Pearls for Boards

1) Monoclonal Immunoglobulin Deposition Disease breakdown – 80 to 90% LCDD, 10 to 20% LHCDD, <5% HCDD. 2) Small studies suggest tamoxifen and steroids may be of benefit in management of Encapsulating Peritoneal Sclerosis in patients on PD. 3) Sodium restriction…

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Does that taste bad? – Part 2

Following on from yesterday’s post about turtles who may have a taste of urine in their mouths, here’s an interesting historical diversion about doctors who, in the past, intentionally drank urine to diagnose disease. An article in Scientific…

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Does that taste bad?

Better known as a delicacy in the Far East, the Chinese softshell turtle has generated some interest in the Nephrology world because of its unusual means of urea elimination. A paper was recently published in the Journal of…

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Spare the Chloride

Fluid therapy is essential in ICUs and not surprisingly there is still much controversy about which fluid to use, how much and when. Nephrologists often roll their eyes at other subspecialty’s preferences, e.g. surgeon’s preferences for Ringers, citing…

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Pearls for Boards

1) Alkaline urine encourages calcium phosphate nephrolithiasis. Three predisposing factors to watch for – 1) distal RTAs 2) Acetazolamide 3) Topiramate. 2) IgA nephropathy, common in Asians and Native Americans, rare in African Americans. 3) Stay alert for triphasic pattern of…

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Image of the Month – GN with a twist

A man in his 30s with no significant medical history presented to the ED following a fainting episode. Routine screening found an abnormal creatinine, hematuria and proteinuria. Serological work-up including complements were negative. In view of a slowly…

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REMS in Renal Disease

In 2007, the Food and Drug Administration (FDA) was granted the authority to require pharmaceutical manufacturers to develop risk evaluation and mitigation strategies (REMS), if deemed necessary. This was made possible by the FDA Amendment Act, which also…

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Pearls for Boards

1) Topiramate – Watch for non-gap acidosis, nephrolithiasis and hyperammonemia. 2) Jak2 – the intracellular kinase activated by the binding of Epo to the Epo receptor. 3) Live vaccines are contraindicated in kidney transplant recipients – these include MMR, Varicella, Yellow…

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