Did you know that diarrhea increases the absorption of Prograf (tacrolimus, FK506)? Drug levels must be monitored closely in this setting to avoid tacrolimus-induced allograft toxicity. Tacrolimus is even considered a cause of diarrhea by some, though its…
Aristolochic acid is an herb used in many varieties of Chinese herbs and health supplements. Interestingly, it also can cause a severe form of interstitial nephritis which has been known by several names, most notably “Chinese herb nephropathy”…
What are the cells that make up crescents, the histopathologic hallmark of rapidly progressive glomerulonephritis (RPGN)? Classically these have been thought to be the parietal epithelial cells which make up Bowman’s capsule. However there is now some thought…
Leflunomide is a drug I’ve seen used with increasing frequency in the renal transplant world. Marketed under the trade name “Arava”, it is an immunomodulatory agent which works by inhibition of the enzyme dihydroorotate dehydrogenase, one of the…
Avastin (bevacizumab) is one of the commonly used VEGF (vascular endothelial growth factor) inhibitors used to inhibit vascular neogenesis, a process which is required for growth of tumor. It has proven to be a valuable agent in a…
The man on the left is Victor Gura, one of the authors on a 2007 Lancet paper demonstrating the efficacy of the wearable artificial kidney (WAK). The machine (which can perhaps be likened to deluxe version of Batman’s…
A rare but interesting (and potentially fatal) type of thrombotic microangiopathy (TMA) called neuraminidase-associated TMA occurs with severe pneumococcal pneumonia or meningitis. Neuraminidase is a protease which cleaves off a specific antigen (Thomsen-Friedreich) on the surface of platelets…
Interesting transplant case: A 35 year old man with a history of acute myelogenous leukemia, status post a bone marrow transplant from his sister eight years ago and now cured, who developed chronic kidney disease as a result…
The differential diagnosis of renal disease in an HIV patient is fairly long. Perhaps the most well-known amongst the list is HIV-associated nephropathy (HIVAN), which involves massive protein wasting, collapsing FSGS, and rapidly-progressive renal failure. Another entity on…
The results from the Acute Renal Failure Trial Network (“ATN Study“) are revealed in the most recent issue of the New England Journal of Medicine. The study was a randomized control trial in which ICU patients with acute…