Middle Molecules

The term “Middle Molecules” is a little confusing, in part due to its evolving definition.  It was initially used to describe anything not dialyzed off by the older dialyzer membranes of the 1970s, which predominantly filtered out only…

Scleroderma & the Kidney

Scleroderma is a chronic autoimmune disease characterized by fibrosis and hardening of the skin and other organs–occasionally involving the kidney to such an extent that dialysis becomes necessary. There are two main flavors of scleroderma: (1) the CREST…

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PAN versus MPA

Polyarteritis nodosa (PAN) and Microscopic polyangiitis (MPA) are two vasculitides which were previously grouped together. However, they are currently thought of as two separate entities. PAN is a vasculitis of the medium-sized arteries, sparing the smaller vessels and…

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Epidural Abscesses in ESRD Patients

Infectious metastases (e.g., infective endocarditis, epidural abscess, liver & lung abscesses, etc) are unfortunately not uncommon in the ESRD population, particularly in those with in-dwelling catheters.  I have personally seen several cases of epidural abscesses as a fellow,…

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ATRA Syndrome

The M3 subtype of acute myelogenous leukemia–also known as acute promyelocytic leukemia–is one of the most responsive forms of leukemia, as the addition of all-trans retinoic acid (ATRA) is known to overcome the maturation block in affected lymphocytes.  While…

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Review: The Juxtaglomerular Apparatus

The juxtaglomerular apparatus (JGA) is located between the afferent arteriole and the returning distal convoluted tubule of the same nephron. It is responsible for regulating both intrarenal (tubuloglomerular feedback) and extrarenal (renin-angiotensin-aldosterone) mechanisms necessary to maintain both renal…

WAGR

The WAGR Syndrome is a rare genetic syndrome whose acronym stands for Wilms tumor, Aniridia (an absence of the iris), Genitourinary abnormalities, and mental Retardation. It is caused by a deletion of chromosome 17p. The genitourinary abnormalities may…

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Ciliary Hypothesis

The “ciliary hypothesis” refers to the idea that primary cilia–single, non-motile, microtubule-based structures which are found on the apical surface of renal tubular epithelial cells–play an integral role in the pathogenesis of polycystic kidney disease. Scientists have long…

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