The close relationship between extracellular (free) calcium concentration and parathyroid hormone (PTH) is tightly sensed by the calcium-sensing receptor (CaSR) expressed at the membrane of parathyroid cells. This control is so well regulated that even a small increase…
Learning points Anatomical variation is high in parathyroid glands In medication resistant hyperparathyroidism associated with kidney disease, surgical exploration is key. Imaging is a useful adjunct to localise ectopic or supernumerary parathyroid glands Hyperparathyroidism causes bone resorption, calcific…
The incidence of acute brain injury, both ischemic and hemorrhagic stroke, is increasing in patients with end-stage kidney disease (ESKD). Risk factors include older age and co-morbidities requiring long-term systemic anticoagulation. Patients with acute traumatic brain injury develop…
One in every 10 cases of chronic kidney disease (CKD) may be attributable to a single gene mutation. Read that again. One in every 10 cases. Wow. That was a shock to me. It took me a few…
My Commission Bias The long awaited PEXIVAS trial was finally published. I was excited to prepare and present this landmark paper at our departmental journal club.The discussion was fascinating until I started realizing that I was fighting hard…
In continuous renal replacement therapy (CRRT), the coagulation cascade is activated due to blood contact with the extracorporeal circuit. Therefore, anticoagulation is often required during CRRT to prevent premature clotting and maintain circuit patency. Unfractionated heparin has been…
More than 30-million Americans are living with diabetes and 90% of these people have type 2 diabetes mellitus (DM2). There are numerous complications associated with long-term diagnosis of DM2, with a prominent concern being the development of impaired…
In April of this year, the highly-anticipated CREDENCE Trial was presented (and live-streamed) at the International Society of Nephrology (ISN) World Congress of Nephrology in Australia and simultaneously published in NEJM. But before we start dusting off our…
As a resident, I received one of the most enduring pieces of advice from a friend who had recently sat through the American Board of Internal Medicine (ABIM) Nephrology Board examination. “You’re already late to study for it,…
It’s almost the end of this academic year and July 1st is just around the corner. Whether you are an internal medicine resident moving on to a nephrology fellowship or a senior nephrology fellow about to become an…