I saw an interesting case yesterday. A 71 year old male, CKD III with a syndrome suggestive of chronic tubulointerstitial disease (U/A trace proteinuria only, disproportionate anemia, mild cortical thinning on ultrasound, normal-appearing vasculature on ultrasound). He had…
Another day, another negative study… this is getting painful! The large, randomized ASTRAL trial comparing renal revascularization to medical therapy found no benefit, and substantial increased risk, in the interventional arm. 806 patients with atherosclerotic reno-vascular disease were…
Metformin is the only hypoglycemic agent proven to reduce mortality in Type 2 DM. As such, we really should be making every effort to prescribe it, and keep patients taking it. Unfortunately, mostly due to it’s relationship to…
Congratulations to my colleague at the Brigham, Jeremy Duffield, who made the cover of Science this week for demonstrating human Serum Amyloid P (hSAP) potently inhibits fibrosis in two independent models of renal fibrosis. hSAP is a naturally…
The TREAT trial was one of the bigger stories to emerge from this years ASN. This was a large, multicenter trial of darbepoeitin (Aranesp) vs. placebo in 4000 predialysis CKD patients with type 2 diabetes and anemia. The…
Peroxisome proliferator-activated receptors (PPARs) are transcription factors that play a critical role in regulating lipid and glucose metabolism, cell growth and cell differentiation. PPAR alpha is expressed in highly metabolically active tissues (alpha = active), including the PT…
I’ve had to revise the renal biopsy complication rates that I’m quoting my patients after reading this review. – Technically, complications occur in 7.4% to 19.5% of patients. These mostly consist of self-limiting macroscopic hematuria or a peri-renal,…
Here are a few important guidelines for prescribing RRT in the Neuro ICU gleaned from this review. First off, a recap of the physiology… Intracranial pressure increases are buffered by CSF, such that increased ICP leads to increased…
Geriatric nephrology is in focus in this weeks NEJM with this excellent article by Tamura et al. By linking the USRDS database to a national registry of nursing home residents, they were able to document changes in functional…
They may have struggled to get girlfriends in college, but members of the International Ascites Club do call the shots when it comes to defining hepato-renal syndrome (HRS). As they were published in Gut, their revised criteria for…
