Ultrafiltration failure is a frequent clinical problem in PD patients. The most common etiologies are: fast peritoneal membrane transport, loss of peritoneal surface membrane and high lymphatic absorption. Mechanical and anatomical etiologies are occasionally seen. Rule of 4’s…
Though adult nephrologists infrequently encounter these disorders in clinic, the Board Exam loves them. Below a short table describing some of these gain- and loss-of-function channel disorders that are worth remembering. The diuretic-targeted channels are shown under parenthesis…
With the results of the eAJKD brackets posted by Gearoid, I thought this article might be pertinent to stimulate further the debate… This article just came out on Transplantation and is a well designed study in which the…
The incidence of auto-immune diseases has dramatically increased in the past 50 years and the concern that environmental exposures have contributed to this increase is broadly suspected. However, it is very hard to pin-point to an individual factor. …
Vascular rejection has been traditionally considered a severe form of acute rejection characterized by infiltration of mononuclear cells beneath the endothelium or by the presence of arteritis. Though initially reported as an aggressive form of T-cell mediated rejection…
A gentleman with ESRD secondary to polycystic kidney disease comes in with vomiting and headache eight months after kidney transplantation. Brain MRI shows a small single enhancing lesion in the temporal lobe. Lumbar puncture reveals an elevated opening…
We have previously discussed cardiovascular mortality after transplantation. But one controversial aspect in the evaluation of potential kidney recipients is the performance of stress tests for risk stratification. With the cost of stress tests ranging from U$2,500-5,000 and the…
It is surprising how high the nonadherence rates for immunosuppressants is among renal transplant recipients, ranging from 15 to 40%, despite the potential impact of nonadherence and the degree of education provided to transplant recipients. Nonadherence to immunosuppressive…
We were evaluating a kidney transplant recipient three weeks after surgery who presented with a rise in creatinine. We obtained an ultrasound which showed a large fluid collection and mild hydronephrosis. Prograf level was at goal. Peritransplant fluid…
One of the frequent situations that we face in the renal transplant clinic is the patient in otherwise good condition who presents with a slight rise in serum creatinine. Although this is sometimes due to reversible causes, such…
