The “Rule of 6s” describes an easy way to evaluate the maturity of a recently-placed arteriovenous fistula for dialysis access–and is even mentioned by name in the most recent KDOQI Guidelines for Dialysis Access. The Rule of 6s…
Basic Clinical Immunology: there are four types of hypersensitivity reactions. Below is a listing of all four types and, since this is a Nephrology Blog, renal examples for each one. Type I Immune Reaction (anaphylactic): Type I hypersensitivity…
Wow. In case you hadn’t heard the news, Shad Ireland, a 37 year-old dialysis patient, recently completed a cross-country bike trip which involved cycling from California to Washington, DC. Mr. Ireland has been on dialysis for 27 years,…
This has been known for awhile, but it is worth repeating–sevelamer (Renagel), in addition to its ability to act as a phosphate binder, also results in LDL cholesterol-lowering effects. Two of the early articles (a 1998 Clinical Nephrology…
Despite the knowledge that AV fistulas and grafts give superior outcomes when compared to dialysis catheters, there remain a large chunk of patients who begin dialysis without a fistula or graft. Conversely, there are also examples of “unnecessary…
Because of the generally poor GI absorption of iron in the setting of ESRD, iron supplementation in dialysis patients is now carried out by intravenous formulations of iron complexed to various carbohydrates. The idea is that these carbohydrate…
Here’s a cool little feature from the folks at CBS News describing the use of the “Lifeport Kidney Transporter”–a new hypothermia-perfusion device which functions as a significant upgrade from the standard cooler in which donor kidneys are transported…
As the longevity of non-renal organ transplants increases, so too does the risk of eventually getting chronic kidney disease. The occurrence of post-transplant CKD is relatively common due to two primary factors: (1) a dependence on calcineurin inhibitors…
Traditionally surgeons have relied on a well-honed abdominal exam, combined with abdominal imaging usually in the form of an iv-contrast CT scan, to make the diagnosis of acute appendicitis. Nevertheless, there remain significant instances of “false negatives” (usually…
Quick one today: interesting article in a recent issue of C-JASN by Shantouf et al that demonstrates a link between serum alkaline phosphatase levels and vascular calcification in patients with ESRD. Briefly, the study examined 137 randomly-selected ESRD…