Anti-Nephrin Antibodies in Minimal Change Disease
Approach to the Patient with Peritoneal Dialysis Catheter Dysfunction- Part 1
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Interventional Nephrology Series
Focus on Point-of-Care Ultrasound in Nephrology (POCUN) Series
Kidney Biopsy of the Month Series
Social Exclusion, Intravenous Drug Use and the Kidneys
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…
The Paradox of Hypertonic Saline Use in Heart Failure
The general notion is that edematous states like acute decompensated heart failure (ADHF) respond to the combination of sodium restriction and diuretic therapy. In fact, non-adherence to sodium restriction is believed to be a primary cause of failure…
A Kidney Perspective on Leukemia & Lymphoma
Based on previous studies, the kidney is the most common site of extra hematopoietic involvement in hematologic malignancies, up to 90% in certain series. As with any other kidney disease, the approach to acute kidney injury (AKI) should…
Donor-Derived Cell Free DNA: Once Trivial Now A Potential Marker of Organ Rejection
“You’ll come to learn a great deal if you study the insignificant in depth” ― Odysseus Elytis In kidney transplant recipients, serum creatinine (SCr) remains the mainstay of allograft function assessment. Biopsy is the gold standard to diagnose…
IdeS (Imlifidase): Breaking Bad Immunoglobulins in Sensitized Transplant Recipients
Despite tremendous advancements in transplant and immunosuppressive therapy, transplantation in sensitized patients remains a major challenge. The presence of pre-transplant donor-specific antibodies (DSA) is strongly associated with poor outcomes, hyperacute, and antibody-mediated rejection. Sensitization can occur through blood…
Treating Anemia in CKD in the Era of HIFs: A Ray of Hope?
I commonly encounter two questions from patients with chronic kidney disease (CKD) in regards to anemia: “How can I avoid taking injections?” “Is this anemia treatment safe” The development of anemia represents a challenging problem in patients with…
Hurricane Maria: A Nephrology Fellow’s Perspective
The 2017 Atlantic Hurricane Season was among the most active and devastating in history. Hurricane Maria caused an estimated $90 billion in damages in Puerto Rico and the U.S. Virgin Islands, making it the third costliest tropical cyclone…
Midodrine in Hemodialysis: Could it do More Harm than Good?
Midodrine [1-(2′,5′- dimethoxy phenyl-1)-2- glycinado-ethanol (1)- hydrochloride] is a prodrug with rapid and near complete bioavailability after oral administration resulting in peak plasma levels 40 minutes after oral consumption. Midodrine is then converted by enzymatic cleavage in the…
The Attack of the Clones: The Armamentarium of Tests to Find Monoclonal Proteins
In 2012, the introduction of the “monoclonal gammopathy of renal significance” (MGRS) for kidney disease associated with monoclonal proteins was revolutionary. MGRS was now clearly different from the benign monoclonal gammopathy of undetermined significance (MGUS). Prior to the…
DNAJB9: Demystifying Fibrillary Glomerulonephritis
Fibrillary glomerulonephritis (GN) is a rare disease which accounts for about 1% of all kidney biopsies. The very first description of the disease was published by Rosenmann and Eliakim in 1977. They described a patient with nephrotic syndrome…