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…
Hepatitis C virus (HCV) infection affects more than 180 million people globally, may lead to renal disease and is prevalent in 11-49% of patients with end-stage renal disease, depending on geographical location. With that picture in mind, we…
We are facing a conundrum in post-transplant lipid management after the recent warning from the FDA, which updated the label of simvastatin. This drug is now contraindicated in patients taking cyclosporine due to the potential for liver dysfunction…
The use of the protocol transplant biopsy is a divisive topic: some units see a protocol program as necessary for proper management post-transplantation, whilst others deride the whole concept as unnecessary. So who is right? Protocol biopsies are…
Many nephrologists will have faced “interesting specialty, shame about the evidence-base” jokes in the past. However, following a profusion of randomised controlled trials in lupus nephritis, we are now entering an era where we can integrate data to…
About 40% of patients treated with mycophenolate after transplantation develop GI side-effects, the commonest of which is diarrhea. A number of strategies can be employed to reduce the severity of these complaints. First, the dose can be taken…
I am still reviewing all my notes from the American Transplant Congress that occurred last May in sunny San Diego but I wanted to share with you a couple of interesting findings that I learned: First of all,…
Take-home points from Mayo Clinic’s Fernando Fervenza’s excellent Renal Grand Rounds this morning, in which he addresses the potential use of rituximab as a treatment for membranous nephropathy: -the “rule of thirds” that we learn about membranous nephropathy (e.g.,…
The ability to adequately suppress the immune system and prevent allograft rejection has been a true success story over the past several decades. With the advent of drugs such as calcineurin inhibitors, induction agents such as thymoglobulin, azathioprine…
One of the major medical advances over the past few decades has been the success of stem cell transplants, which serves as a potential cure for many patients with previously untreatable leukemias and lymphomas. With the expanded use…
