As usually happens when the renal fellows help with the medical student nephrology block, I found myself confronted last week with questions I couldn’t answer. One involved the pathophysiology of posterior urethral valves (PUV), which came up in…
As mentioned previously by Nate, there is some evidence that lowering urine osmolarity below that of the serum can reduce the rate of growth of cysts in PCKD and thus preserve renal function. The rationale for this is…
Please take a moment today to remember our dear friend and colleague Nate Hellman, founder of Renal Fellow Network, who died tragically on this day last year. Our thoughts go out to his family, especially his wife, Claire, his two…
It was the usual sort of day in clinic and the team was seeing a middle aged woman with stable diabetic nephropathy and subnephrotic proteinuria. Her blood pressure and blood sugars had been well controlled since the last…
GeriPal took the win by a hair. Thanks for all of the support. Follow the link to see the final results in the 2010 Clinical Sciences Category of the Seventh Annual Medical Weblog Awards from MedGadget! RFN was…
I’ve always been skeptical about ACE inhibitors as a cause of hyponatremia, despite there being almost 20 case reports of this complication in the literature. Given the fact that so many patients I see are taking an ACE…
No time like the present for a quick review of urine electrolytes. Is there any such thing as a ‘normal’ urine sodium? Not really – like all great answers in medicine, ‘it depends’. In general, in patients who…
The issue of whether a marked elevation in the BUN when compared with the creatinine might represent gastrointestinal bleeding was nicely covered previously on RFN. One of our attendings recently had our group of first year fellows review…
A talk recently about the HIM study at MGH (Hypogonadism In Men, Clin trial NCT00114114) prompted me to wonder about testosterone from the renal perspective. Testosterone is important for several aspects of male health, including fertility, bone density,…
Keeping the bone theme: A 50-year-old woman with ESRD secondary to PKD underwent a living related-kidney transplant one-month prior. At clinic visit, she was complaining of severe throbbing pain in her hands and feet. The pain was worse…