Nathan Hellman
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Nathan Hellman

Transvaginal Nephrectomy

Recently two separate groups have reported the successful carrying out of the first-ever human transvaginal nephrectomy–one report coming from the Cleveland Clinic and another from Venezuela. The surgery is being developed as an even less invasive surgical approach…

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Chronic Pain in ADPKD

About 60% of all ADPKD patients are estimated to have a chronic pain syndrome, and often this is the initially presenting symptom of an ADPKD patient that brings them to medical attention. An excellent review of this field…

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Two-Hit Hypothesis & ADPKD

One of the really interesting aspects of autosomal dominant polycystic kidney disease (ADPKD) is that only about 1% of all nephrons form cysts. You can do the math: if you have about 1 million nephrons per kidney, and…

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A better way for CKD staging?

Presently the KDOQI Staging system for CKD (see figure) is what is used most commonly to classify the severity of reduced renal function. This is based purely on an estimation of the GFR, using equations such as the…

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The Erythropoietin Receptor

As we all know, erythropoietin is secreted predominantly by the kidney (85% from the kidney, 15% from the liver) in response to hypoxia and its function is to stimulate erythropoiesis in the bone marrow.  What  is the receptor…

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Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) accounts for a significant fraction of renal artery stenosis. The distinction between fibromuscular dysplasia and atherosclerotic renal artery stenosis is important as the former tends to respond much more readily to interventional therapy than the…

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Combined Kidney/Bone Marrow Transplants

One of the interesting ongoing protocols at the Massachusetts General Hospital Kidney Transplant Program is the combined kidney/bone marrow transplant protocol. The idea here is to transplant both kidney & hematopoeitic stem cells from the same donor, which…

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Lithium-Induced Hyperparathyroidism

Lithium, a very effective medication in the treatment of bipolar disorder, has a variety of well-documented renal side effects, including interstitial nephritis and nephrogenic diabetes insipidus.  A less well-recognized complication is an increased prevalence of hyperparathyroidism in chronic…

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