Fabry’s Disease is an X-linked disease caused by a mutation in the alpha-galactosidase A gene, resulting in the accumulation of glycosphingolipids within lysosomes. In the kidney under electron microscopy, this is manifested as the presence of multiple round…
The glomerular filtration barrier is traditionally thought of as being comprised of 3 layers: (1) the fenestrated endothelium, (2) the glomerular basement membrane, and (3) the podocyte foot processes. Focusing on (2) the glomerular basement membrane (GBM), this…
Why is there a picture of a toad on the Renal Fellow Network? In reading the most recent edition of ESRD/Dialysis “NephSAP” (the ASN’s periodic review of relevant nephrology-themed literature), I learned about an unusual cause of hyperkalemia:…
The Hemoglobin A1c has proven to be one of the most utilized and helpful tests in the management of diabetes. Instead of relying on random blood sugars to adjust a diabetic’s insulin regimen, the HgbA1c (which increases in…
Ototoxicity–which can occur via both auditory and vestibular mechanisms–is one of the major side effects of aminoglycoside use, particularly in dialysis patients. A recent paper looked at N-acetyl cysteine (NAC) as a potential strategy for preventing ototoxicity in…
Potter’s Syndrome–perhaps more accurately referred to as Potter’s Sequence as it refers to the pathophysiologic consequences of lack of kidney function in utero–is characterized by absence of renal function, oligohydramnios, pulmonary hypoplasia, and a characteristic “Potter’s facies”, in…
Renagel (sevelamer hydrochloride) is one of the most utilized phosphate binders in the U.S., though its superiority compared to other (and cheaper) phosphate binders remains controversial. One of the theoretical benefits of using Renagel is that it should…
The constant “K” pops up in many forms in nephrology, particularly in the realm of dialysis, as each dialysis membrane has its own characteristic K values. There is first and foremost the Kt/V equation, the currently accepted…
We prescribe them with abandon to our CKD and ESRD patients…Nephrocaps, Renavit, whatever you want to call it. How many nephrologists do you think are able to name all the ingredients in this vitamin-containing tablet? The not-so-secret ingredients:…
A relatively new immunosuppressant agent–originally approved for treatment of refractory rheumatoid arthritis but now gaining steam as an anti-rejection medication for kidney transplant recipients–is abatacept (marketed under the trade name Orencia by Bristol-Myers-Squibb. Its mechanism of action is…