Cadmium Toxicity

Heavy metals & the kidney are an interesting topic all-around. Aberrant metabolism of heavy metals such as iron, copper, lead all contribute to significant renal pathology. And you can add the heavy metal cadmium to that list as…

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Case of Hyperammonemia & Fanconi’s Syndrome

Quick case summary as presented in Renal Grand Rounds today:  A 54 year-old man presents with altered mental status, a sky-high ammonia level (>200) and anemia requiring blood transfusion.  Other unusual lab values include hypophosphatemia and hypokalemia with…

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Adynamic bone disease

Adynamic bone disease is being increasingly recognized as the most common form of renal osteodystrophy. It is characterized by the reduced synthesis of bone matrix due to decreased osteoblastic and osteoclastic activity. Adynamic bone disease is distinct from…

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Water as therapy for PKD?

There are several clinical trials regarding the slowing of progression of polycystic kidney disease currently being conducted; amongst the drugs being studied are V2 receptor antagonists. The rationale for this is that cyclic AMP (cAMP) is known to…

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Measuring Adequacy

Dialysis adequacy is traditionally measured as either Kt/V (most popular in outpatient dialysis units) or urea reduction ratio (URR, most popular with acute dialysis/inpatient dialysis units). Both methods use the degree to which urea is cleared–by comparing the…

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Congenital Nephrotic Syndrome

Congenital nephrotic syndrome only makes up between 2-8% of all forms of nephrotic syndrome, but is a hot topic in that there are numerous genes continuously being identified which are helping to advance our understanding of podocyte biology….

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Toluene & The Kidney

Toluene–a hydrocarbon which is present in gasoline, paint thinners, and many industrial solvents–can have a variety of effects on acid-base metabolism by the kidney:  it can cause both a non-anion gap OR an anion gap metabolic acidosis, depending…

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“Full House” Immunostaining

Renal pathologists may throw out the term “full house” immunostaining…what does this mean? This means quite simply that all five major immunofluorescent stains on a renal biopsy (IgM, IgG, IgA, C3, and C1q) are all positive.  The analogy…

Hypertension/Brachydactyly Syndrome

One of the as-yet unresolved major controversies in nephrology is whether or not the entity “hypertensive nephropathy” really exists.  Certainly there are a large percentage of the dialysis population who do not have diabetic nephropathy, glomerulonephritis, nephrotic syndrome,…

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