Aristolochic acids (AA) are found in products derived from the aristolochia genus of plants which are used extensively in herbal medicines, particularly in Asia. Nephrotoxicity resulting from AA exposure was originally described in a case series of women…
I recently saw an interesting case series published in CJASN where they reported four cases of oliguric AKI associated with synthetic cannabinoids use. Renal biopsy revealed acute tubular injury in three of them and calcium oxalate crystals in…
A young woman with h/o polysubstance abuse and seizures was admitted to hospital with status epilepticus. She was treated with a propofol infusion at 5mg/kg/hr which was maintained due to perceived continuing seizure activity. On hospital day 5,…
The excellent drug development blog “In the pipeline” highlighted a fascinating phase 2 trial that is ongoing at the moment. Pentoxifylline is a methylxanthine phsophodiesterase inhibitor that has been used to treat peripheral vascular disease. It is also…
The debate about which thiazide diuretic to prescribe patients with hypertension has been going on for years without resolution and both HCTZ and chlorthalidone have their supporters. This topic has been discussed in the past on the blog…
Currently there is no good treatment for the most common inherited cause of ESRD, adult polycystic kidney disease. There have been a number of high profile trials in ADPKD in recent years. These trials have endeavored to show…
Cystinosis is an autosomal recessive disease caused by a mutation in CTNS, which encodes the lysosomal transporter of cystine. This leads to intracellular cystine accumulation which leads to renal, neurological and cardiac damage. The treatment for this condition…
Interesting paper this month in JAMA about post-marketing studies of adverse drug effects. Randomized controlled trials are obviously the gold standard for the detection of common adverse events related to treatment. The problem is that, if an adverse…
In 2007, the Food and Drug Administration (FDA) was granted the authority to require pharmaceutical manufacturers to develop risk evaluation and mitigation strategies (REMS), if deemed necessary. This was made possible by the FDA Amendment Act, which also…
Sometimes when something appears too good to be true, it is too good to be true. Last year, a paper was published in the NEJM reporting a preliminary study of bardoxolone for the treatment of diabetic nephropathy. At…
