When managing patients with metabolic acidosis, some nephrologists are afraid of prescribing NaHCO3 because of the potential adverse consequences of increasing ECF volume and worsening blood pressure. However, there is significant evidence that the kidneys handle NaCl in…
How does sodium retention occur in liver cirrhosis? Most of us accept Schrier’s peripheral arterial vasodilation hypothesis. This hypothesis postulates that overproduction of vasodilatory substances in the splanchnic circulation in cirrhosis leads to splanchnic pooling and decreased “effective”…
There are a number of glomerulopathies that feature organized deposits of nonbranching fibrils, some more common than others. The diseases make their first major separation into Congo Red positive (amyloid) and Congo Red negative categories. Amyloid fibrils are…
Here are some points from one of the cases presented at the electrolyte workshop this afternoon: The major teaching point was that the reabsorption of calcium closely follows that of sodium. Therefore, in sodium avid states, calcium tends…
I attended a very interesting talk from Dr Bakris today on the latest approaches to BP targets in the CKD population. The highlights are nicely illustrated in a systematic review published in the Annals this year. They searched…
The NKF Spring Clinical meeting started today in Las Vegas. I thought I’d share of the interesting highlights from some of the talks I’ve attended. This post relates to Dr Appel’s lecture on IgA nephropathy, where he described…
What are the most common type of cancers in kidney transplant recipients? The three most common cancers are: non-melanoma skin cancers, Kaposi’s sarcoma and non-Hodgkin lymphomas. Compared to the general population, the risk of squamous cell carcinoma is…
One of the major problems we struggle with in haemodialysis patients is excess, volume, inter-dialytic weight gain and ultrafiltration. Despite constant reminders by nursing staff, physicians and nutritionists, patients seem to find it extremely hard to restrict their…
Mechanisms of edema formation in nephrotic syndrome (NS) are controversial. The traditional underfill hypothesis has come under heavy fire, and there are now many clinical and experimental observations that contradict it. The overfill hypothesis has now captured the…
The recent publication of the landmark FHN Daily Trial was a step forward in our understanding of dialysis care. One of the authors, Dr. Brent Miller from Washington University School of Medicine in Saint Louis, is giving a…