How does sodium retention occur in liver cirrhosis? Most of us accept Schrier’s peripheral arterial vasodilation hypothesis. This hypothesis postulates that overproduction of vasodilatory substances in the splanchnic circulation in cirrhosis leads to splanchnic pooling and decreased “effective”…
Mechanisms of edema formation in nephrotic syndrome (NS) are controversial. The traditional underfill hypothesis has come under heavy fire, and there are now many clinical and experimental observations that contradict it. The overfill hypothesis has now captured the…
One of my transplant patients came to clinic last week excited about his trip to Tanzania. He had undergone kidney transplantation three years ago and has had an uneventful course. As a transplant nephrologist, you kind of become…
In something of a first for Nephrology, today sees the simultaneous release of a powerful tool for predicting ESRD risk in CKD patients at the World Congress of Nephrology, in JAMA and as a mobile application (free download; see…
Critically ill patients receiving continuous renal replacement therapy are frequently given heparin to maintain circuit patency. In the presence of active HIT-II or HITT, even in the absence of clinical thrombosis, systemic anticoagulation with a direct thrombin inhibitor…
A few months ago I took care of a patient who, having been on peritoneal dialysis for a number of years, was losing weight, had poor small solute clearances and worsening edema. We transitioned her over to HD…
While recently reading about hypogonadism in the dialysis population, I came across this review on the pregnancy outcomes in women on dialysis, summarizing observational studies published between 1995 and 2009. I have participated in only a few pregnancy-planning…
Please take a moment today to remember our dear friend and colleague Nate Hellman, founder of Renal Fellow Network, who died tragically on this day last year. Our thoughts go out to his family, especially his wife, Claire, his two…
GeriPal took the win by a hair. Thanks for all of the support. Follow the link to see the final results in the 2010 Clinical Sciences Category of the Seventh Annual Medical Weblog Awards from MedGadget! RFN was…
I’ve always been skeptical about ACE inhibitors as a cause of hyponatremia, despite there being almost 20 case reports of this complication in the literature. Given the fact that so many patients I see are taking an ACE…
