One of the most feared complications of peritoneal dialysis is that of PD peritonitis. Infection with gram positive (50-70%) organisms accounts for the vast majority of cases. The typical presentation is with abdominal pain, fever and cloudy dialysate…
This intriguing set of clinical signs was discovered by von Bezold and Hirt in 1867 – they found that injection of a veratrum alkaloid caused bradycardia, hypotension and apnea. In the 1930’s Jarisch and Richter were performing similar…
In the previous blog we discussed some of the physiological principles underlying the JVP. Now I thought I’d present some manuscripts relating to the utility of the isolated use of JVP in clinical practice. The first is a…
The physical examination of volume status is perhaps the most common assessment we perform in everyday clinical practice. It is also one of the most difficult and subjective tasks to perform. In particular, the JVP is one of…
IgA nephropathy is the most common cause of glomerulonephritis in countries where renal biopsies are commonly performed. See a previous post on the wide variety of presentations with this syndrome and this review. But what do we know…
Here are some interesting points on the pharmacokinetics of immunosuppressant drugs, taken from NephSAP in July 2010. It’s always to good to have an idea of how the body manages these drugs; this can sometimes help to predict…
Consider a patient with long-standing SLE who has biopsy proven WHO class IV lupus nephritis, previously treated with cyclophosphamide and steroids, which induced remission. Due to recurrence of proteinuria and desire to remain steroid-free, MMF was commenced with…
We were following a CKD patient with CLL in hospital with the haematology team. One morning, out of the blue, his potassium came back at 6.5mmol/L. It had been stable in the high four range for the duration…
Here are some interesting points I picked up at an ASN review to reinforce Gearoids post discussing changes in reference values during pregnancy and Michael’s board review post which covers a lot of the physiology also. Kidneys increase…
Have you ever been consulted to dialyze for a high BUN. Or have you ever been asked to comment on the high BUN’s effects on bleeding and platelet function. Here’s an interesting case report I came across in…
