We frequently receive requests to dialyze patients with moderate renal failure who are bleeding due to the concern that uremia may be contributing to failure to control blood loss. Patients with renal failure do have an increased tendency…
I recently evaluated a young patient for kidney transplant who had been diagnosed at age 13 with MPGN III. He had a slow reacting C3NeF, low C3, normal C4, low terminal complement levels, and by biopsy had paramesangial…
I recently admitted a dialysis patient to a general medicine service for shortness of breath. When receiving signout from the ED resident, she told me that his troponin T was elevated, but since he had had prior high…
There are a number of glomerulopathies that feature organized deposits of nonbranching fibrils, some more common than others. The diseases make their first major separation into Congo Red positive (amyloid) and Congo Red negative categories. Amyloid fibrils are…
The recent publication of the landmark FHN Daily Trial was a step forward in our understanding of dialysis care. One of the authors, Dr. Brent Miller from Washington University School of Medicine in Saint Louis, is giving a…
Nearly every time I walk through the dialysis unit at the VA, at least one patient calls me over to tell me that their itchy skin is driving them crazy. Pruritus is a torment to many dialysis patients,…
Emily mentioned in her recent post on the Rule of 6s that potassium administration needs to be taken into account when correcting the plasma sodium in cases of hyponatremia. Why is this the case? When potassium is given…
I took the MCAT with pencil and paper. Over 500 nervous sweaty pre-meds in one giant auditorium. Everyone was so tense I’m surprised there wasn’t a spontaneous combustion. Ever since, it’s been electronic standardized testing were you often…
Here is a really excellent atlas covering all aspects of hemodialysis access function and malfunction which all renal fellows should read. We are indebted to Dr. Tushar Vachharajani, Marianne Neumann RN, and everyone at fistulafirst (www.fistulafirst.org/) for providing…
