The urine anion gap is calculated as follows: [urine Na] + [urine K] – [urine Cl]. Think about the urine anion gap much as you think about the serum anion gap. The urine anion gap is really…
The antibiotic Bactrim is frequently associated with an increase in creatinine shortly after starting it. While Bactrim is a not uncommon cause of acute interstitial nephritis (AIN), the most frequent reason for a Bactrim-associated creatinine increase is actually…
Check out this video I found of the alleged first-ever home dialysis patient in England. Very civilized, except for the fact that it looks like the patient is using a permanent femoral dialysis catheter–something which would be used…
A current controversy in the CKD community involves definitions of CKD in the elderly. The issue is not trivial: were we to apply the standard KDOQI definitions of CKD staging, using the MDRD equation to estimate GFR, this…
At the Brigham and Women’s Hospital & the Dana Farber Cancer Institute, there is an ongoing trial of using pneumonectomy and injected, heated cisplatin into the pleural space for patients with malignant mesothelioma, a condition with an overall…
Mesangial cells–which historically have received less attention than their more “sexy” neighbor cell types of the glomerulus such as podocytes & endothelial cells–are actually quite interesting. They were originally seen as having purely a “matrix” function–that is, serving…
Heard a very good Renal Grand Rounds yesterday from visiting professor Michael Emmett, currently chair of the Dept. of Medicine at Baylor, regarding the anion gap. Amongst the pearls I took away from his lecture: 1. “Gamblegrams” (left),…
We’ve known this medical factoid since we were medical students: you can’t successfully replete a potassium-depleted patient if they have low magnesium levels. But what is the mechanism by which this occurs? One possible explanation is put forth…
The TGF-beta family of proteins has wide effects on nearly every tissue of the body–it is one of the key players in a mammalian development and homeostasis. It also has particular relevance to renal pathophysiology as one of…
One of the earliest time-saving tricks I learned as a Nephrology fellow was to always ask the covering housestaff to have a specimen of piping hot urine waiting for me at the time of the initial consult: I…