Obese mice?
Recently there was a very interesting series in three parts in the online magazine Slate.com concerning the use of mice and rats as surrogates for humans in animal studies. Anyone who has worked with mice in the lab…
To buy or not to buy
A number of years ago, I was at a lecture given by a transplant surgeon from London. He was discussing the dangers surrounding living unrelated kidney transplantation and he told the story of a member of a royal…
Tumor lysis or tubular lysis?
A patient presented to the outpatient service with progressive renal insufficiency and sub-nephrotic range proteinuria. He had a long history of CMML with few blasts in his bone marrow aspirate but a peripheral white cell count that was…
SLE and Dialysis
It is well known that patients who are referred to see a nephrologist earlier in the course of their disease are more likely to start dialysis with a functioning fistula and have better overall survival relative to those…
Diarrhea and Tacrolimus
Recently, a patient presented to the transplant service with diarrhea and dehydration. He had been trying unsuccessfully to manage his diarrhea at home and was admitted for intravenous fluids. During his work-up, his tacrolimus levels were noted to…
Don’t forget the vitamins
In the absence of glucose, the brain requires a water-soluble, fat-derived fuel for metabolism and ketoacids serve this function. Unsurprisingly, as a result of this, the main factor controlling the production of ketoacids is the relative lack of…
Fractional Excretion
The fractional excretion of sodium (FeNa) is a test that is often used in the setting of acute renal failure to help distinguish between pre-renal and intra-renal causes that has been mentioned in previous blog posts. In general,…
A spoonful of sugar…
Cholera epidemics have been a major public health issue throughout recorded history and much energy was devoted towards preventing them and treating affected patients once they occurred. However, it was not until 1831 that it was recognized that…
Mind the Gap
As Nate mentioned in a previous post, the urinary anion gap is helpful in differentiating whether a non-gap acidosis is of renal or extra-renal origin. Urinary Anion Gap = Na + K – Cl Because the major cation…
A suPAR breakthrough in FSGS
As has been mentioned in previous post, the identification of the anti-PLA2R antibody has the potential to revolutionize the diagnosis of membranous GN and is already being used clinically on a small scale. It is found in 70%…