This week on the Inside EMS podcast, Chris Cebollero and Kelly Grayson shine a spotlight on the kidneys and their impact on patient outcomes. What starts as a chat about chronic kidney stones quickly dives into a sharp, clinical breakdown of renal anatomy, physiology and the far-reaching consequences of kidney dysfunction in EMS care. Chris and Kelly unpack the kidneys’ role in fluid balance, blood pressure regulation and acid-base stability, including how the renin angiotensin aldosterone system (RAAS) system can either save a patient … or make things worse. They outline the key types of acute kidney injury (pre-renal, intrinsic, post-renal), tie them back to underlying anatomy, and explain why perfusion matters long before labs confirm failure. With field-focused tips on what to ask (yes, diaper counts matter), what to look for and how to manage critical complications, this episode gives medics the tools to recognize renal red flags early — and act fast. Additional resources: Acute kidney injury assessment and treatment The science behind shock: Why providers must understand the RAAS Caring for the dialysis patient One for the Road: Is this a kidney stone? Memorable quotes “In EMS, we don't really pay attention to the functioning of the kidneys until everything goes south.” “They're not lying when they say the kidneys are the windows to the viscera.” “Kidney problems don't happen in isolation.” Enjoying the show? Email theshow@ems1.com to share feedback or suggest guests for a future episode.