Low Anion Gap

Classically, we are taught to look out for an elevated anion gap in patients with a metabolic acidosis. Although much less common, a low anion gap can also be a useful sign and there are a variety of…

The ABCs of ADME in AKI

The pharmacokinetics of a drug refers to the study of the absorption, distribution, metabolism and elimination of that drug (often referred to as ADME). Each of these characteristics can be greatly altered in a patient presenting with acute…

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AKF Kids Calendar Art Contest 2013

The American Kidney Fund’s Calendar Kids Art Contest recognizes kids with kidney disease for their artistic talent and helps to increase awareness of kidney disease. The contest winners have been selected but help is needed to choose the…

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Isolated C3 deposits on an inflammed glomeruli

Six months after a kidney transplant, a patient developed a rising creatinine, significant proteinuria (~2g/day), hematuria and low C3 levels. A kidney graft biopsy showed severe glomerulonephritis with mostly occluded capillary loops with immunofluorescence staining negative for immunoglobulins…

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Antibiotics and encephalopathy

Recently I was involved in the care of a renal transplant recipient who was admitted with C. Difficile colitis that was complicated by a bowel perforation. He had a history of hepatitis C with relatively preserved hepatic function….

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Origins of Renal Physiology Course

We’ve posted several times about the ‘Origins of Renal Physiology’ held in the Mount Desert Island Biological Laboratory every year. Fellows who have taken the course over the past 5 years have consistently raved about it, with many describing it as transformative in…

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Under Pressure

As a medical student I was taught the CKD hypertension gospel straight from the good book of JNC VII: Thou shalt lower the blood pressure to less than 130/80! This was many years after David Bowe and Freddie…

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