Hematuria: Deep on the DDx

Recently at our biopsy conference we had the case of a healthy middle aged man presented who had come to medical attention with episodes of painless gross hematuria. He had consistent rbcs on UAs, normal renal imaging, a…

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Peak or Trough?

We were recently consulted on a patient with a history of repeated admissions with pneumonia who had developed AKI following treatment with Tobramycin. It got me thinking about the mechanisms of aminoglycoside toxicity. The traditional teaching is that…

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Hypercalcaemia induced polyuria

So Leo’s post got me thinking about the pathophysiology of hypercalcaemia-induced polyuria. I wanted to share what I have learned in relation to the mechanisms of this phenomenon. Calcium-sensing receptors (CaSR) are found on the basolateral membrane of…

Post-transplant Lymphoproliferative Disease

Although the term Post-transplant Lymphoproliferative Disease (PTLD) encompasses all lymphoproliferative disorders post transplant, it generally refers to extra-nodal B-cell lymphomas due to Ebstein-Barr virus (EBV) infection. PTLD is a B-cell disease caused by iatrogenic T-cell dysfunction: in people…

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NSAIDs: new tricks from an old drug

A 62-year-old man with CKD stage 3 secondary to presumed hypertension presented with new-onset hypercalcemia. PTH level was low at 11 and abdominal imaging revealed a right renal mass that later was confirmed to be a renal cell…

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Creatine vs Creatinine

Creatine monohydrate is a widely available dietary supplement. It frequently pops up during both outpatient and inpatient discussions on the differential for acute kidney injury. However, the literature is scant and appears to be conflicting. So, here are…

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