Last July, for my Dad’s 65th Birthday, I managed to somehow convince the Indiana branch of the National Kidney Foundation to loan me their “Billy the Kidney” mascot costume. While it was in my possession, I figured why…
Why do we write notes in the chart day after day? Why does the chart even exist? In my mind, the main function of the medical chart (and progress notes) is communication: charting allows physicians (and other members…
Why do some dialysis patients require so much more Epogen than others? Some patients manage to hit their targets with relatively low doses, and may even require “holding” EPO injections to avoid the upper hemoglobin range where excess…
A promising new class of oral hypoglycemic agents for type 2 diabetes, the SGLT inhibitors, are on the horizon. As they work on the kidney, and potentially have renal side effects, it may be helpful to review them….
Very interesting results from last week’s poll, in which the question asked was essentially, “Do you believe that steroids are effective in the treatment of AIN?” The vote was generally split 50-50; that is, about half of individuals…
I was taught the rule of 6’s when it came to using opiates in dialysis patients: they’re metabolized by hepatic glucuronidase to 6-glucurinides (e.g. morphine 6 glucuronide or M6G) these metabolites are renally excreted, increasing the half-life to…
Restless legs syndrome (RLS) is one of the potential neurologic complications associated with CKD or ESRD, though it can also occur independently of kidney dysfunction, with some cases of familial transmission documented (though no gene has yet to…
There is a good review article in this month’s NEJM entitled “Use of Diuretics in Patients with Hypertension” by Ernst and Moser which focuses predominantly on the thiazide class of diuretics. The thiazides are considered a FUNCTIONAL rather…
One of the things I was definitely grateful for at this year’s Thanksgiving table: I’m not on-call and can spend the holiday with my family! Best wishes to those renal fellows working hard on this holiday. Poll Results…
In my experience, it’s unusual to perform a transplant nephrectomy in a patient who has returned to dialysis in the absence of a ‘hard’ indication such as macroscopic hematuria or severe symptoms suggestive of rejection or infarction. There…