There has been a lot of attention these days regarding increasing “middle molecule clearance”, a topic already covered previously here. Certainly it is well-established that buildup of beta-2-microglobulin can lead to a dialysis-derived form of amyloidosis, and it…
Hepatorenal syndrome (HRS) is thought to be caused by splanchnic vasodilatation with relative renal vasoconstriction. The reversible nature of HRS is highlighted by the observation that patients with HRS who undergo liver transplant usually see a complete reversal…
Hepatorenal syndrome is a very common consult topic for the 1st year renal fellow. All MDs trained in internal medicine realize that cirrhotic patients are amongst the sickest in the hospital, and one of the reasons for this…
The study of acute kidney injury has been hampered by a lack of a standard definition. Some of this is semantics–for instance, the decision to change “acute renal failure” to “acute kidney injury” does nothing to help in…
Renal disease is not uncommon in patients with rheumatoid arthritis, and the differential diagnosis is quite interesting. Here is a list of the major causes, some of which are caused by the RA itself and others of which…
There has been a lot of buzz surrounding the recent NEJM article by Gutiérrez (a recently graduated fellow from my program!) et al regarding the potential role of measuring FGF23 levels as an important biomarker in patients with…
Managing hypertension in pregnancy is difficult in the sense that there is not a lot of data to guide us. Most of the drugs listed as “safe during pregnancy” are considered so largely based on many years of…
What is hepcidin and why is it important to nephrologists? Hepcidin is a 25-amino acid peptide (see left) secreted by the liver which seems to be the “master regulator” of iron metabolism. It works by binding to the…
NSAIDs are a tricky class of drugs. As an internal medicine resident, I used to prescribe ibuprofen 800mg po tid willy-nilly for my clinic patients with back pain, since I generally had good results using this strategy, and…
The treatment of HIV infection has been radically changed with the development of HAART–highly active antiretroviral therapy. Fortunately for nephrologists, these medications are relatively safe from a renal standpoint. There are two notable exceptions to be aware of….