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…
Happy World Kidney Day! Celebrated every year in March, World Kidney Day is a day devoted to raising awareness of kidney disease across the globe. This year promised to be a huge success: cities throughout the world, from…
I have just learned two very interesting aspects of kidney donation that I would like to share with you. As part of my transplant fellowship, I am required to participate in the decisions about accepting or not a…
This is one that Nate would have liked….I recently saw a case of renal disease in an albino Peurto Rican woman with severe pulmonary fibrosis. She holds the diagnosis of Hermansky-Pudlak Syndrome (HPS).HPS is an autosomal recessive disorder…