To better understand continuous renal replacement therapies (CRRT), we must understand the process of solute removal by diffusion and convection. Diffusion is the process by which “molecules that are present in a solvent and can pass freely across…
People on hemodialysis (HD) are ten times more likely to suffer from a stroke, compared with the general population. In addition to this risk, patients on HD are at a three-fold higher risk of hemorrhagic transformation of ischemic…
I always like to remind my cardiology colleagues that some of the most important drugs used in the cardiovascular arsenal, are in fact exerting their benefits through the kidneys. Case is point, drugs that target the renin-angiotensin-aldosterone system….
Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic kidney disorders with a reported incidence ranging from 1:500 to 1:1000. The genes implicated in the disorder are PKD1 (encoding polycystin 1) and PKD2 (encoding…
Hyponatremia from the Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH) is a common consult a fellow encounters on the inpatient service. In addition to stopping potentially offending drugs, management can range from fluid restriction, loop diuretics, demeclocycline, salt tablets,…
Introduction Fibroblast growth factor-23 (FGF23) is an osteocyte derived hormone that regulates serum phosphorus levels and vitamin D synthesis; inducing a negative phosphorus balance. Serum FGF23 levels increase early in chronic kidney disease (CKD). Furthermore, such elevations precede…
“Doctor, I’m calling because Mrs. X has 2 hours of treatment left. This is the third time her blood pressure has been low…What do you want me to do?” Intradialytic hypotension (IDH) is a universal, often unavoidable scenario…
When consulted by your infectious disease colleagues as to the cause of new or worsening renal impairment in a patient with human immunodeficiency virus (HIV), the differential is broad but changing. The classic HIV-associated collapsing glomerulopathy has become…
If you are like me, you vaguely know about renal scintigraphy but not so much about the details of the radioactive agents or the utility of the scan itself. Basically, renal scintigraphy is a 2D nuclear medicine scan…
Social exclusion is a broad term describing a continuum of inclusion/exclusion characterized by unequal access to resources, capabilities and rights. Social exclusion has been associated with reduced access to health care and worse outcomes. Currently, I work in…