One of the coolest aspects of the renin-angiotensin-aldosterone system (RAAS) is that it involves multiple organ systems: the liver, lung, adrenal gland, kidney, and vasculature are all prominently involved. It never hurts to review basic physiologic principles, right?…
It’s a hot topic amongst dialysis centers around the country: bundling. Here’s my attempt to explain it in a brief manner. If anybody has corrections or comments about this explanation, feel free to make them known. With the…
BK Nephropathy refers to damage suffered to a renal allograft as a result of the polyomavirus BK virus. It is named based on the fact that it was originally isolated in the urine of a kidney transplant…
Two recent articles in JASN–one by Siew et al and the other by Paragas et al–provide further support to the idea of using urinary NGAL as a biomarker for acute kidney injury. An accompanying editorial by Lynda Szczech,…
There are two general strategies for CVVH replacement solution entering into the blood circuit: pre-dilution (in which replacement solution is mixed with the blood prior to its entry into the filter), or post-dilution (in which replacement solution is…
Keeping with our recent theme of “numerical rules in Nephrology”, let’s briefly discuss the “Rule of Thirds” for Membranous Nephropathy. The “Rule of Thirds” is frequently taught in medical school and a useful way of thinking about the…
Most of the time when we are consulted for an inpatient with a rising creatinine, the assumption is that the kidney is to blame. However, there is an important list of non-renal conditions which can increase either BUN…
I had always assumed that the “Bence-Jones” protein–essentially, the demonstration of monoclonal light chains on urine protein electropheresis (UPEP)–was named after two doctors, Bence & Jones. However I recently found out that actually it was named after a…
One of the hot topics in Nephrology over the past few years has been the epidemiologic and histopathologic studies suggesting oral sodium phosphate colonoscopy preparations as a cause of acute phosphate nephropathy. As evidence continued to mount, the…
In peritoneal dialysis, ultrafiltration failure is defined as the inability of the peritoneal dialysate to maintain euvolemia–and generally speaking, this implies some degree of hypervolemia. Technically, it can occasionally result from trivial explanations–for example, an incorrect PD prescription…