As a new pediatric nephrology fellow, my first weeks taking care of patients on hemodialysis were overwhelming. Each of my patients had complex problems and intricate physiology, and I initially learned to focus on the numbers – clearance,…
This is part 2 of a blog on LVAD for the nephrologist. Part 1 may be found here. Predicting reversibility of renal dysfunction is a difficult task in the setting of heart disease and has a significant effect…
Advanced heart failure is associated with very poor survival rates of about 10 % at one year. Treatment options include cardiac transplantation or cardiac assist devices. A left ventricular assist device (LVAD) is a mechanical circulatory support for…
Presently, death with a functioning graft is one of the most important causes of kidney transplant failure with the leading cause of death being from cardiovascular events. Withdrawing or avoiding steroids to improve cardiovascular outcomes is a controversial…
The ELITE-Symphony study enshrined standard triple therapy immunosuppression of tacrolimus, mycophenolic acid and prednisolone, for renal transplant recipients. We get familiar with these agents relatively quickly in our renal training, but what about the other less common agents…
When I first began learning about Nephrology, I came across ‘dialysis dementia’, a progressive and fatal condition described in hemodialysis patients. Several studies in the 1970s implicated aluminium found in phosphorus binders and dialysate water as the cause….
In the pre-DAA era, the dogma was to treat HCV pre-transplant for two reasons: active HCV increases post-transplant hepatic complications, NODAT, and decreases patient and graft survival and that IFN cannot be used post-transplant because of higher risk…
The Burden of Hepatitis C The estimated global Hepatitis C viral infection (HCV) burden was slashed down to 71 million by the WHO in 2015, from the earlier estimate of 130-150 million, after Rao et all showed that…
The MUDPALES mnemonic for raised anion gap acidosis was drilled into me from medical school. However recently after working through each category I became stumped when nothing ticked the box to identify the cause. The lady I had…
Therapeutic plasma exchange (PLEX) is a type of therapy where a patient’s plasma volume is removed over a period of a few hours, through a process of centrifugation of blood with subsequent separation of its constituents, and replaced…
