence for future discussions on payment reforms.

This Medical News article discusses new research into the rise of intravenous hydration spas and the perceived benefits and known risks that come with the unproven treatments.