Phototoxic skin disorders in renal failure: Patients with renal failure or ESRD secondary SLE can have a photosensitive skin rash. For example: Discoid Lupus Erythematosus (DLE); these lesions are thick and scaly, plug the hair follicles, appear usually…
Nephrology grand rounds in Duke University Medical Center this week inspired me to write this blog on a subject I now realise that I am weak on. Patients on dialysis are a unique group in whom we see…
It’s an important anniversary for the Brigham and Women’s Hospital and as a result there are events planned in all departments of the hospital over the next year. Not to be left out, the Renal Division invited some…
This month’s eJournal club concerns early initiation and withdrawal from dialysis in Canada. Over the last 20 years, there has been a move towards starting people on dialysis earlier, at least when this is defined in terms of…
A few years ago, a unit that I worked at started using hemodiafiltration (HDF) routinely for the first time. Prior to starting our patients, we visited another unit where they had been using HDF for a few years…
In the quest for better solute clearance, two divergent paths were taken on each side of the Atlantic. The US nephrology community has concentrated more on low weight molecules. The European counterpart has focused on both low and…
One of the issues that we come across repeatedly in the clinic is the timing of access insertion. We all want to avoid the use of catheters and so we refer patients early (when possible) for fistula formation….
This has been discussed between the renal division and the cardiac surgery division in my institution. We know that AKI post cardiac surgery is an independent prognostic factor for mortality (Am J Nephrology 2010 31 408). It’s a…
An ESRD patient on CAPD was recently admitted to our hospital with possible pneumonia. It was noticed that he had painful plaque-like necrosis, with areas of ulceration. Even in the absence of a skin biopsy, the consensus was…
One of the true arts learned during renal fellowship is the timing of initiation of dialysis in outpatients with advanced chronic kidney disease. This a crucial skill to develop as the beginning of dialysis has major implications for…
