‘Shrooms and Renal Failure

While toxic mushroom ingestions are generally known for their ability to cause acute liver failure, certain varieties of mushrooms can also result in acute renal failure. One such type of mushroom is Amanita smithiana, (shown at left) which…

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TRP Channels in Nephrology

The TRP (transient receptor potential) family of proteins is a group of related ion channels which is becoming increasingly relevant to the field of nephrologists. The TRPs are cation channels which are responsible for moving Ca2+ and Mg2+…

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Reverse Osmosis

Reverse osmosis (RO) is a critical aspect of providing the large volume of relatively purified dialysate water to dialysis patients worldwide.  If you’ve never taken a peek at the water treatment room in your hospital’s dialysis unit (it…

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Plasma Exchange Nuts & Bolts

There are many indications for plasma exchange in nephrology:  some common ones include antibody-mediated rejection of a kidney transplant, Goodpasture’s, ANCA-associated vasculitis, and TTP–all of which are commonly associated with loss of renal fellows’ sleep–that is, you may…

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Renal Vein Thrombosis

Renal vein thrombosis is a thrombotic occlusion of one or both renal veins. Its most common cause is nephrotic syndrome, which is a hypercoaguable state though to be due at least in part to loss of the anticoagulant…

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Urine Anion Gap

The urine anion gap is calculated as follows:  [urine Na] + [urine K] – [urine Cl].   Think about the urine anion gap much as you think about the serum anion gap.  The urine anion gap is really…

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Bactrim & elevated creatinine

The antibiotic Bactrim is frequently associated with an increase in creatinine shortly after starting it. While Bactrim is a not uncommon cause of acute interstitial nephritis (AIN), the most frequent reason for a Bactrim-associated creatinine increase is actually…

Old Dialysis Video

Check out this video I found of the alleged first-ever home dialysis patient in England. Very civilized, except for the fact that it looks like the patient is using a permanent femoral dialysis catheter–something which would be used…

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CKD in the Elderly

A current controversy in the CKD community involves definitions of CKD in the elderly. The issue is not trivial: were we to apply the standard KDOQI definitions of CKD staging, using the MDRD equation to estimate GFR, this…

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