Reverse osmosis (RO) is a critical aspect of providing the large volume of relatively purified dialysate water to dialysis patients worldwide. If you’ve never taken a peek at the water treatment room in your hospital’s dialysis unit (it…
There are many indications for plasma exchange in nephrology: some common ones include antibody-mediated rejection of a kidney transplant, Goodpasture’s, ANCA-associated vasculitis, and TTP–all of which are commonly associated with loss of renal fellows’ sleep–that is, you may…
Renal vein thrombosis is a thrombotic occlusion of one or both renal veins. Its most common cause is nephrotic syndrome, which is a hypercoaguable state though to be due at least in part to loss of the anticoagulant…
The urine anion gap is calculated as follows: [urine Na] + [urine K] – [urine Cl]. Think about the urine anion gap much as you think about the serum anion gap. The urine anion gap is really…
The antibiotic Bactrim is frequently associated with an increase in creatinine shortly after starting it. While Bactrim is a not uncommon cause of acute interstitial nephritis (AIN), the most frequent reason for a Bactrim-associated creatinine increase is actually…
Check out this video I found of the alleged first-ever home dialysis patient in England. Very civilized, except for the fact that it looks like the patient is using a permanent femoral dialysis catheter–something which would be used…
A current controversy in the CKD community involves definitions of CKD in the elderly. The issue is not trivial: were we to apply the standard KDOQI definitions of CKD staging, using the MDRD equation to estimate GFR, this…
At the Brigham and Women’s Hospital & the Dana Farber Cancer Institute, there is an ongoing trial of using pneumonectomy and injected, heated cisplatin into the pleural space for patients with malignant mesothelioma, a condition with an overall…
Mesangial cells–which historically have received less attention than their more “sexy” neighbor cell types of the glomerulus such as podocytes & endothelial cells–are actually quite interesting. They were originally seen as having purely a “matrix” function–that is, serving…
Heard a very good Renal Grand Rounds yesterday from visiting professor Michael Emmett, currently chair of the Dept. of Medicine at Baylor, regarding the anion gap. Amongst the pearls I took away from his lecture: 1. “Gamblegrams” (left),…
