A patient presented to the outpatient service with progressive renal insufficiency and sub-nephrotic range proteinuria. He had a long history of CMML with few blasts in his bone marrow aspirate but a peripheral white cell count that was…
This is a question we face quite often in the Nephrology clinic when we are commencing patients on high dose steroids for glomerular and other systemic inflammatory diseases. I came across a couple of interesting retrospective studies while…
When one is just beginning as a nephrology fellow, it may seem as if all the major glomerular diseases (e.g., membranous nephropathy, FSGS, lupus, etc) are all treated with the same protocols and same immunosuppressive agents: steroids, Cytoxan,…
As an intern, and I’m sure many can relate to this story, I remember trailing after the team, disheveled and exhausted as we rounded endlessly postcall one day. Our hospital had the county jail contract and as we…
Date for your diary Dr Zeidel and the MDIBL crew wish to invite all previous attendees to the Second Annual Reunion of the Mount Desert Island Biological Laboratory National Course for Renal Fellows. This is a great opportunity…
I’ve had the privilege of being a part of the care team for several patients who have participated in Stanford’s Immune Tolerance program here in Palo Alto. The idea behind the program is pretty cool: create chimerism (the…
We are frequently faced with patients on multiple anti-hypertensives still with poorly controlled BP levels. I learned some very interesting points on an article at CJASN from Dr Townsend on how to approach the management of those patients:…
One of the most important concepts in nephrology is that of chronic systemic inflammation and its role in increased cardiovascular (CV) risk in patients with chronic kidney disease (CKD) and those on dialysis. Despite a significant research effort…
It is well known that patients who are referred to see a nephrologist earlier in the course of their disease are more likely to start dialysis with a functioning fistula and have better overall survival relative to those…