The rate of patients >75 years of age initiating dialysis has grown substantially in the U.S. over the past two decades. This has to do with several factors, including improvements in medical technology enabling people to live long…
The following “3 Key Facts Regarding Catheter-Related Bacteremia” are taken from Eliot Heher’s “MGH Nephrology Handbook” distributed to nephrology fellows every year which I find very helpful: Fact #1: Fever and chills are highly predictive of positive blood…
One of the diagnostic dilemmas which frequently comes up in the outpatient evaluation of hypercalcemia (and also, I’m told, on boards-type exams) is how to differentiate familial hypocalciuric hypercalcemia versus primary hyperparathroidism–both of which are common causes of…
For the research component of my Nephrology fellowship, I’ve chosen an unorthodox route: I am using the zebrafish as a model organism for the study of kidney disease. The zebrafish system has a number of advantages. First,…
The potassium-sparing diuretics consist of the following 4 medications–only some of which (spironolactone & eplerenone in the list below) are structurally similar. Spironolactone is an antagonist of the aldosterone receptor, which like other steroid receptors is an…
A recent review in this month’s AJKD by Perl and Bargman describes the increasingly recognized importance of residual renal function in dialysis patients’ prognoses. Although the benefits of residual renal function are most obvious in patients undergoing peritoneal…
Couldn’t figure out how to embed the video so I’ve just posted the link of a daredevil who “exploded his kidney” (according to the video at least) during a bike jump. Just think, somewhere out there there’s a…
Having grown up in Minnesota and being a rabid sports fan, I have an obligation to closely follow the Minnesota Vikings, no matter how much trouble with the law the team has encountered in recent years. Here’s a…
Following up on the discussion of milk-alkali syndrome, a similar syndrome (hypercalcemia, metabolic alkalosis, and acute renal failure) may also occur due to betel nut chewing. Betel nut chewing is a common habit and cultural practice amongst Indian…
Heard about a case of milk-alkali syndrome at Renal Grand Rounds yesterday. This is an interesting condition whose pathophysiologic mechanism really tests your knowledge of calcium and acid-base homeostasis. I won’t attempt to chart the pathway but a…