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…
Nearly every time I walk through the dialysis unit at the VA, at least one patient calls me over to tell me that their itchy skin is driving them crazy. Pruritus is a torment to many dialysis patients,…
Emily mentioned in her recent post on the Rule of 6s that potassium administration needs to be taken into account when correcting the plasma sodium in cases of hyponatremia. Why is this the case? When potassium is given…
Ok, so here is the brief review of the various clinical methods of detecting sodium concentration (as I understand it): Flame photometer The older flame photometer method measured the concentration of sodium in plasma. The preparation of the…
One of my transplant patients came to clinic last week excited about his trip to Tanzania. He had undergone kidney transplantation three years ago and has had an uneventful course. As a transplant nephrologist, you kind of become…
In something of a first for Nephrology, today sees the simultaneous release of a powerful tool for predicting ESRD risk in CKD patients at the World Congress of Nephrology, in JAMA and as a mobile application (free download; see…
Cisplatin was discovered more than 40 years ago, and is still widely used in chemotherapy regimens for many different types of cancer. Its wider use has been limited by toxicities, one of which is nephrotoxicity. Nate Hellman also…
We were recently consulted on a patient with a history of multiple myeloma who had developed severe hypercalcemia and acute renal failure. The calcium on admission was 15mg/dl (albumin 2.6) and the patient was treated aggressively with IV…