The evaluation of a dialysis patient for possible kidney transplantation is a great challenge. On one side, we know that if the patient continues on dialysis, his yearly mortality will be around 20%. On the other hand, kidney…
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…
A 62-year-old man with CKD stage 3 secondary to presumed hypertension presented with new-onset hypercalcemia. PTH level was low at 11 and abdominal imaging revealed a right renal mass that later was confirmed to be a renal cell…
A 53-year-old Caucasian male presented with pulmonary embolism, and was found to have nephrotic syndrome. A kidney biopsy showed membranous nephropathy (MN). The disease progressed despite treatment and six years later, the patient underwent a pre-emptive living unrelated…
In general, when we are asked to evaluate a patient with liver disease for the development of acute renal failure, the three top differentials are usually: true hepatorenal syndrome, a prerenal picture (often 2/2 overdiuresis) and ATN. Cholemic…
What are the most common type of cancers in kidney transplant recipients? The three most common cancers are: non-melanoma skin cancers, Kaposi’s sarcoma and non-Hodgkin lymphomas. Compared to the general population, the risk of squamous cell carcinoma is…
One of my transplant patients came to clinic last week excited about his trip to Tanzania. He had undergone kidney transplantation three years ago and has had an uneventful course. As a transplant nephrologist, you kind of become…
Keeping the bone theme: A 50-year-old woman with ESRD secondary to PKD underwent a living related-kidney transplant one-month prior. At clinic visit, she was complaining of severe throbbing pain in her hands and feet. The pain was worse…
In a recent survey of 630 bone biopsy samples from patients with CKD stage 5 on dialysis, bone turnover was low in 52%, normal in 21% and high in 27% of biopsies. Defective mineralization was found in only…
* How common is neutropenia after kidney transplantation and when does it usually occur? About 20-50% of kidney recipients will experience at least one episode of neutropenia. It typically occurs around day 100 after transplantation and it can…
