Efforts aimed at lowering homocysteine levels in order to prevent the progression of CKD and cardiovascular disease takes another major hit in the April 28 issue of JAMA. High dose B-vitamin therapy has been shown to lower the…
I read a nice review of Fabry’s disease recently, and was surprised to read that its prevalence in ESRD may be as high as 1-2%. That figure is likely an underestimate, given the frequent failure to screen for…
I attended a 2-day conference on home dialysis known as “PD University for fellows” sponsored by the International Society for PD (ISPD), Wake Forest University, Baxter and NxStage in Baltimore, MD. This is a free conference for renal…
This morning at ATC, the results of a very interesting trial were presented. I would like to share them with you so we can look at them more carefully once the paper is published. The CAPRIT trial is…
We have had a rush of patients with isolated hematuria in my clinic recently. The question that occupies so much precious time of the nephrologist reared it’s head……. ‘what are the indications for a renal biopsy’. Isolated persistent…
Vomiting or nasogastric tube (NG) decompression can lead to metabolic alkalosis, often associated with hypokalemia. When asked what the source of the K loss is, most people assume it is lost in the gastric fluid. However, gastric fluid…
I had a patient come to see me last week with the rare disorder, Birt Hogg Dube Syndrome (BHD). She was referred with a mildly elevated serum creatinine and microalbuminuria against a background of a single kidney following…
This is the story of a 64 year old male mason with past medical history notable for hypertension and hyperlipidemia who was referred to me for evaluation of proteinuria. The patient noted onset of lower extremity edema nine…
According to the most recent NHANEs data, 15.5 million Americans have CKD III, a figure that has increased by over 40% in less than a decade. CKD III is primarily a marker of global health outcomes, and affected…
Lactic acidosis is frequently seen in the hospital setting. Diverse etiologies account for the accumulation of lactic acid as reviewed by Nathan last year. The main impetus for the production of lactate is having a hypoxic state either…