I heard a great talk today detailing possible changes in store for the national policy for kidney transplant allocation, as set forward by the Organ Procurement and Transplanation Network (OPTN) (the organization which helps administer UNOS). The current…
Schistosoma species–also known as blood flukes and bilharzia–can cause some interesting forms of renal disease. Although this is not so common in the United States, it is a very common public health problem in Africa and Asia. Chronic…
In the U.S., erythropoietin is typically delivered as 3x/week intravenous injections in the ESRD population. This turns out to be a fairly significant cost, as Medicare-related payments for EPO comprise about 25% of the ESRD budget, which itself…
Intradialytic hypotension is a relatively common complication in dialysis patients. Here are some of the common therapeutic options to deal with this: 1. Increase the dry weight: one cause for intradialytic hypotension is simply over-ultrafiltration–if a patient is…
Extracorporeal shock wave lithotripsy (ESWL), invented during the 1980s in Germany, uses concentrated pulses of sound waves to break up kidney stones too large to pass on their own into smaller pieces, which will then have a chance…
A subset of patients with ANCA-associated vasculitis have drug-induced ANCA disease. There are a few features of drug-induced ANCA disease which set it apart from “idiopathic” ANCA disease, but overall the clinical symptoms are similar. Drug-induced ANCA almost…
Have you ever given THAM (tromethamine)? For whatever reason I was completely unfamiliar with the drug as a resident, but it is given not infrequently in the surgical ICU’s in the hospitals in which I’ve worked as a…
The Journal C-JASN has begun a new monthly feature: “The Nephrology Hall Of Fame”, in which each month an outstanding contributor to the field of Nephrology will be honored by an article describing their major contributions. The first-ever…
Cardiovascular mortality in the general ESRD population is between 10- and 20-fold higher than that of the general population, and is an astounding 65-fold higher in ESRD individuals in the 45-54-year-old subgroup of the Framingham study. A recent…
There has been a lot of literature over the past few years regarding the identification of gadolinium-based contrast dye as the driving force behind the dermatologic fibrosing condition nephrogenic systemic fibrosis (NSF). While there remain doubters that gadolinium…