Diagnosing Reset Osmostat

The “reset osmostat” is a cause of hyponatremia, sometimes considered a variant of SIADH, in which the kidney retains its ability to appropriately concentrate and dilute the urine; however, the threshold for ADH secretion is reset downward. That…

Aminoglycoside Toxicity

The aminoglycosides are amongst the most well-known nephrotoxic drugs. Yet due to their efficacy against many organisms, they are amongst the most common antibiotics used. The next time your nephrology service goes toe-to-toe with the infectious disease service…

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Metformin-induced Lactic Acidosis

Metformin is the only hypoglycemic agent proven to reduce mortality in Type 2 DM. As such, we really should be making every effort to prescribe it, and keep patients taking it. Unfortunately, mostly due to it’s relationship to…

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Classification of Cryoglobulins and MPGN

Cryoglobulinemia is characterized by the presence of circulating antibodies which precipitate at cooler temperatures, and not infrequently leads to renal failure/glomerulonephritis. The stereotypical histologic lesion of cryoglobulinemia is membranoproliferative glomerulonephritis, which takes the appearance on light microscopy of…

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Serum Amyloid P prevents renal fibrosis

Congratulations to my colleague at the Brigham, Jeremy Duffield, who made the cover of Science this week for demonstrating human Serum Amyloid P (hSAP) potently inhibits fibrosis in two independent models of renal fibrosis. hSAP is a naturally…

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