Amphotericin is one of those medications which keeps nephrologists in business by virtue of its predictable nephrotoxic effects. The mechanism of amphotericin-induced renal failure is felt to be acute tubular necrosis (ATN); the drug binds to sterols in…
Cardiovascular disease is by far and away the #1 killer for patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD_. Therefore, HMG coA reductase inhibitors (a.k.a. “statins”)–with their impressive track record of clinical trials showing a…
I have never seen “First Use Syndrome” firsthand, but it usually comes up as a topic when discussing “Complications of Dialysis.” It refers to a severe IgE-mediated anaphylactoid reaction which occurs during the first use of a dialyzer,…
Isopropyl alcohol is unique amongst the toxic alcohols (e.g., ethylene glycol, methanol, etc) in that it causes an osmolar gap WITHOUT causing an anion gap. In addition, unlike the toxic alcohols listed above, it is the isopropanol itself…
UPJ obstruction is another common congenital abnormality which under some circumstances can lead to significant renal scarring and chronic kidney diseases. About 50% of ultrasounds during pregnancy which detect antenatal hydronephrosis turn out to have UPJ obstruction. UPJ…
Horseshoe kidney is a relatively common (1 in 400 live births) congenital malformation of the kidney in which the kidneys are fused together. 90% of the time the fusion occurs at the lower poles (upper left photo) and…
Pauci-immune disease–a common cause of glomerulonephritis–refers to the histologic finding that there is an absence of glomerular immune staining (e.g., no immune complex or anti-GBM staining). Usually this is accompanied by positive ANCA titers, but not necessarily. When…
The case: a 60 year-old woman with a history of metastatic ovarian cancer who presents with a markedly tense, distended abdomen and acute-on-chronic kidney injury, with a Cr which had risen from 1.4 mg/dL to 4.5 mg/dL and…
The first report that lead can cause nephrotoxicity was by Lancereaux in 1863, who observed chronic kidney disease in an artist who habitually would hold paintbrushes in his mouth; there are some who believe that the collapse of…
As I’ve mentioned previously on this blog, the “MUDPALES” mnemonic for anion gap metabolic acidosis is one of the most successful medical mnemonic’s of all time. A less successful (and admittedly less useful) mnemonic exists for non-anion gap…
