There are two general strategies for CVVH replacement solution entering into the blood circuit: pre-dilution (in which replacement solution is mixed with the blood prior to its entry into the filter), or post-dilution (in which replacement solution is…
Keeping with our recent theme of “numerical rules in Nephrology”, let’s briefly discuss the “Rule of Thirds” for Membranous Nephropathy. The “Rule of Thirds” is frequently taught in medical school and a useful way of thinking about the…
Most of the time when we are consulted for an inpatient with a rising creatinine, the assumption is that the kidney is to blame. However, there is an important list of non-renal conditions which can increase either BUN…
I had always assumed that the “Bence-Jones” protein–essentially, the demonstration of monoclonal light chains on urine protein electropheresis (UPEP)–was named after two doctors, Bence & Jones. However I recently found out that actually it was named after a…
One of the hot topics in Nephrology over the past few years has been the epidemiologic and histopathologic studies suggesting oral sodium phosphate colonoscopy preparations as a cause of acute phosphate nephropathy. As evidence continued to mount, the…
In peritoneal dialysis, ultrafiltration failure is defined as the inability of the peritoneal dialysate to maintain euvolemia–and generally speaking, this implies some degree of hypervolemia. Technically, it can occasionally result from trivial explanations–for example, an incorrect PD prescription…
The “Rule of 6s” describes an easy way to evaluate the maturity of a recently-placed arteriovenous fistula for dialysis access–and is even mentioned by name in the most recent KDOQI Guidelines for Dialysis Access. The Rule of 6s…
Basic Clinical Immunology: there are four types of hypersensitivity reactions. Below is a listing of all four types and, since this is a Nephrology Blog, renal examples for each one. Type I Immune Reaction (anaphylactic): Type I hypersensitivity…
Wow. In case you hadn’t heard the news, Shad Ireland, a 37 year-old dialysis patient, recently completed a cross-country bike trip which involved cycling from California to Washington, DC. Mr. Ireland has been on dialysis for 27 years,…
This has been known for awhile, but it is worth repeating–sevelamer (Renagel), in addition to its ability to act as a phosphate binder, also results in LDL cholesterol-lowering effects. Two of the early articles (a 1998 Clinical Nephrology…
