Saturday Night Acute Kidney Injury
We recently took over the care of a 20 year old man of Asian origin who was admitted under the surgical team. He presented with 4 days of bilateral, colicky loin pain. He had no past medical history…
Posts by
Paul Phelan
When to Start Renal Replacement Therapy in the Critically Ill?
The vast majority of us have been confronted with these questions: When to start dialysis in a patient in the ICU ? What modality should I start with? What kind of vascular access should I place? How I…
APOL1 risk alleles and kidney transplant function: time for mission APOLLO
APOL1 is the newest addition to the list of CKD risk factors- possibly never before in the history of nephrology has a gene associated with such a high odds ratio with disease – above 7 for hypertensive…
Donor specific antibodies made easy
Donor specific Antibodies (DSA) are one of the established biomarkers for predicting antibody mediated rejection (ABMR). This blog is a short synopsis on DSA and their complex characteristics in kidney transplantation. DSA may be preformed (before transplantation) or de-novo…
The Kidney in Diabetes: Not Always Plain Vanilla Diabetic Nephropathy
Diabetic nephropathy (DN) is well recognized by the glomerular basement thickening (GBM), mesangial matrix expansion and formation of nodules in the mesangium – the classic Kimmelsteil Wilson lesions. The very sight of these lesions makes a pathologist confirm…
Nodular Glomerulosclerosis – beyond diabetic nephropathy
A glomerular nodule, i.e. an acellular hyaline structure, can have varied etiologies. Most commonly we see it in the setting of diabetic nephropathy (DN). In these cases, it posesses all the associated features of DN on light microscopy…
The Uncertainty of Monoclonal Gammopathies
I spend a lot of time discussing patients with renal disease and monoclonal gammopathies with my haematology colleagues, trying to figure out what is of ‘renal significance’ and ‘undetermined significance’. One of those discussions recently was around a…
Assessing the risk of CKD progression using Kidney Failure Risk Equations
“The best way to predict your future is to create it“. Abraham Lincoln Predicting the future is a tenuous concept and at face value is perhaps better suited to popular media and science fiction than medicine. We have…
Evolution of PLA2R as biomarker, diagnostic tool and prognostic indicator in Membranous Nephropathy
Membranous nephropathy is among the most common causes of the nephrotic syndrome in non-diabetic adult. It is an immune complex mediated disease which occurs when circulating antibodies permeate the glomerular basement membrane and form immune complexes with epitopes…
A Paisa of Prevention is Cheaper than a Few Rupees of Cure: CKD in India
Raji* was feeling increasingly distraught as she waited at the doctor’s clinic with her 14 yr old daughter. The teenager had not been eating well and was losing weight for the past 6 months. She was always tired…