Nathan Hellman
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Nathan Hellman

What is hepcidin?

What is hepcidin and why is it important to nephrologists? Hepcidin is a 25-amino acid peptide (see left) secreted by the liver which seems to be the “master regulator” of iron metabolism. It works by binding to the…

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NSAIDs & the Kidney

NSAIDs are a tricky class of drugs. As an internal medicine resident, I used to prescribe ibuprofen 800mg po tid willy-nilly for my clinic patients with back pain, since I generally had good results using this strategy, and…

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Renal Side Effects of HIV Medications

The treatment of HIV infection has been radically changed with the development of HAART–highly active antiretroviral therapy. Fortunately for nephrologists, these medications are relatively safe from a renal standpoint. There are two notable exceptions to be aware of….

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Urine eosinophils

Eosinophils in the urine can be detected by applying a Hansel’s stain to the urine sediment. The presence of >1% eosinophils of the total urine WBCs constitute a positive test. In general, the same things which cause +urine…

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The Cryocrit

Whenever you recommend that “cryoglobulins” be drawn on a patient, it is important to realize that the specimen must be collected in a very specific way. It cannot be simply “added on” to a specimen already drawn. Cryoglobulins…

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Unusual Causes of Anion Gap Metabolic Acidosis

The “MUDPALES” acronym, which details the main causes for anion gap metabolic acidosis (Methanol, Uremia, Diabetic ketoacidosis, Paraldehyde, Alcohol, Lactic acidosis, Ethylene glycol, Salicylate toxicity), is one of the most successful medical acronyms of all time. There are…

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NSIAD (not NSAID)

A subset of pediatric patients with a clinical and biochemical profile consistent with SIADH (the syndrome of inappropriate ADH secretion)–that is, euvolemic hyponatremia with an inappropriately elevated urine osmolarity–have low to undetectable levels of ADH. What’s going on?…

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NODAT

The acronym NODAT stands for “new onset diabetes after transplant”. Diabetes is one of the many complications which occur in the post-renal transplant setting. The reasons for this are manifold. Transplant recipients who require long-term steroids will obviously…

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Collapsing Variant of FSGS

The collapsing form of FSGS is a histologic variant which is characterized by mesangial hypercellularity and resultant collapse of the glomerular capillaries, as illustrated in the photo to the left. Its identification is important for prognostic reasons as…

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