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…
We all know that FSGS can exist in both primary and secondary forms. In both cases light microscopy identifies partially (“segmental”) sclerotic glomeruli in a variable (“focal”) distribution in the biopsy. How can you tell the different between…
The situation: a 53 year old ESRD patient shows up with vomiting. She is normally dialyzed Monday, Wednesday and Friday and now [ Her Na level is 111. What to do? There are several reports of central pontine…
Friday we did two biopsies on the Consult Service…one of which turned out to be a fairly interesting diagnosis of fibrillary glomerulonephritis. The case in brief: a 71 yo woman with a history of HTN and no diabetes…