Much of medical residency training in the US is centered in the hospital. This is also true of many of the fellowship programs in internal medicine. As we have seen a continual increase in the number and acuity…
The picture above comes from a case report in KI where a PD patient presented with hypertension and edema. She was normally compliant and a plain film of her abdomen was performed to make sure that her catheter…
Dealing with patients on dialysis can be challenging. In addition to the management of many comorbidities, nephrologists have to go down a list similar to a pilot’s checklist. Those include dialysis adequacy, access, electrolyte balance, fluid status, BP…
Each of the following choices is expected to occur during pregnancy except for A and D. Let’s go through each of the possible choices. A. This in partially incorrect. Hyperventilation (with resultant hypocapnea, not hypercapnea) occurs during pregnancy…
Partly because I like the idea of my patients taking spoonfuls of household remedies for their kidney disease, and partly because I like the elegant simplicity of the remedy, I was pleased to see another study touting the…
Hypokalemia and metabolic alkalosis are considered precipitating factors for hepatic encephalopathy, as hypokalemia stimulates ammoniagenesis in the proximal tubule. Although, the mechanism is not entirely clear, the likely hypothesis is as follows: *Hypokalemia causes the movement of potassium…
I will share with you some of the tips I learned from my pathologist friend Ibrahim Batal.When evaluating an allograft kidney biopsy for acute changes, you should:First, scan at low power magnification, look for arteries, check for necrosis…
It can often be difficult to stop something once it’s been started; take statins for example. It seems that despite consistent evidence from two large, randomized controlled trails demonstrating the lack efficacy of statins for preventing cardiovascular mortality…
Hepatorenal syndrome (HRS) is a frequent consult encountered on the nephrology service. The criteria have recently been revised. Conall reviewed the revised criteria on a prior post last year. To review the pathophysiology of HRS click here. In…
The way drug discoveries happen is always fascinating. Today, I heard Dr Nadler describe how he discovered Rituximab. He was a young oncology fellow at Dana-Farber back in 1979 when he convinced a colleague dentist to teach him…