Dropsy
I would highly recommend the following book for renal fellows everywhere: “Dropsy, Dialysis, Transplant: A Short History of Failing Kidneys“, by Steven Peitzman. I am presently reading it during my trips on the “T” while commuting into Mass…
Posts by
Nathan Hellman
An Unexpected Case of AIN
Here’s a case I saw on the consult service last week which demonstrates the utility of examining the urine sediment yourself. The clinical scenario: a 50 year-old male with a history of hepatitis C liver disease who was…
Cardiorenal Syndrome
Any nephrology fellow running the Consult Service will rapidly realize that heart failure and renal failure often go hand in hand, earning the moniker “cardiorenal syndrome.” The thought here is that decreased forward flow from pump failure results…
ANCA Madness
ANCA-positive vasculitides are a not uncommon cause of rapidly progressive glomerulonephritis. When we send off an ANCA test, what are we actually measuring? ANCAs (anti-neutrophil cytoplasmic antibodies) are a type of IgG autoantibodies that are directed against antigens…
Bilateral Renal Cell Carcinomas
The case: a 50-ish yo woman, normal baseline renal function, and a history of nephrolithiasis x 2 episodes presented with gross, painless hematuria. She was initially thought to have another stone event, but she had no significant flank…
Hemolysis-with-Dialysis
Hey, it rhymes! One of the rare but potentially severe complications seen with hemodialysis is intravascular hemolysis. There is an interesting differential diagnosis of what might cause dialysis-associated hemolysis, many of which have to do with contamination of…
Ovarian Hyperstimulation Syndrome
I saw my 2nd case this year of renal effects of Ovarian Hyperstimulation Syndrome (OHSS). OHSS is a complication of in vitro fertilization therapy, in which pharmacologic doses of gonadotropin therapy can lead to enlarged ovaries filled with…
Side-Effects of Cytoxan
Welcome to Cytoxan (cyclophosphamide), one of the most versatile (albeit toxic) medications in the nephrology world. Its mechanism of action is as an alkylating agent; it induced alkylation of DNA in actively proliferating cells, which explains its use…
Trick Question Regarding Contrast-Induced Nephropathy
Trick Question: Which would you imagine to be lower osmolarity between “low osmolar iv contrast” and “iso-osmolar iv contrast”? The answer is, for historical reasons, “iso-osmolar contrast.” The increasing use of iv contrast agents led to the identification…
Post-Transplant Lymphoproliferative Disorder
Post-transplant lymphoproliferative disorder (PTLD) occurs in < 1% of kidney transplant recipients, but can often be a serious complication. In essence, PTLD is a form of lymphoma which occurs due to decreased immune surveillance as a result of...