The presence of chronic kidney disease (CKD) portends a much higher mortality in patients who suffer an acute myocardial infarction. There are several potential reasons as to why this might be the case–for instance, the treatment of resultant…
Currently, the most widely-utilized method for routine estimation of GFR (eGFR) is the 4-variable MDRD Equation, in which serum creatinine, age, gender and race are the variables entered into a mathematical formula. eGFR as determined by the MDRD…
How many nephrologists does the U.S. need? I recently heard a thought-provoking calculation from MGH’s Dr. David Steele which helps illustrate a likely shortage in the number of American nephrologists. The calculation is admittedly a rough estimate, but…
A recent article just published in Nature Genetics by Kottgen et al identifies several loci which appear to confer susceptibility to the development of CKD. How did researchers identify these genes? By a genome-wide association study. Briefly, researchers…
Presently the KDOQI Staging system for CKD (see figure) is what is used most commonly to classify the severity of reduced renal function. This is based purely on an estimation of the GFR, using equations such as the…
The three letter acronym EMT: what should it mean to nephrologists? Not just “emergency medical technician”…but also “epithelial-to-mesenchymal transition.” As we all know the nephron is comprised of a long tube of highly-differentiated epithelial cells. These cells…
There is an insightful article in this month’s C-JASN entitled “Misapplications of Commonly-Used Kidney Equations: Renal Physiology in Practice” by Nguyen et al which is kind of fun to read. One of the clinical vignettes they present involves…
A recent paper in AJKD by Patel et al describes a curious but well-documented phenomenon: the finding that patients with CKD who are hospitalized with acute coronary syndrome (ACS) are less likely to receive therapies known to be…
Continuing on with a brief discussion of the landmark MDRD Study: at the time of the study, several smaller studies suggested that a low protein diet would prolong time to ESRD for patients with CKD. The theory was…
