An interesting scenario of “acquired” anti-GBM disease can occur when a patient with Alport’s Syndrome gets a renal transplant. Patients with Alport’s Syndrome–a cause of hematuria with progressive renal failure and hearing loss–have mutations in genes encoding certain…
Even though most studies have not shown any mortality benefit to CVVH when compared to intermittent hemodialysis, that doesn’t mean that we don’t use CVVH all the time. At our centers (Mass General Hospital and Brigham & Women’s…
We all realize that maintaining vascular access is a dialysis patient’s life-line. Many patients must undergo multiple interventional radiology or surgical procedures in order to sustain fistula or graft patency over a prolonged period of time. The physical…
Often on the official radiology report for a renal ultrasound with Doppler flows, a number called the “resistive index” is listed. What does this number mean and how is it derived? The resistive index (RI) measures the resistance…
The two most common organisms causing PD-related peritonitis are (1) Staph aureus and (2) Pseudomonas. Certainly there are other causes–for instance fungal peritonitis (one of the indications for immediate catheter removal) and coagulase-negative Staph species (which usually responds…
How much peritoneal dialysis is enough? This question has been the basis of two major, landmark trials in the peritoneal dialysis community, the CANUSA study (named as such because it looked at PD patients in Canada and the…
There are numerous different types of radionuclide imaging which are used in renal imaging–more commonly in pediatric than in adult patients, and as such my knowledge of these procedures as it pertains to adult nephrology patients has always…
In order for renal cysts to grow in patients with polycystic kidney disease, it turns out this requires the pumping of chloride ion into the cyst lumen. This is carried out by the CFTR channel, the same chloride…
A question which comes up not infrequently during nephrology fellowship is whether or not to perform pheresis on patients with multiple myeloma. Once very much in vogue, the results of a fairly recent (Annals of Internal Medicine, 2005)…
A quick one before the July 4th Weekend… Peritoneal dialysis solutions are often color-coded based on the dextrose concentration. Dextrose is used as the osmotically-active agent. As it is partially absorbed, patients with diabetes have to watch out…
