While making rounds, I was paged to the dialysis unit to evaluate a patient on hemodialysis via a tunneled dialysis catheter, who began having chills and hypotension during a session. Unfortunately, this is not an uncommon situation and…
An interesting study appeared in my email this morning examining the association between the use of iv iron and outcomes in hemodialysis patients with systemic infections. Current guidelines from all of the major societies suggest that if patients…
Peritoneal dialysis associated peritonitis is the second commonest cause of death among PD patients (35/1000 years) and the most common cause of treatment failure. It confers a CV risk of 7 times normal for 6 months following the…
The following few posts are a summary of tick borne illnesses that can cause renal failure and/or electrolyte problems. Babesiosis First identified on Nantucket Island in 1969 and was initially know as Nantucket fever. Endemic areas. CDC map….
In the PD literature, peritonitis has been referred to as an Achilles’ heel because it could lead to catheter removal and PD treatment failure. Topical antibiotics have been used for prevention of an exit site infection (ESI) which…
This is a question we face quite often in the Nephrology clinic when we are commencing patients on high dose steroids for glomerular and other systemic inflammatory diseases. I came across a couple of interesting retrospective studies while…
When caring for dialysis patients, we all use the well described KDOQI and KDIGO guidelines and ensure that the published goals are reached (please remember that the necessary government forms must also be completed!). We all pay special…
Although it’s not common (somewhere between 0.5 – 0.9% of all native kidney biopsies according to published case series), one of the fellows produced an interesting case of granulomatous interstitial nephritis in Renal Grand Rounds today. The case,…
I’ve done a post on renal-relevant HIV drugs previously, but I just heard an interesting case of tenofovir-induced renal failure at our Renal Grand Rounds and thought I’d mention a few interesting tidbits from the presentation. 1. HIV-Associated…
Why do some dialysis patients require so much more Epogen than others? Some patients manage to hit their targets with relatively low doses, and may even require “holding” EPO injections to avoid the upper hemoglobin range where excess…
