The Accreditation Council for Graduate Medical Education (ACGME) continues to restrict resident duty hours in an effort to improve patient care related to resident fatigue. These restrictions are beginning to impact fellowship training as the shift in workload…
Interest in nephrology as a career continues to decline as highlighted by this recent editorial entitled “The Future Nephrology Workforce: Will There Be One” in CJASN. This article, which was presented at ASN in Denver as the Summit…
An observational study of urinary sodium excretion (a surrogate of dietary salt intake) and it’s association with cardiovascular mortality was published in JAMA last week. The trial involved 3681 patients in Europe without cardiovascular disease at baseline. The…
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…