This blog post focuses on some of the lesser-discussed aspects of ESRD: depression and psychosocial issues related to ESRD. Studying depression in the ESRD population is an important issue because it is likely the most prevalent psychiatric disease…
The interest in machine perfusion for preservation of kidney transplants has been revived. Were we serious when we decided to put the organ in ice??? A recent NEJM prospective, controlled trial randomizing 336 consecutive deceased donors to either…
Focal segmental glomerulosclerosis (FSGS) is a clinicopathologic syndrome manifesting with proteinuria, usually of nephrotic range. Early in the disease process, there is a pattern of glomerular sclerosis that is focal, involving a subset of glomeruli, and segmental, involving…
Within the last 2 years dialysis facilities in the US have been adjusting to the now not-so-new Center for Medicare & Medicaid Services (CMS) Conditions of Coverage. CMS, as many of you know, funds the ESRD program to…
That cardiac biomarkers, including Troponin and BNP, can be elevated in CKD or ESKD without necessarily having clinical significance is familiar to most of us. Whether you believe that an elevated Troponin in ESKD is due to diminished…
At Renal Grand Rounds yesterday, we discussed the case of a previously healthy 50 year old man who presented with fulminant hepatic failure and AKI. He was initially thought to have AKI related to either SIRS/hypotension or Hepatorenal…
We have all been taught that before making the diagnosis of SIADH, we have to ensure that the patient has normal adrenal and thyroid axes. Why is this so important and how do thyroid and adrenal dysfunction cause…
I’ve recently had the privilege of caring for a patient undergoing chemotherapy for a metastatic malignancy using agents targeting the vascular endothelial growth factor (VEGF) pathway. This patient, having tolerated three cycles of avastin and ipilumimab without any…
The renin-angiotensin system is powerful regulator of blood pressure homeostasis. An article published in the March 24 issue of JASN highlights an emerging area of research into the modulation of AT1 receptors on different tissues. The majority of…
It seems like there have been a lot of recent developments in the management of hypertension, and several sacred cows have become burgermeat. I thought I’d summarize a few of these important developments here: 1. Blood pressure targets…