Pre-transplant: All the donors and recipients of kidney transplants (both living and deceased) should be tested for status of CMV by CMV IgG in the blood. If there is history of recent transfusion, pre-transfusion status should be regarded…
Over at the Atlantic this week, an article was published written by one of the people who took part in the early trials of tolvaptan for APKD. The article shows just how much hope people with this disorder…
We have all been called in to see patients who have developed AKI after receiving mechanical ultrafiltration (UF) for acute decompensated heart failure (ADHF). In almost all situations I have experienced, UF was started early, perhaps without optimization…
In my experience the appetite to biopsy patients with clinical renal disease varies widely between clinician, institution and country. This is most apparent when it comes to the diabetic patient with renal disease. In my opinion there is…
I recently managed an elderly African American man who was admitted from the clinic for a renal biopsy. He was referred for proteinuria that had not been quantified by his PCP but had been present for over a…
Nice case report in AJKD recently raised the issue of Type B Lactic Acidosis. Lactic acidosis occurs when there is excessive anaerobic glycolysis or decreased removal of lactate from the circulation. Classically, Type A lactic acidosis is related…
Nate wrote a couple of posts in the past about the use (and misuse) of urinary eosinophils for the diagnosis of acute interstitial nephritis (AIN). Since the original report describing the use of this test in the NEJM…
There is an excellent review of the use of statins is CKD in KI from last month. The authors point out that the association between LDL cholesterol and CVD is not as strong in patients with CKD, particularly…
I give a regular talk to the residents in the ICU on CRRT and one of the things that I focus on is prognosis. We all know that the outcomes of patients requiring CRRT in the ICU are…
A young patient who was engaging in heavy weightlifting presented to the ED with proximal muscle weakness. The night before he had one hour of acute onset bilateral leg and hip flexor cramps with stiffness and “hardened” muscles…
