The term chronic allograft nephropathy (CAN) has long been used to describe the non-specific injury to kidney transplants that is the most common cause of late (>1 year post-transplant) allograft dysfunction. With the 2007 Banff classification system, however,…
Glucocorticoid-Remediable Aldosteronism (GRA) is an inherited autosomal dominant disorder which causes early-onset (often childhood) high blood pressure, often occuring in individuals with Celtic ancestry. It typically presents with standard symptoms of aldosteronism (hypertension, hypokalemia, and metabolic alkalosis) with…
Question: How is renal plasma flow (RPF) measured? Answer: By measuring para-aminohippurate (PAH) clearance. How does it work? Ideally, one would simply choose a substance which is neither synthesized nor metabolized by the kidney; the amount of such…
Are renin inhibitors the next big weapon in the fight against hypertension? As we all know, ACE-I’s & ARB’s have so many renoprotective effects that there is substantial evidence towards using these medications as first-line agents for blood…
There are a variety of interesting genetic diseases that can cause hereditary Magnesium wasting. Renal magnesium handling is a little different than other ions in that the primary site of reabsorption is not the proximal convoluted tubule. Rather,…
For many years, the existence of “phosphatonins”–substances secreted by certain tumors which result in profound renal phosphorus wasting and resultant osteomalacia–has been postulated. Evidence has recently been accumulating that fibroblast growth factor 23 (FGF-23) is the phosphatonin we…
I was consulted yesterday on a patient with liver and renal failure–obviously, not an uncommon occurrence, as the two often go hand in hand. The patient had presented with altered mental status, and the question came up: hepatic…
A quick fact about foscarnet, one of the many drugs which can cause drug-induced hypocalcemia. Foscarnet is an antiviral medication, commonly used in the treatment of herpesviruses and CMV infections (e.g., CMV retinitis). The mechanism of its hypocalcemic…
Autosomal dominant polycystic kidney disease (ADPKD) acconts for about 10% of patients on dialysis in the U.S. and occurs in 1:400 – 1:2000 live births. As the disease is inherited in an autosomal dominant fashion, the question of…
Welcome to the Renal Fellow Network. My name is Nathan Hellman and I am presently a Nephrology Fellow at the Massachusetts General/Brigham & Women’s Hospital Combined Fellowship Program. I am in the midst of my first (clinical)…
