The reason this is such a remarkable explanation and brilliantly explained is because the doctor obviously understands the subject in depth. Thank you for taking the time to share with us

This lecture is better than anything I got in PA school. Perfect review for internal medicine rotations!

its amazing, i've relied on my memory of the associated lab values for pre-renal vs renal, (BUN/CR 20:1 pre-renal and 15:1 for renal) and have used them to distinguish for awhile, but this video explains it so easily; no more memorization required. thanks!

I know I'm not a Med student... but you explain this way better than my nursing instructor did! Better educated nurses make for better patient which make happy, less stressed Doctors (maybe). Thanks for the videos!

Thank you so much for this video!! I was never fully satisfied the explanations given in my nephrology lectures until i came across this video.

This video seriously changed my life... I completely understand the kidneys SO MUCH better! Thank you!

we need a professor like you at my vetschool ;)

This is Amazing Doc! I have only seen a couple of people with the ability to explain and teach at your level. I only recently started spreading the word but you are now very popular in the PA - Student world. Keep up the great work!

Thanks for the question. Most of the Na reabsorption is via the Na+/K+ ATPase in the basolateral membrane.

Thia is such a valuable resource. Explained beautifully.

Thank you so much for takin the time to explain the labs so well. Really appreciate it.

The more you educate the greater impact you are having in the medical community, and the better we can take care of our patients! Thank you for doing this, I am a nurse and because of your lectures I am able to understand and help treat my patients that I have better.

CKD stage5 patient here. I understand it more clearly this way 💗

Thank you. I have CKD3 and was needing to learn what and why my blood labs numbers are. Now I can better ask my doctor questions.

DR, Thank you so much for your lectures, I hope you read this, I'm from Malaysia, and currently preparing for my MRCP. I really hope you'll continue to do short lectures regarding internal medicine which make things much more easier to understand. Thnk u DR!

Thank you for the clear and concise lecture on ARF - much appreciated!

Thank you so much!! This explained to me to a question I've been stuck on.

Omg thx so much, I will watch all your videos, I feel like all my unanswered questions being answered in your video, and I hope you make more and more videos for students like us!!!

Great videos! I was hoping you had a website were I could download pdf's or powerpoints of these videos.

I love these videos!

Thank you for the explanations.

Fantastic lecture! Thank you!!

Wow!!!! Fantastic videos!!

Well experienced But can you make lectures on hemodialysis patients Why what and how treat????

What a great lecture! I finally really understand the concepts of renal failure and the BUN and creatinine. The only thing is, why does the BUN get reabsorbed in the tubules into the blood to begin with when it is a waste product of protein breakdown? What does the body need it for?

Short &sweet 👌

These vids rule! Thanks so much.

3 years of renal CLEARLY covered in 3 videos.

thanks,wonderful teaching.

thanks so much i in remote area in Ethiopia so that nice for me

Love this videos, pretty helpful. I was wondering what kind of software do you use to make them? I mean, all the drawings and stuff. Thanks.

Hi, Dr. Seheult! I am a second-year medical student, and I find your teaching style to be extremely helpful!! I am looking to buy access to your courses to study for Step, and I was wondering if you had a code I could use. That would help me out immensely!!! Thank you!!

absolute genius!

i love your videos. very informative. i am working now but i still have a lot to learn so thanks for this clear explanations. simplified!!!!

@Medcram

9 жыл бұрын

6886butterfly Good to hear- thank you for the comment

Great. Thanks

thank you

thank you!

earned a lot in a short time

Excellent sir..

Such a helpful video! (Sidenote: 'osmolarity' or 'osmolality'? Does it change from latter to former when outside the body?)

great videos. thank you!

@Medcram

9 жыл бұрын

iluvsyouporgy Thanks for your comment

Lovely

verrry helpful thanks I have Q in pre renal cases if urine has low sodium and water as well why high osmolarity ? as solutes are even low ?

At the luminal membrane, sodium is reabsorbed via cotransporters (ex - sodium-glucose cotransporter), the energy for which is provided via secondary active transport (Na+/K+ ATPase) on the basolateral membrane. Hope this helps.

??Do lab values normalize/improve if someone is fasting? or water fasting? very informative when I want to geek out or need something explained, TY, Be Well.

My lab measured Urea in mmol/l not BUN and creat in umol/l.., how do I appreciate this ratio without need to convert it to BUN??what is the ratio using this units, to say its pre renal or renal????

See the whole series at www.medcram.com along with other top quality videos including reviews in pulmonary, cardiology, infectious disease, and hematology!

It's really the glomerular filtration rate that decreases (GFR). Creatinine clearence is an estimate of this. renal blood flow is only one determinant of the GFR. For instance, low RBF can cause prerenal azotemia.

hello thank you for the vidoe ;=) .. i have a question though.. what biology results do you get in an obstructive acute renal failure?

Can muscle wasting occur rapidly/acutely enough to diagnostically affect serum creatinine levels? I don't know. But it does make sense that less muscle tissue = less muscle breakdown products (creatinine) in the blood.

if you're talking about serum creatinine at 11:47 muscle wasting and damage should increase it not decrease it because you said it comes from muscles

Thank you so much for all these videos! Finding them extremely helpful for pre-clinical years.

sir, in acute renal failure, oliguria is important manifstation . then why in renal acute kidney failure increased sodium occur(that mean polyuria)....

i have a question though , why does the renal blood flow decrease if the cells in the PCT aren't working for some reason? is that because Na and H2O aren't absorbed so the blood volume will decrease which will cause a decrease in the blood flow to the kidneys ? will that cause a constriction of the afferent arteriole ? please explain , thank you .

in the example of BUN: creatinine ratio for intra-renal (intrinsic) AKI, it is shown as changing from 15:1 to 30:2, however i don't understand why serum creatinine goes UP. in the previous example of pre-renal AKI, it is clear that low GFR leads to higher serum creatinine. i understand the logic here that both BUN and creatinine are filtered less, but that BUN is reabsorbed in the PCT and thus serum levels are elevated proportionally more than creatinine. however, in the second example, GFR is not necessarily lower, just reabsorption is prevented. as creatinine is not reabsorbed anyway, i dont see why serum levels would go up.

@gabrielRcorrea3

7 жыл бұрын

well, if the BUN isnt reabsorbed, Cr can't be secreted! so. 1 reason to serum BUN increase (lack of reabsorption) AND 1 reason to serum Creatinine to increase (Lack of secretion). Theeeen, altough serum BUN and Cr are increased (30/2), the ratio (15/1) is still the same. :) well, i think that it is

IS the sodium re-absorbed via SGLT2 or something else?

wow

wasting can be a very slow process and it doesn't present the same as damage like crushing etc. I think as you slowly lost muscle mass from wasting it would decrease proportionally to the mass you lost. If there was actually damage then you'd expect an increase bc like his burn example there is a lot of protein that is broken down. That's my thoughts on it, you might be right of course, I'm not expert.

how do hanta virus' cause renal failure? is it a fall in GFR?

Thanks For Another video , But One of causes of Renal ARF is Acute rubular necrosis in that case we shouldnt have High sodium or H2O in Urine , we will be having oligria right?

@Medcram

8 жыл бұрын

+Vayne Manson We can have oliguric or non oliguric renal failure. Both can happen in ATN. Non oliguric is easier to take care of because there is less hyperkalemic and less fluid overloaded state. However, in both cases, the tubule cells are not working and therefore there is no absorption of Na and therefore water. urine Na is going to be high in concentration.

lovely video. One question though, arent steriods ANABOLIC though? Please reply

@Medcram

9 жыл бұрын

Christerfa Akuse Thanks for the question. Some steroids are anabolic and some are catabolic. Catabolic = cortisone Anabolic = testosterone

@christerfaakuse

9 жыл бұрын

MEDCRAMvideos oooooo! i get it now! thanks!

@mbibi

4 жыл бұрын

MedCram - Medical Lectures Explained CLEARLY you’re the best !!!

>20:1 for pre-renal?

Hello what about BUN/Cr ratio in postrenal failure?

@chandanareddy5083

7 жыл бұрын

more than 15 because the tubules are intact in post renal failure.

@chandanareddy5083

7 жыл бұрын

more than 15 because the tubules are intact in post renal failure.

@chandanareddy5083

7 жыл бұрын

more than 15 because the tubules are intact in post renal failure.

Why wouldn't tubular cells be working if we only have Glomerulonephritis? WOuldnt then Renal ABI have the same Lab as Pre-renal ABI ?

@Raxorium

5 жыл бұрын

wondering the same thing

What causes the shift from prerenal to renal renal failure? :)

@autumnv9438

9 жыл бұрын

prerenal and intra-renal are two different types of acute kidney failure. Prerenal is renal failure caused by decreased blood flow- the kidney itself is fine but its the lack of blood flow is causing the problem. So a person in shock, a burn patient, a patient hemorrhaging, or maybe heart failure. if no blood is flowing no filtering is happening. Intra-renal is a problem inside the kidney itself and could be caused by toxins, dyes, infection etc. where damage to cells within the kidney are causing the filtering problems

Is rhabdomyolysis related to renal failure?

@Medcram

2 жыл бұрын

Yes it causes myoglobin to pass through the kidneys. When this happens it causes renal failure.

what is the difference between (acute and chronic) Renal failure and Nephrotic or Nephritic Syndrome?

@DeepBlueMuslim

8 жыл бұрын

+Yusuke Yurameshi nephrotic is protein only in the urine, nepritic involves blood in urine

@yusukeyurameshi2482

8 жыл бұрын

Omer Elhassan but my question was ARF/CRF vs. nephrotic/nephritic? tho i think ARF and CRF are just general medical conditions, while the nephrotic and nephritic are more specific diseases that could cause or fall into a condition of either ARF or CRF..

what software is this?

@Medcram

8 жыл бұрын

+Haobo Sun Smooth Draw 4 and a Bamboo Tablet

How does fever cause an increase in the BUN?

@yasmine4754

4 жыл бұрын

Daniel Curtis, increased metabolism secondary to increased body temperature with the result of more protein breakdown, resulting in increased BUN.

Why would muscle wasting cause the Cr to drop?

@tartanhandbag

7 жыл бұрын

because creatine phosphate exists in, and is secreted, by muscles, so less muscle = less creatine (and it's metabolites)

@Raxorium

5 жыл бұрын

creatinine is released at a constant rate proportional to amount of muscle you have, so old people will have less creatinine being dumped into the blood cuz they got less muscle

y do u hv to draw tat toilet😋....the lesson is beautifully explained though!!

@prem9185

4 жыл бұрын

Liked your comment How does it feel to get your first like after 4 yrs

Fever = increased catabolism = increased BUN

Please send lectures in simple details not in biology everyone don't know biology ..

So you don't know about postrenal acute renal failure?

@DieWatcher

9 жыл бұрын

Ok, video 3 solved it...

You keep drawing a NEPHRON and saying it's a glomerulus.

I don't understand why you can't just say UREA instead of BUN... Americans lol