Can you have an acidosis with normal serum bicarbonate? Of course you can, it’s just incomplete. Incomplete distal renal tubular acidosis (idRTA) that is. RTA was first described in 1935, confirmed as a renal tubular disorder in 1946,…
In a previous post, we discussed the way the cilastatin prevents imipenem nephrotoxicity by inhibiting dihydropeptidase, a proximal tubular brush border enzyme which facilitates the uptake of imipenem metabolites into proximal tubular cells. This allows imipenem to be…
One of the issues that we come across repeatedly in the clinic is the timing of access insertion. We all want to avoid the use of catheters and so we refer patients early (when possible) for fistula formation….
Diabetes is a common cause of CKD and the prevalence of diabetic nephropathy is increasing. A question that sometimes arises in the clinic is when it is appropriate to biopsy a patient with a presumptive diagnosis of diabetic…
CJASN eJC Article of the Month, 2012-08-15 Prevalence and Factors Associated with Hyperkalemia in Predialysis Patients Followed in a Low-Clearance Clinic “Pantelis A. Sarafidis, Rochelle Blacklock, Eleri Wood, Adam Rumjon, Shanique Simmonds, Jessica Fletcher-Rogers, Rachel Ariyanayagam, Aziza Al-Yassin,…
A 47 year old man with ESRD secondary to a chronic TMA presented 3 months following a renal transplant with a rising creatinine (1.44 mg/dl from a baseline of 0.9 mg/dl). His prograf level had ranged from 5-7….
Current Opinions in nephrology and hypertension has an excellent review this month on the rationale for bicarbonate treatment to slow the progression of CKD. The original data animal data was derived from the 5/6 nephrectomy model where rats…
Azilsartan medoxomil is a relatively new angiotensin receptor blocker and a study was recently published in Hypertension which compared the combination of two different doses of this drug with chlorthalidone against olmesartan in combination with hydrochlorothiazide for the…
Summer has come to the northern hemisphere and it is time to praise our kidneys for all the hard work of preserving the intravascular volume. Although only 30% of Na reabsorption takes place in the distal nephron, this…
A man in his early 60s was being treated for metastatic adenocarcinoma of the lung for 2 years. Recently, he had been complaining of increasing hemoptysis and a PET CT was performed which showed progression of his disease….
