THAM
Have you ever given THAM (tromethamine)? For whatever reason I was completely unfamiliar with the drug as a resident, but it is given not infrequently in the surgical ICU’s in the hospitals in which I’ve worked as a…
Posts by
Nathan Hellman
Inaugural Member of Nephrology Hall Of Fame
The Journal C-JASN has begun a new monthly feature: “The Nephrology Hall Of Fame”, in which each month an outstanding contributor to the field of Nephrology will be honored by an article describing their major contributions. The first-ever…
Risk Factors for Enhanced CV Mortality in ESRD Patients
Cardiovascular mortality in the general ESRD population is between 10- and 20-fold higher than that of the general population, and is an astounding 65-fold higher in ESRD individuals in the 45-54-year-old subgroup of the Framingham study. A recent…
Can dialysis prevent nephrogenic systemic fibrosis?
There has been a lot of literature over the past few years regarding the identification of gadolinium-based contrast dye as the driving force behind the dermatologic fibrosing condition nephrogenic systemic fibrosis (NSF). While there remain doubters that gadolinium…
Dent Disease
Dent Disease is a rare, X-linked inherited disease of pediatric nephrology. It can be filed under the category of “renal tubular dysfunction” and is also known as “X-linked Recessive Nephrolithiasis.” Clinical characteristics of Dent Disease include recurrent renal…
Differential Diagnosis: Lactic Acidosis
As discussed in a recent post describing the success of early goal-directed therapy for sepsis, the test for serum lactate has enjoyed a rise in prominence in recent years. However, all that is lactic acid is not necessarily…
Do Kidney Stem Cells Exist?
Hot topic of research: do kidney stem cells kidney exist? Stem cells are defined as a subpopulation of cells which retain the ability of self-renewal and differentiation into a specialized cell type. Stem cells specific to many tissue…
Treatment of Sepsis
I heard a talk on “Sepsis & Renal Failure” today, which reviewed much of the recent evidence-based medicine trials regarding the treatment of sepsis in the ICU. Honestly, the main message I came away with was this: most…
Differential Diagnosis of Fibrillary Glomerulopathies
The finding of fibrils on electron microscopy of a renal biopsy specimen may be an extremely important clue in establishing the diagnosis. In fact, for many of the conditions listed below, the diagnosis may be based PURELY on…
Empiric Management of Suspected RPGN
RPGN is a nephrologic emergency, and one of the more exciting consult cases for nephrologists to participate in. Much like dealing with a stroke or heart attack, delays in initiating therapy can lead to substantially worsened outcomes. Prompt…