Introduction Fibroblast growth factor-23 (FGF23) is an osteocyte derived hormone that regulates serum phosphorus levels and vitamin D synthesis; inducing a negative phosphorus balance. Serum FGF23 levels increase early in chronic kidney disease (CKD). Furthermore, such elevations precede…
“Doctor, I’m calling because Mrs. X has 2 hours of treatment left. This is the third time her blood pressure has been low…What do you want me to do?” Intradialytic hypotension (IDH) is a universal, often unavoidable scenario…
Renal artery stenosis (RAS) can lead to a reduction in kidney blood flow with resultant ischemia of the affected kidney. The consequences of this reduction are a decline in estimated glomerular filtration rate (eGFR) and activation of the…
When consulted by your infectious disease colleagues as to the cause of new or worsening renal impairment in a patient with human immunodeficiency virus (HIV), the differential is broad but changing. The classic HIV-associated collapsing glomerulopathy has become…
Cardiorenal syndrome (CRS) is a complex clinical entity that encompasses multiple interactions between the heart and kidney. Ronco and colleagues classified CRS into five types. Below, we’ll focus on CRS type 1, or acute cardiac dysfunction (such as…
If you are like me, you vaguely know about renal scintigraphy but not so much about the details of the radioactive agents or the utility of the scan itself. Basically, renal scintigraphy is a 2D nuclear medicine scan…
Social exclusion is a broad term describing a continuum of inclusion/exclusion characterized by unequal access to resources, capabilities and rights. Social exclusion has been associated with reduced access to health care and worse outcomes. Currently, I work in…
The general notion is that edematous states like acute decompensated heart failure (ADHF) respond to the combination of sodium restriction and diuretic therapy. In fact, non-adherence to sodium restriction is believed to be a primary cause of failure…
Last week we covered 5 clinical scenarios involving arteriovenous fistula and graft complications. We now discuss another 5 common scenarios as part 2 of the series. Please note: these cases are vignettes created for educational purposes and patient…
Based on previous studies, the kidney is the most common site of extra hematopoietic involvement in hematologic malignancies, up to 90% in certain series. As with any other kidney disease, the approach to acute kidney injury (AKI) should…