Metabolic acidosis is a common condition encountered routinely by Nephrologists. Etiology of this condition is quite varied often requiring detailed history and a battery of tests to tease out the diagnosis. In most of the scenarios, co-existing biochemical…
Liraglutide (marketed as Victoza or Saxenda) is a glucagon-like peptide -1 (GLP-1) receptor agonist that is dipeptidyl peptidase-4 (DPP-4) resistant. It is a once a day subcutaneous injection with doses ranging from 0.6mg to 1.8mg daily. It is…
Metformin is one of the most useful drugs in patients with type 2 diabetes and yet its use in patients with CKD is limited by the perceived association with lactic acidosis. These concerns are due to the association…
Diabetic nephropathy (DN) is a major cause of ESRD worldwide. While many attempts have been made to develop reliable animal models that mimic human disease—ob/ob, db/db obese diabetes type 2 diabetes models, NOD1 mice, streptozotocin (STZ)-induced diabetes model…
There are two important issues to remember when assessing glucose control in patients ESRD, one relating to immediate blood sugar measurement, and another relating to longer term diabetes control. The first has previously been mentioned on this blog….
The routine use of estimating equations for GFR has revolutionized the way that we view renal disease over the last 15 years and although some argue that this has lead to overdiagnosis of CKD, I believe that this…
One of the issues surrounding the study of bardoxolone in animal models was that, because of the way that it is metabolized in rats and mice, it is highly toxic when given for long periods. This specific toxicity…
A man in his 50s with a history of diabetes, renal stones, gastric bypass surgery and CKD stage III/IV presented to the clinic with fevers, chills and vague abdominal pain. A urine culture was positive for E Coli…
A man in his 30s with a history of type 1 DM and chronic hypokalemia was referred to the renal clinic for investigation of CKD. His creatinine was 1.8g mg/dl. His DM was well controlled without any evidence…
Last year, we had a post about Bardoxolone for the treatment of diabetic nephropathy. After one year of treatment, eGFR increased significantly in patients treated with Bardoxolone relative to controls. At the time, significant concerns were raised about…
