Diuretics act at the apical surface of specific segments of the renal tubular epithelium. Question: how do diuretics get to the apical surface? One could imagine several such scenarios, such as diuretics getting filtered at the glomerulus and…
NSAIDs are a tricky class of drugs. As an internal medicine resident, I used to prescribe ibuprofen 800mg po tid willy-nilly for my clinic patients with back pain, since I generally had good results using this strategy, and…
The treatment of HIV infection has been radically changed with the development of HAART–highly active antiretroviral therapy. Fortunately for nephrologists, these medications are relatively safe from a renal standpoint. There are two notable exceptions to be aware of….
Rituxan is seeing a lot of use these days. Although technically only having formal indications for rheumatoid arthritis and non-Hodgkin’s lymphoma, it is being used for a number of off-label indications, and in general the results seem to…
Welcome to Cytoxan (cyclophosphamide), one of the most versatile (albeit toxic) medications in the nephrology world. Its mechanism of action is as an alkylating agent; it induced alkylation of DNA in actively proliferating cells, which explains its use…
Aristolochic acid is an herb used in many varieties of Chinese herbs and health supplements. Interestingly, it also can cause a severe form of interstitial nephritis which has been known by several names, most notably “Chinese herb nephropathy”…
Interesting case from one of my calls last week (although I understandably would have been more enthusiastic about the case at the time had I been called about it 10 am rather than at 10 pm, prompting an…
Are renin inhibitors the next big weapon in the fight against hypertension? As we all know, ACE-I’s & ARB’s have so many renoprotective effects that there is substantial evidence towards using these medications as first-line agents for blood…
A quick fact about foscarnet, one of the many drugs which can cause drug-induced hypocalcemia. Foscarnet is an antiviral medication, commonly used in the treatment of herpesviruses and CMV infections (e.g., CMV retinitis). The mechanism of its hypocalcemic…
