This past week CMS announced the formation of a new form of payment and service delivery for patients with ESRD – the ESRD Seamless Care Organization (ESCO) – essentially an ACO specifically and exclusively for individuals with ESRD….
1) Surreptitious vomiting or diuretic abuse – metabolic alkalosis, Laxative abuse – non-gap metabolic acidosis. 2) Aquaporin 2 – apical membrane of collecting duct, Aquaporins 3 and 4 – basolateral membrane of collecting duct, Aquaporin 1 – proximal tubule….
Ever encountered this situation? You’re going about your daily business and discover that one of your patients on hemodialysis has an elevated phosphorous. You skim through the list of prerequisites and see that yes, the nutritionist has been…
1) In diabetic glomerular disease you can see linear staining of GBMs with IgG, Kappa and Lambda. 2) The three C3 immunoflourescence patterns of post strep GN 1) Starry Sky (most common) 2) Garland (less common) 3) Mesangial (resolving Starry…
1) Icodextrin sometimes causes a desquamating rash on the palms and soles. 2) Sirolimus, five side effects to watch 1) Poor wound healing 2) Lung toxicity 3) Hyperlipidemia 4) Proteinuria 5) Anemia/Thrombocytopenia. 3) Classic EM finding in post infectious GN: Large…
1) Monoclonal Immunoglobulin Deposition Disease breakdown – 80 to 90% LCDD, 10 to 20% LHCDD, <5% HCDD. 2) Small studies suggest tamoxifen and steroids may be of benefit in management of Encapsulating Peritoneal Sclerosis in patients on PD. 3) Sodium restriction…
It doesn’t take much to get me to take a trip to San Diego so when the opportunity came up to attend this year’s Home Dialysis University conference I booked my flight. Having lived in San Diego for…
1) Alkaline urine encourages calcium phosphate nephrolithiasis. Three predisposing factors to watch for – 1) distal RTAs 2) Acetazolamide 3) Topiramate. 2) IgA nephropathy, common in Asians and Native Americans, rare in African Americans. 3) Stay alert for triphasic pattern of…
1) Topiramate – Watch for non-gap acidosis, nephrolithiasis and hyperammonemia. 2) Jak2 – the intracellular kinase activated by the binding of Epo to the Epo receptor. 3) Live vaccines are contraindicated in kidney transplant recipients – these include MMR, Varicella, Yellow…
I was recently rounding on a gentleman in the ICU with acute promyelocytic leukemia (APL) who, after starting induction therapy with tretinoin (all-trans retinoic acid), developed fever, hypotension, new pulmonary infiltrates with associated respiratory failure and AKI requiring…
