Microalbuminuria – Matelich

Do we continue to follow microalbumin after diagnosing microalbuminuria?   YES - the ADA does recommend yearly checking of the eGFR and microalbumin. At T2DM - start at time of dx At T1DM - start 5 years after dx   Kidney care: Glucose control BP control < 140/90 ACE/ARB   Microalbuminuria = 30-300  Macroalbuminuria >… Continue reading Microalbuminuria – Matelich


Hypertension Treatment – NNTs

Based on new guideline from ACP and AAFP for the treatment of HTN in adults, published in Ann Intern Med 2017 Mar 21; 166:430. For adults with SBP ≥ 160 mmHg, lowering the BP to < 150 mmHg, over a 5 year period: All-cause mortality:   NNT = 61 Stroke:  NNT = 88.5 Adverse cardiac events:… Continue reading Hypertension Treatment – NNTs

Heart Failure with Preserved Ejection Fraction (HFpEF) – NEJM

Notes from NEJM Review Article:  Redfield MM. (2016), Heart Failure with Preserved Ejection Fraction Case:  73 yo woman seen for hospital f/u after admission for AF with RVR and pulm edema.  She c/o fatigue and DOE. Cr 1.4, eGFR 37, NT-proBNP 300.  Echo EF 70% with nl LV dimensions.  Elevated LA pressure and pulm arterial… Continue reading Heart Failure with Preserved Ejection Fraction (HFpEF) – NEJM

Alpha-blockers aid in passage of kidney stones (meta-analysis)

Meta-analysis: alpha blockers effective for kidney stonesClinical Question:In patients with kidney stones (ureteric calculi), is treatmentwith an alpha blocker effective in improving passage rate and decreasingpain?Bottom Line:Although a recent large study found no benefit to alpha blocker treatment (Lancet 2015;386:341-49), this meta-analysis of 55 studies found a benefit to using alpha blockers to increase the… Continue reading Alpha-blockers aid in passage of kidney stones (meta-analysis)

Asymptomatic Hypertensive Urgencies Can Be Managed Outpatient

Retrospective study of 59,000 patients presenting to outpatient setting with severe asymptomatic hypertension. No difference between those sent to the ED vs those managed as outpatients in: Major adverse CV events Uncontrolled HTN 6 mos later Only difference - those who went to the ED were hospitalized more often. Take-away:  Asymptomatic severe hypertension can be… Continue reading Asymptomatic Hypertensive Urgencies Can Be Managed Outpatient