UNASSIGNED: ChatGPT, a state-of-the-art large language model, has shown potential in analyzing images and providing accurate information. This study aimed to explore ChatGPT-4 as a tool for identifying commonly prescribed nephrology medications across different versions and testing dates.
UNASSIGNED: 25 nephrology medications were obtained from an institutional pharmacy. High-quality images of each medication were captured using an iPhone 13 Pro Max and uploaded to ChatGPT-4 with the query, \'What is this medication?\' The accuracy of ChatGPT-4\'s responses was assessed for medication name, dosage, and imprint. The process was repeated after 2 weeks to evaluate consistency across different versions, including GPT-4, GPT-4 Legacy, and GPT-4.Ø.
UNASSIGNED: ChatGPT-4 correctly identified 22 out of 25 (88%) medications across all versions. However, it misidentified Hydrochlorothiazide, Nifedipine, and Spironolactone due to misreading imprints. For instance, Nifedipine ER 90 mg was mistaken for Metformin Hydrochloride ER 500 mg because \'NF 06\' was misread as \'NF 05\'. Hydrochlorothiazide 50 mg was confused with the 25 mg version due to imprint errors, and Spironolactone 25 mg was misidentified as Naproxen Sodium or Diclofenac Sodium. Despite these errors, ChatGPT-4 showed 100% consistency when retested, correcting misidentifications after receiving feedback on the correct imprints.
UNASSIGNED: ChatGPT-4 shows strong potential in identifying nephrology medications from self-captured images, though challenges with difficult-to-read imprints remain. Providing feedback improved accuracy, suggesting ChatGPT-4 could be a valuable tool in digital health for medication identification. Future research should enhance the model\'s ability to distinguish similar imprints and explore broader integration into digital health platforms.

Tumoral calcinosis (TC) is a rare condition characterized by dystrophic calcinosis. TC in end stage kidney disease is associated with severe hyperparathyroidism. It is radiologically characterized by multilobulated cystic calcifications in periarticular regions without erosive arthropathy or osseus destruction. Secondary TC may necessitate medical or surgical parathyroidectomy for symptom control.

Xanthogranulomatous Pyelonephritis (XGP) is a serious and rare inflammatory disease of unknown etiology. This systematic review analyzes XGP cases. We performed a literature search for \"Pyelonephritis, Xanthogranulomatous.\" The primary composite outcome was recovery with post-surgery complications, partial recovery, death, or chronic kidney disease. The secondary outcome was any presentation or treatment complication. Predictor variables consisted of demographics, history, symptoms, and diagnosis/management. Among the 251 patients, the mean age was 36.1 years, and 57.4% were female. The most common symptom and finding were fever (55.0%) and renal stones (53.8%), respectively. There were 15.5% with the composite outcome. There were 51.0% with any presentation or treatment complication. Multivariate logistic regression analysis for the composite outcome showed that kidney of both/horseshoe (OR:3.86, 95% CI:1.01, 14.73, p = 0.048), dialysis required (OR:8.64, 95% CI:2.27, 32.94, p = 0.002), and operative treatment of nephrostomy or nephrostomy followed by nephrectomy (OR:4.57, 95% CI:1.58, 13.17, p = 0.01) were each significantly associated with increased odds. Fever (OR:3.04, 95% CI:1.63, 5.67, p <0.001) and renal stones (OR:2.55, 95% CI:1.35, 4.81, p = 0.004) were each significantly associated with increased odds for any presentation/treatment complication. In conclusion, XGP patients with involvement of both or horseshoe kidneys, dialysis requirements, or treatment of nephrostomy or nephrostomy followed by nephrectomy may require aggressive treatment to mitigate poor patient outcomes.

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Selected abstracts from the 42nd Vicenza Course AKI-CRRT-ECOS and Critical Care Nephrology.

Dr. Manuel Martinez-Maldonado is a distinguished Puerto Rican internist, nephrologist, physician-scientist, mentor, and prolific writer whose leadership in academic and clinical settings has significantly advanced the fields of nephrology, renal physiology and pharmacology, fluids and electrolyte metabolism, calcium metabolism, hypertension research, and medical education. His research on electrolyte imbalances has led to innovative hypercalcemia treatments, notably furosemide with IV fluid therapy. This is an approach that, combined with pharmacotherapy using calcitonin and bisphosphonates, became the standard practice for managing hypercalcemia until specific therapies became available. His nephrology research team and laboratory in the San Juan VA (Veterans Affairs) Medical Center and the Medical School of the University of Puerto Rico were internationally renowned. Throughout his career, he fostered a culture of mentorship while spearheading superb clinical teaching and research initiatives. His transformative tenures at several institutions, including Baylor College of Medicine; the University of Puerto Rico-Medical Sciences Campus; the VA medical centers in Atlanta, Houston, and San Juan; Emory University; Oregon Health Sciences University; Ponce School of Medicine; and the University of Louisville School of Medicine demonstrate his lasting contributions to medical science and education. His interdisciplinary approach, advocacy for kidney and clinical research, and contributions to understanding the renin-angiotensin system and the role of sodium-potassium-activated adenosine triphosphatase in renal concentration mechanisms illustrate his enduring impact on renal physiology and human health.

BACKGROUND: Continuous renal replacement therapy (CRRT) is commonly used for the treatment of acute kidney injury (AKI) in critically ill neonates. This study investigated the effectiveness and feasibility of CRRT for AKI in neonates who weigh ≤3 kg.
METHODS: Data from 19 neonates with a weight ≤3 kg and AKI who underwent CRRT at two centres between January 2015 and October 2021 were collected retrospectively. Kidney function, circulatory function, complications and clinical outcomes were recorded. Repeated-measures analyses of variance, t-tests and non-parametric tests were conducted.
RESULTS: The median patient age at CRRT initiation was 3 days (IQR: 1-7 days). The median patient weight at CRRT initiation was 2.67 kg (IQR: 2.20-2.85 kg). The median CCRT duration was 46 hours (IQR: 32-72 hours). The serum creatinine and blood urea nitrogen levels decreased significantly, and the mean arterial pressure increased significantly after 12 hours of CRRT and at the end of CRRT. The urinary output was significantly increased at the end of CRRT. 11 patients had thrombocytopaenia, 6 had electrolyte disorders and 3 had blocked tubes. Five patients were discharged, six died after their parents chose to discontinue treatment and eight died after active treatment. Weight at CRRT initiation and urinary output at the end of CRRT were significantly lower among patients who died than among patients who survived.
CONCLUSIONS: CRRT is feasible and effective for AKI in neonates who weigh ≤3 kg when accompanied by elaborate supportive care. Lower body weight and persistent oliguria may be correlated with an increased risk of poor clinical outcomes.