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  1. Article ; Online: Mind the Cast: FENa versus Microscopy in AKI.

    Hoenig, Melanie P / Parikh, Samir M

    Kidney360

    2022  Volume 3, Issue 4, Page(s) 583–585

    MeSH term(s) Creatinine ; Humans ; Kidney Tubular Necrosis, Acute ; Microscopy
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2022-02-17
    Publishing country United States
    Document type Editorial ; Comment
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0001212022
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  2. Article ; Online: Pattern Recognition versus Pathogenesis: Electrolytes in a Patient with Adrenal Insufficiency.

    Hoenig, Melanie P / Lecker, Stewart H

    Clinical journal of the American Society of Nephrology : CJASN

    2022  Volume 17, Issue 4, Page(s) 585–587

    MeSH term(s) Adrenal Insufficiency/complications ; Adrenal Insufficiency/diagnosis ; Electrolytes ; Humans ; Hyponatremia
    Chemical Substances Electrolytes
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.16061221
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  3. Article ; Online: Commentary.

    Hoenig, Melanie P

    Clinical chemistry

    2019  Volume 65, Issue 4, Page(s) 518

    MeSH term(s) Alkalosis ; Child ; Humans ; Hypocalcemia
    Language English
    Publishing date 2019-03-25
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 80102-1
    ISSN 1530-8561 ; 0009-9147
    ISSN (online) 1530-8561
    ISSN 0009-9147
    DOI 10.1373/clinchem.2018.299339
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  4. Article ; Online: The times they are K+-changin': bringing the potassium curriculum out of the 20th century.

    Hoenig, Melanie P / Lecker, Stewart H / William, Jeffrey H

    Current opinion in nephrology and hypertension

    2023  Volume 33, Issue 2, Page(s) 186–191

    Abstract: Purpose of review: Although most of the current medical education literature has focused on teaching strategies, little attention has been devoted to selecting appropriate course content. Despite elegant descriptions of physiologic mechanisms in recent ... ...

    Abstract Purpose of review: Although most of the current medical education literature has focused on teaching strategies, little attention has been devoted to selecting appropriate course content. Despite elegant descriptions of physiologic mechanisms in recent decades, medical school curricula and students continue to rely on outdated textbooks and certification examination study aids composed to fit an antiquated exam blueprint.
    Recent findings: Advances in our understanding of potassium physiology offer multiple examples of key concepts that deserve to be included in the modern-day renal physiology curriculum, including the relationship of potassium to blood pressure and the potassium 'switch', the aldosterone paradox, and novel pharmacologic agents that target dietary potassium absorption and potassium handling in the kidney.
    Summary: Key advances in our understanding and application of renal physiology to patient care have not been readily integrated into the nephrology curriculum of medical students. Difficult questions remain regarding when new concepts are sufficiently established to be introduced to medical students in the preclinical years.
    MeSH term(s) Humans ; Potassium ; Curriculum ; Education, Medical ; Kidney/physiology ; Students, Medical
    Chemical Substances Potassium (RWP5GA015D)
    Language English
    Publishing date 2023-12-04
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000958
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  5. Article ; Online: Race-Based eGFR Assessment for Kidney Transplantation.

    Hoenig, Melanie P / Pavlakis, Martha

    Clinical journal of the American Society of Nephrology : CJASN

    2021  Volume 16, Issue 10, Page(s) 1464–1466

    MeSH term(s) Creatinine ; Glomerular Filtration Rate ; Humans ; Kidney Transplantation/adverse effects
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2021-10-06
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.11020821
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  6. Article ; Online: Biomarkers vs Machines: The Race to Predict Acute Kidney Injury.

    Ghazi, Lama / Farhat, Kassem / Hoenig, Melanie P / Durant, Thomas J S / El-Khoury, Joe M

    Clinical chemistry

    2024  

    Abstract: Background: Acute kidney injury (AKI) is a serious complication affecting up to 15% of hospitalized patients. Early diagnosis is critical to prevent irreversible kidney damage that could otherwise lead to significant morbidity and mortality. However, ... ...

    Abstract Background: Acute kidney injury (AKI) is a serious complication affecting up to 15% of hospitalized patients. Early diagnosis is critical to prevent irreversible kidney damage that could otherwise lead to significant morbidity and mortality. However, AKI is a clinically silent syndrome, and current detection primarily relies on measuring a rise in serum creatinine, an imperfect marker that can be slow to react to developing AKI. Over the past decade, new innovations have emerged in the form of biomarkers and artificial intelligence tools to aid in the early diagnosis and prediction of imminent AKI.
    Content: This review summarizes and critically evaluates the latest developments in AKI detection and prediction by emerging biomarkers and artificial intelligence. Main guidelines and studies discussed herein include those evaluating clinical utilitiy of alternate filtration markers such as cystatin C and structural injury markers such as neutrophil gelatinase-associated lipocalin and tissue inhibitor of metalloprotease 2 with insulin-like growth factor binding protein 7 and machine learning algorithms for the detection and prediction of AKI in adult and pediatric populations. Recommendations for clinical practices considering the adoption of these new tools are also provided.
    Summary: The race to detect AKI is heating up. Regulatory approval of select biomarkers for clinical use and the emergence of machine learning algorithms that can predict imminent AKI with high accuracy are all promising developments. But the race is far from being won. Future research focusing on clinical outcome studies that demonstrate the utility and validity of implementing these new tools into clinical practice is needed.
    Language English
    Publishing date 2024-02-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 80102-1
    ISSN 1530-8561 ; 0009-9147
    ISSN (online) 1530-8561
    ISSN 0009-9147
    DOI 10.1093/clinchem/hvad217
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  7. Article ; Online: Advances in the management of chronic kidney disease.

    Chen, Teresa K / Hoenig, Melanie P / Nitsch, Dorothea / Grams, Morgan E

    BMJ (Clinical research ed.)

    2023  Volume 383, Page(s) e074216

    Abstract: Chronic kidney disease (CKD) represents a global public health crisis, but awareness by patients and providers is poor. Defined as persistent abnormalities in kidney structure or function for more than three months, manifested as either low glomerular ... ...

    Abstract Chronic kidney disease (CKD) represents a global public health crisis, but awareness by patients and providers is poor. Defined as persistent abnormalities in kidney structure or function for more than three months, manifested as either low glomerular filtration rate or presence of a marker of kidney damage such as albuminuria, CKD can be identified through readily available blood and urine tests. Early recognition of CKD is crucial for harnessing major advances in staging, prognosis, and treatment. This review discusses the evidence behind the general principles of CKD management, such as blood pressure and glucose control, renin-angiotensin-aldosterone system blockade, statin therapy, and dietary management. It additionally describes individualized approaches to treatment based on risk of kidney failure and cause of CKD. Finally, it reviews novel classes of kidney protective agents including sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, non-steroidal selective mineralocorticoid receptor antagonists, and endothelin receptor antagonists. Appropriate, widespread implementation of these highly effective therapies should improve the lives of people with CKD and decrease the worldwide incidence of kidney failure.
    MeSH term(s) Humans ; Angiotensin-Converting Enzyme Inhibitors/pharmacology ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Renal Insufficiency, Chronic/therapy ; Renin-Angiotensin System ; Kidney ; Mineralocorticoid Receptor Antagonists/pharmacology ; Diabetes Mellitus, Type 2
    Chemical Substances Angiotensin-Converting Enzyme Inhibitors ; Sodium-Glucose Transporter 2 Inhibitors ; Mineralocorticoid Receptor Antagonists
    Language English
    Publishing date 2023-12-05
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj-2022-074216
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  8. Article ; Online: Acid Base Disorders in Cirrhosis.

    Xu, Eric J / Zarm, Ayaa M / Lecker, Stewart H / Hoenig, Melanie P

    Advances in kidney disease and health

    2023  Volume 30, Issue 4, Page(s) 336–342

    Abstract: Metabolic and respiratory acid-base disorders are common in individuals with liver disease and cirrhosis. The most common disorder is respiratory alkalosis, which may be related to dyspnea or respiratory stimulation. Primary metabolic disorders are less ... ...

    Abstract Metabolic and respiratory acid-base disorders are common in individuals with liver disease and cirrhosis. The most common disorder is respiratory alkalosis, which may be related to dyspnea or respiratory stimulation. Primary metabolic disorders are less common. Although the liver plays a role in metabolism of amino acids and generation of acid from dietary sources, it does not play a role in the regulation of pH. Instead, metabolic disorders may arise from alterations in normal metabolism or from medications, particularly diuretics and osmotic laxatives, used in the treatment of these complex patients. Understanding the mechanistic underpinnings of these disorders can aid in the management of individuals with liver disease in the hospital and in outpatient settings.
    MeSH term(s) Humans ; Liver Cirrhosis/complications ; Alkalosis, Respiratory ; Amino Acids ; Antifibrinolytic Agents
    Chemical Substances Amino Acids ; Antifibrinolytic Agents
    Language English
    Publishing date 2023-07-17
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 3156601-7
    ISSN 2949-8139
    ISSN (online) 2949-8139
    DOI 10.1053/j.akdh.2023.04.002
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    Zs.A 4627: Show issues Location:
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  9. Article: More than meets the I(ris): Use of manual urine microscopy to complement automated findings in acute kidney injury.

    Hoenig, Melanie P / Mena, Jose D / Lecker, Stewart H

    Practical laboratory medicine

    2022  Volume 29, Page(s) e00267

    Abstract: Evaluation of patients with acute kidney injury requires comprehensive assessment that includes a urinalysis, which features both semi-quantitative assessment with a urine dipstick and urine microscopy. This process is labor intensive for clinical ... ...

    Abstract Evaluation of patients with acute kidney injury requires comprehensive assessment that includes a urinalysis, which features both semi-quantitative assessment with a urine dipstick and urine microscopy. This process is labor intensive for clinical laboratories, and availability of excellent automated instruments for urinalysis has prompted utilization and acceptance of this strategy by both by laboratories and clinicians. Recently, however, interest in provider performed microscopy has enjoyed a renaissance thanks to both improved microscopy techniques and the endorsement from social media in nephrology. Here, we present two cases of acute kidney injury in which manual microscopy added valuable information to the automated microscopy.
    Language English
    Publishing date 2022-02-07
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2834973-8
    ISSN 2352-5517
    ISSN 2352-5517
    DOI 10.1016/j.plabm.2022.e00267
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  10. Article ; Online: What's Old Is New Again: Harnessing the Power of Original Experiments to Learn Renal Physiology.

    Hoenig, Melanie P / Lecker, Stewart H / William, Jeffrey H

    Advances in chronic kidney disease

    2022  Volume 29, Issue 6, Page(s) 486–492

    Abstract: Although medical schools across the United States have updated their curricula to incorporate active learning techniques, there has been little discussion on the nature of the content presented to students. Here, we share detailed examples of our ... ...

    Abstract Although medical schools across the United States have updated their curricula to incorporate active learning techniques, there has been little discussion on the nature of the content presented to students. Here, we share detailed examples of our experience in using original experiments to lay the groundwork for foundational concepts in renal physiology and pathophysiology. We believe that this approach offers distinct advantages over standard case-based teaching by (1) starting with simple concepts, (2) analyzing memorable visuals, (3) increasing graphical literacy, (4) translating observations to "rules," (5) encouraging critical thinking, and (6) providing historical perspective to the study of medicine. Although we developed this content for medical students, we have found that many of these lessons are also appropriate as foundational concepts for residents and fellows and serve as an excellent springboard for increasingly complex discussions of clinical applications of physiology. The use of original experiments for teaching and learning in renal physiology harnesses skills in critical thinking and provides a solid foundation that will help learners with subsequent case-based learning in the preclerkship curriculum and in the clinical arena.
    MeSH term(s) Humans ; United States ; Curriculum ; Students, Medical ; Thinking
    Language English
    Publishing date 2022-11-10
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1548-5609 ; 1548-5595
    ISSN (online) 1548-5609
    ISSN 1548-5595
    DOI 10.1053/j.ackd.2022.03.006
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