Medication Management Strategies Among Patients with Chronic Kidney Disease (CKD)

NKF 2017 Spring Clinical Meetings Abstracts Gustavo Borda, Ashfaq Balla. Metrowest Medical Center, Framingham, MA, USA HEALTH OR BEAUTY: A CASE OF AN UNUSUAL CAUSE OF 59 SEVERE Sevelamer Induced Diffuse Crystal Colitis: A Case Report of HYPERCALCEMIA: Gulshan Dangol, Sashi Ariyaratne, Hilmer Negrete, St. Elizabeth Hospital, Youngstown, OH, a Rarely Reported SideYoungstown Effect USA Samir Brahmbhatt, Michaelabnormality Cruise, James Simon. Cleveland Hypercalcemia is an electrolyte of which multiple causes Clinic Foundation, Cleveland, exist. Sometimes the possibility of rare OH, causesUSA of hypercalcemia should entertained when more such as primary 61 beAn Unusual Casecommon of causes, Hyponatremia Attributed to hyperparathyroidism and malignancy, have been ruled out. Trimethoprim-Sulfamethoxazole Therapy We present a case of a 67 year old Caucasian female who was admitted hospitalMichael with intermittent, burning Roberto epigastric pain Adamto our Bsiso, Sheffield, Collazoassociated with nausea and vomiting the past 2Center, months. Dallas, She Maldonado. Methodist DallasforMedical TX, appeared cachectic and was severely dehydrated. She was incidentally USA found to have severe hypercalcemia (18.4 mg/dl) and 62 hypophosphatemia Enteroccous Species Causing Bacterial-Endocarditis Asso(6.8 mg/dl). Multiple palpable calcified non-tender masses were found in both arms and physical exam and Xciated Glomerulonephritis in thighs an AtonRisk Population rays demonstrate subcutaneous soft tissue calcifications. Her serum Emma was Bueno, Keyrillos Rizg, Mario Further Cisneros, Juanof Chique creatinine 0.9 mg/dl (baseline 0.5 mg/dl). workup Figueroa, revealed Ryan aKunjal, Andreea Poenariu, Raafat F hypercalcemia low PTH (13 pg/ml), PTH-RP (<2 pmol/L), normal SPEP, aUniversity low normal 25-OH Vit D (40ng/ml) and of a strikingly Makaray. of Florida College Medicineelevated 1-25 OH Vit D (291pg/ml). CTUSA scan of the chest showed a Jacksonville, Jacksonville, FL, clear lung field with calcified bilateral breast implants and a thyroid 65 mass, Recurrent Microangiopathy in anegative RenalforAlloconsistentThrombotic with retrosternal goiter, the FNAC was malignancy. The breastConundrum implants (placed in1971) were hard in graft: A Clinical consistency with no distinct margin of the right implant lower pole Olivia Campa, Jose A. Morfin. University of California suggesting rupture. Although strongly suspected patient denied silicone Davis, on Sacramento, CA, USA injections her arms or thighs. Based on the quite elevated levels of D, theofdiagnosis of silicone-induced hypercalcemia was 68 1,25-OH A RareVitCase Neonatal Bartter Syndrome strongly considered. Patient calcitonin and 1 was treated with IV 2 fluids, 1 Tushar Chaturvedi , Rupesh Raina . Akron Nephrology pamidronate with improvement of calcium2levels with corrected Associates, OH, USA; Cleveland Clinic Akron calcium of 10.96 Akron, mg/dl upon discharge. Silicone hasAkron, been shown induce a granulomatous reaction, General, OH,toUSA in an extra-renal production of 1, 25 OH Vit D, which is the 71 resulting An Unusual Case of Negative Anion Gap in a Patient with basis for hypercalcemia in such cases. The exact treatment of it is Hypercalcemia unknown but removal of the source and use of steroids has shown some benefit in the reported cases. As the prevalence of elective cosmetic Avantika Chenna, Pradeep Reddy Thodima, Rasib Raja. enhancement continues to rise, siliconePA, induced Albert Einstein, Philadelphia, USAhypercalcemia remains a diagnostic and a therapeutic challenge. 74 Atypical Presentation of Metastatic Esthesioneuroblastoma with Ectopic ACTH Syndrome After 7 Years 90 Vamsi Chilluru, Jay Hawkins. University of Nebraska Medical Center, Omaha, NE, USA RECURRENT DENSE DISEASE: A REPORT OF TWO CASES VARYING PRESENTATIONS, FINDINGS 86WITH Prosthetic Valve Endocarditis PATHOLOGIC from Mycobacterium AND PATIENTInfection OUTCOMES: Dilini Granulomatous Daswatta, SharonInterstitial Graves, Chimaera Causing Carla Ellis. Emory University, Atlanta, Georgia, USA Nephritis Recent developments in the understanding of complementJonathanglomerular Da Costa, Ahmed Abdalrhim, Ivan Porter,ofPeter mediated disease have led to reclassification Fitzpatrick, Mayo Clinic, Dense DepositCherise DiseaseCortese, (DDD) asNabeel a type Aslam. of C3-predominant Jacksonville, FL, USA classified as type 2 primary glomerulopathy, previously (MPGN). retains 87membranoproliferative Health or Beauty: Aglomerulonephritis Case of an Unusual Cause DDD of Severe the unique characteristic of dense, osmiophilic deposits along Hypercalcemia the glomerular basement membranes, and has an alarming Gulshan rate Dangol, Sashi Ariyaratne, Hilmer Negrete. recurrence in renal allografts. We report two cases of St. Elizabeth Youngstown Youngstown, OH, USA recurrent DDD with clinicalHospital, presentations, pathologic findings patient outcomes on opposite ends of of a spectrum. 88and Recurrent Dense Disease: A Report Two Cases with The cause of ESRD in both patients (male and female) was Varying Presentations, Pathologic Findings and Patient MPGN, diagnosed in adolescence (15-16 years). At recurrence, Outcomes both displayed no evidence of cell or antibody mediated rejection. Both revealed C3 predominant intensityEllis. by Emory Dilini Daswatta, Sharon Graves, Carla immunofluorescence mesangial University, Atlanta,inGA, USA areas and along capillary walls with typical dense deposits noted ultrastructurally. The 90female Crystalglobulin-Induced Nephropathy and Keratopathy patient presented with acute pain over the allograft, 12.4 Matthew D’Costa, Sandhya Manohar, Joe Grande, Samih g/day of proteinuria and a Cr level of 3.33 mg/dL. Pathology demonstrated DDD andClinic, 33% glomeruli showing acute Nasr, Marie recurrent C. Hogan. Mayo Rochester, MN, USA chronic crescentic The male patient was re91onVitamin C Inducedproliferation. Oxalate Nephropathy transplanted after initial failure secondary to recurrence and Matthewa second D’Costa, Loren Herrera Hernandez, Sandra developed recurrence. Proteinuria and Cr at the Herrmann. Mayowere Clinic, Rochester, second recurrence 3.73 g/day andMN, 1.89 USA mg/dL respectively. attempted on patients, however 92 Rituximab A Case oftherapy Severe was Hyponatremia andboth Acute Kidney Injury due to recurrent infections, female patients progressed to ESRD Eddy DeJesus, Nasr, Rabih. Bronx Lebanon Hospital whereas male patient continues to have worsening renal Center, Bronx, NY, USA function. DDD can manifest in an array Administration of clinical 103 Recurrent Acute Glomerulonephritis Post of presentations. PegfilgrastimProliferative glomerulitis with epithelial crescents is typically associated with an acute presentation and more rapid Hatem Elabd, Naheed Ansari, Belinda Jim. Jacobi Medical progression to ESRD. Center, New York, NY, USA

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Am J Kidney Dis. 2017;69(4):A1-A105

108 Refractory Hypomagnesemia During Pregnancy in a Patient with Gitelman Syndrome MEDICATION MANAGEMENT STRATEGIES AMONG ThomasWITH Frohwein, Kim, Isaiarasi PATIENTS CHRONICSusan KIDNEY DISEASE (CKD)Gnanasekaran. 1 1 1 , Wendyand M. Parker , Kirsten M. Donato , Sabrina Joseph M. Davis Lincoln Medical Mental Health Center, Bronx, NY, 2 Daoui , Rachid Daoui2, Katie E. Cardone1 USA 1. Albany College of Pharmacy and Health Sciences, Albany, NY; 110 Diagnosis and Treatment of Renal VeinSprings, Thrombosis 2. Div of Nephrology, Saratoga Hospital, Saratoga NY. (RVT) in thedataSetting of Lupus Nephritis and Antiphospholipid Limited exist regarding medication management strategies in CKD, despite being at high risk for medication-related problems and Syndrome (APS) non-adherence. Optimization of medication management strategies are Pablo Garcia, Felix Renneberg, Maanit Kohli, Steve Bibu, required to reduce this risk. The objective of this study was to assess Navya Anne Van Dwivedi. health literacy,Kuchipudi, medication knowledge and Hoven, strategies Shaunak for medication Saint Peter’s University Hospital, New Brunswick, NJ, USA management in CKD. survey about medication management 111 A Scleroderma Renal Crisis (SRC)was in administered the Setting toofpatients Systemic of an outpatient nephrology office. Validated assessments of health Sclerosis Sine Scleroderma (ssSSc) in Pregnancy literacy (Short Test of Functional Health Literacy in Adults (STOFHLA)) CKD knowledge Knowledge Survey (KiKS)) Pablo and Garcia, Shaylika (Kidney Chauhan, Maanit Kohli, Navya wereKuchipudi, included. DataShaunak were analyzed using SAS. Dwivedi. Saint Peter’s University Seventy-five patients participated in the survey; 56% were male, 61% Hospital, New Brunswick, NJ, USA were at least 65 years old and 92% were Caucasian. A majority of 121 Red(88%) Eyes Renal in Aknowledge Middle Age patients hadand adequate healthInsufficiency literacy. CKD-related varied among participants; 78% correctly answered a validated Gentleman knowledge question regarding medication use in CKD and 61% of Maryam Gondal, Mae Timbol, Jeffery Turner. Yale patients correctly answeredHeidi that the kidney produces urine. Among University, New Haven, CT, USA patients who reported knowing their medications’ indications, 89% correctly answered the medication knowledge question. Medication 125 Atypical Case of Behcet’s Disease Leading to IGA management strategies reported by patients included use of a pill box Nephropathy (69%), arranging meds in a specific location (97%), color coding (9%) Sanjeev Gupta, Anastasios Yorg Al-Azzi. and using a phone app (9%). For patientsPapanagnou, using a phone app, 100% reported ability to pronounce names, knowing medNY, indications Westchester Medical med Center, Westchester, USA and asking questions at medical appointments. All also correctly answered 126 Cefepimeknowledge Toxicityquestion Presenting Statushealth Epilepticus the medication and hadasadequate literacy. in a Patient with End Stage Renal Disease Medication management strategies varied among study participants. 1 Electronic underutilized. Jayaprakashresources Dasariwere , Aziz Bakhous1, Raed Mohitmedication Gupta1, management Despite having state 1 a highly literate cohort1of patients, a gap in disease 1 Azzem , Donald Dumford , Patrick Gallegos , Rupesh knowledge 1existed, highlighting educational needs pertaining to 1 Raina use . Cleveland Clinic Akron General, Akron, OH, USA medication and kidney disease. Medication management strategies should be explored in more diverse cohorts of patients withSevere CKD. Symp129 Tenofovir Causing Hospitalization Due to tomatic Hypophosphatemia Sanjeev Gupta, Anastasios Papanagnau, Savneek Chugh. 92 Westchester Medical Center, Valhalla, NY, USA OF KIDNEY TRAUMA AND SUBSEQUENT FUNCTION 130REVIEW The Significance of Anti-Phospholipase Antibodies in a AT DISCHARGE OVER A 13 YEAR SPAN Patient with Membranous Nephropathy Jayaramakrishna Depa, Ishita Bansal, Brittany Kalosza, George Mohit Icahn Gupta, Jayaprakash CoritsidisSchool of Medicine,Dasari, ElmhurstRupesh Hospital Raina, Center, Pallavi Queens, NY, Cleveland USA Reddy. Clinic Akron General, Akron, OH, USA We were interested in examining the epidemiology of renal trauma 132over AtheMystery Case of Blood Leak Alarm Going On past decade and any acute kidney function changes. Seifeldin Hakim, Maditz, Sadichhya Lohani, Sami Retrospective review ofRhyan electronic health records for patients treated for kidney injuries at our level 1 traumaWilliam center from January 2004Zarouk. Oakland University Beaumont Hospital, October 2016. Demographic, Royal Oak, MI, USA clinical, and hospital outcomes were analyzed using chi square and t-tests. 133 We Previously ANCA Preanalyzed 71Undiagnosed patients from the traumaAssociated registry with Vasculitis kidney senting Onetrauma Month Aftertend Kidney Transplantation injuries. Kidney patients to be young and male. The most common cause was MVA-related. Blunt traumaMohammad was most likely Ayman Hallab, Karthik Kannegolla, S. toYaqub. result in kidney laceration and hematoma. Average length of stay Indiana University School of Medicine, Indianapolis, IN, (LOS) was >17 days, where blunt trauma resulted in a longer LOS than USA trauma. Creatinine levels did not change between admission penetrating discharge (DC). of a Dialysis Dependent Immunotactoid 149and Case Report Total Glomerulopathy with FavorableBlunt ResponsePenetrating to Rituximabp N=71 76.1% 23.9%(17) 3 1 2 (54) , Rohan Bhojwani , Glen Markowitz Mehak Idrees Age, µ ± SD4 1 31.8±15.9 33.1±17.2 27.7±10.02 , Aaron 0.11 Dommu . Griffin87.3 Hospital, Derby, USA; Sex,Male,%(n) (62) 83.3 (45) CT,100.0 (17) Fairview 0.07 New Hospital, Cleveland, OH, USA; 3Columbia University,0.01 Injury Type,%(n) Contusion (4) 4.6 (2) 11.8 (2) York, NY, USA; 46.6 Nephrology Associates, Bridgeport, CT, Disruption 3.3 (2) 0.0 (0) 11.8 (2) USA Hematoma 32.8 (20) 43.2 (19) 5.9 (1) 150Laceration De Novo Atypical57.4 Hemolytic Uremic (35) 52.3 (23) Syndrome 70.6 (12) Fourteen Months After Renal Transplant Severity,%(n) 0.99 Grade 1-3 Isikalu, Jennifer 64.2 (34)Thompson, 64.1 (25)Maria64.3 (9) Posadas Olusola Aurora Grade 4-5 Medical University 35.9 (19) of35.9 (14) Carolina, 35.7 (5) Salas. South Charleston, Mortality,%(n) 9.2 (6) 11.8 (6) 0.0 (0) 0.18 SC, USA LOS 17.7±30.3 21.0±34.3 7.6±4.6 0.01 151DC“Lone” Lupus Nephritis: Histopathological to Rehab,%(n) 17.0 (10)A Seronegative, 22.2 (10) 0.0 (0) 0.05 Diagnosis Admission Cr 1.1 ± 0.3 1.0 ± 0.3 1.1 ± 0.3 0.27 DCJamal Cr 1.0 ± 0.6 1.0 ± Aiman 0.7 0.9 ± 0.3Gundersen 0.43 Janjua, Pratima Kamada, Riaz. InHealth conclusion, kidneyLa trauma doesWI, not result System, Crosse, USAin acute kidney injury.

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