Meloney Oliveira, MD1st year fellow Division of Nephrology Rush University Medical Center *The patient history in this post is fictitious, but represents how a patient with these biopsy findings might present Case*: A 40-year-old with a 16-year history of heroin…
One of the things that I always highlight when teaching fellows and residents is the importance of appropriate drug dosing for patients on dialysis and one of the drugs that is most often inappropriately dosed in my experience…
Azathioprine is one of the oldest immunosuppressant medications, which has been used in the field of solid organ transplantation over the past 5 decades. It is metabolized into its inactive forms by the enzyme thiopurine methyltransferease (TPMT). Genetic…
I recently saw an interesting case. A woman was being treated with cidofovir for adenovirus which was presumed to be responsible for an acute cardiomyopathy. Concurrent with cidofovir, she was also receiving probenecid for renoprotection, which I was…
A few weeks ago, one of our pharmacists gave a comprehensive presentation about the potential nephrotoxicity of a variety of commonly used herbal, alternative and dietary supplements. He has a particular interest in this as he deals largely…
A biopharmaceutical, or biologic, is any medicinal product manufactured in or extracted from a living system, such as a microorganism or plant or animal cells. Several biologic agents are produced using recombinant DNA technology, while others may be…
As a renal fellow, I have found myself reaching for spironolactone more and more. It is very helpful when treating the patient with resistant hypertension, but it continues to be under-utilized. Aside from the renal-centric effects of aldosterone,…
At our hospital, we started noticing a pattern of admissions among some of our maintenance dialysis patients. In one case, an elderly woman with DM, peripheral arterial disease, and ESRD on thrice weekly hemodialysis was sent to the…
Lithium is indispensable as an effective treatment for bipolar affective disorder. However, it has a narrow therapeutic index with desired therapeutic levels between 0.6 and 1.2 mEq/L. Lithium is handled by the kidney (responsible for almost all its…
A 42-year-old man developed AKI during his recent hospitalization due to presumed sepsis. He was started on vancomycin and levofloxacin as empirical therapy. When renal was consulted 7 days after admission, creatinine level had peaked at 4.39 mg/dl…
