The Brenner Hypothesis–developed by Barry Brenner of the Brigham and Women’s Hospital, author of the well-known Brenner & Rector “The Kidney” textbook–states that individuals with a congenital reduction in nephron number have a much greater likelihood of developing…
It was not an unusual event during my clinical fellowship to get a call from the cardiac team asking for dialysis in a patient with hyperkalemia and acute renal failure. On a few occasions the hyperkalemia seemed disproportionate…
Dr John Gennari had another typically excellent review of metabolic alkalosis in AJKD in October. He suggests an alternative means of classifying a metabolic alkalosis according to the etiology of the alkalosis along with the physiological basis for…
Recently, we were asked to see a patient on the consult service with a rising creatinine, a BUN of close to 200 and decreased urine output. The patient was a diabetic who had an STEMI several months previously…
Dr Steele pointed me in the direction of this article from JAMA that was written back in 1927. Although not directly related to the world of Nephrology, it contains advice on building a relationship with your patients and…
Treating hypertension on pregnancy sometimes feels a little like going back in time. As Nate posted previously, the list of anti-hypertensives that are considered safe in pregnancy is relatively short – first line agents include labetalol, hydralazine, methyldopa…
An 18 year-old girl with end stage renal disease secondary to focal segmental glomerular sclerosis had a double cuff flex neck peritoneal dialysis (PD) catheter uneventfully inserted in order to begin dialysis. Ten days after this procedure, following…
Recently there was a very interesting series in three parts in the online magazine Slate.com concerning the use of mice and rats as surrogates for humans in animal studies. Anyone who has worked with mice in the lab…
A number of years ago, I was at a lecture given by a transplant surgeon from London. He was discussing the dangers surrounding living unrelated kidney transplantation and he told the story of a member of a royal…
A patient presented to the outpatient service with progressive renal insufficiency and sub-nephrotic range proteinuria. He had a long history of CMML with few blasts in his bone marrow aspirate but a peripheral white cell count that was…
