Happy Thanksgiving
One of the things I was definitely grateful for at this year’s Thanksgiving table: I’m not on-call and can spend the holiday with my family! Best wishes to those renal fellows working hard on this holiday. Poll Results…
Renal Disease in Sjogren’s Syndrome
Sjogren’s syndrome is an autoimmune disorder in which there is immune-mediated damage to the exocrine glands which produce tears and saliva. Many patients (up to 25%) will have extraglandular manifestations of the disease, one of the possibilities of…
Renal TB
TB is classically thought of as a pulmonary disease–and in general, this is true, as pulmonary TB is by far the most common (and often very severe) manifestation of infection by Mycobacterium tuberculosis. However, the most common NON-pulmonary…
Utility of Testing For Eosinophiluria
Testing for the presence of urine eosinophils is often performed when the diagnosis of acute interstitial nephritis is suspected. The landmark paper touting the use of this test is a 1986 New England Journal of Medicine article by…
‘Shrooms and Renal Failure
While toxic mushroom ingestions are generally known for their ability to cause acute liver failure, certain varieties of mushrooms can also result in acute renal failure. One such type of mushroom is Amanita smithiana, (shown at left) which…
Bactrim & elevated creatinine
The antibiotic Bactrim is frequently associated with an increase in creatinine shortly after starting it. While Bactrim is a not uncommon cause of acute interstitial nephritis (AIN), the most frequent reason for a Bactrim-associated creatinine increase is actually…
Renal manifestations of rheumatoid arthritis
Renal disease is not uncommon in patients with rheumatoid arthritis, and the differential diagnosis is quite interesting. Here is a list of the major causes, some of which are caused by the RA itself and others of which…
Urine eosinophils
Eosinophils in the urine can be detected by applying a Hansel’s stain to the urine sediment. The presence of >1% eosinophils of the total urine WBCs constitute a positive test. In general, the same things which cause +urine…
An Unexpected Case of AIN
Here’s a case I saw on the consult service last week which demonstrates the utility of examining the urine sediment yourself. The clinical scenario: a 50 year-old male with a history of hepatitis C liver disease who was…
Aristolochic acid
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”…