Post obstructive diuresis

Urinary tract obstruction is a frequent occurrence in the hospitalized setting. Thankfully, after relief of the obstruction a vast majority of patients have complete recovery of kidney function. However, a few patients will have marked polyuria (>4-5L per…

Something fishy?

A 30-year-old man was admitted to our hospital for evaluation of lung nodules detected during pre transplant evaluation for his stage V chronic kidney disease (CKD). Sounds routine, but what caught me completely clueless was when I was…

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Epo: The honeymoon is not over

Having just returned from my own honeymoon, I was taken by this recent hypothesis-piece by Fishbane et al. They have made some observations on the natural history of untreated renal anemia from examining the placebo arm of the…

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Secondary forms of hypertension

Lisa Cohen recently summarized rare “genetic” forms of hypertension including Liddle’s syndrome and PHA type II (Gordon’s syndrome). I want to summarize other causes of “secondary” hypertension which are not inherited (at least not typically in a Mendelian…

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Interventional nephrology in fellowship training

Interventional nephrology is quickly becoming a sought after “subspecialty” of nephrology. However, many training programs do not offer a structured training program (as highlighted in this recent AJKD paper). Traditionally nephrology training is spent rounding in the hospital,…

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Genetic causes of hypertension

And now for some board review tidbits! Below are some genetic causes of hypertension attributable to specific gene mutations. Glucocorticoid-remediable hyperaldosteronism (GRE)- Autosomal dominant condition caused by uneven crossing over on chromosome 8. A chimeric protein is created…

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I recommend some nuts

I have a fresh case with great learning points that I would like to discuss today. So I will continue with the management of sensitized patients on my next blog. Case: This is a 70 yo female with…

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Are all thiazides created equal?

At the Brigham Renal Board Review course (review of board prep options) a few weeks ago, Dr Burton Rose argued that for all of us who use thiazide diuretics (review of thiazides) to treat mild hypertension, chlorthalidone should…

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