Creatinine: A Cautionary Tale
In recent months I’ve been seeing a number of referrals for patients with creatinine values in the normal range but eGFR as reported by the lab at below 60ml/min. This is particularly the case in middle aged women….
Carotid Endarterectomy for CKD Patients
Cardiovascular complications are the major cause of morbidity and mortality in patients with CKD and ESRD. Although myocardial infarction and sudden cardiac death get a lot of attention, stroke is also extremely important in this population. How should…
Cardiovascular Complications of Kidney Disease
Question: Who is the most important medical subspecialist for a patient with CKD to have regular contact with? Is it the nephrologist? A case could be made, relying purely on mortality statistics, that it’s actually the cardiologist. CKD/ESRD…
Is cystatin C the next creatinine?
As we all know, there are significant limitations to the use of creatinine as an estimate of GFR. Creatinine is freely filtered at the glomerulus, but in addition is also secreted to some degree, meaning that creatinine clearance…
“The eGFR Consult”
Cool new resource for all those iPod/iPhone (or whatever your MP3 player or PDA of choice happens to be): the ASN Kidney News podcast series. I have been listening to these during days in the lab where I…
When To Refer for AV Fistula Placement
The “Fistula First” initiative, which has as its goal the increase in % of dialysis patients who dialyze via an AV fistula rather than an AV graft or catheter, has been a controversial initiative. Although few would debate…
Development of CKD in Non-Renal Organ Transplants
As the longevity of non-renal organ transplants increases, so too does the risk of eventually getting chronic kidney disease. The occurrence of post-transplant CKD is relatively common due to two primary factors: (1) a dependence on calcineurin inhibitors…
Serum Alkaline Phosphatase as risk factor for CV Disease in ESRD Patients
Quick one today: interesting article in a recent issue of C-JASN by Shantouf et al that demonstrates a link between serum alkaline phosphatase levels and vascular calcification in patients with ESRD. Briefly, the study examined 137 randomly-selected ESRD…
Use of Hypoglycemic Agents in CKD
Maintaining adequate glycemic control in patients with diabetic kidney disease can be a challenge. First, it is hypothesized that worsened glycemic control will lead to a greater tendency towards diabetic nephropathy. Second, individuals with more advanced CKD are…
Race & Risk for ESRD
See if you can answer this True or False question: The increased risk of ESRD in African-Americans is due to the increased risk of hypertension and diabetes seen in this population. I think the prevailing view in…