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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1000th Post

In celebration of our 1000th post, we asked Matt Sparks. a former editor of the Renal Fellow Network who is now a faculty member at Duke University in North Carolina for his perspective on his time with this…

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Differentiation Syndrome

I was recently rounding on a gentleman in the ICU with acute promyelocytic leukemia (APL) who, after starting induction therapy with tretinoin (all-trans retinoic acid), developed fever, hypotension, new pulmonary infiltrates with associated respiratory failure and AKI requiring…

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Pearls for Boards

1) Isopropyl alcohol does NOT cause an elevated anion gap acidosis, retinal toxicity (as does methanol), or renal failure (as does ethylene glycol). 2) Fibril diameter of the more common fibrillary diseases – Amyloid, Fibrillary GN, and Immunotactoid GP – is correlated…

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