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Nathan Hellman

Big Pharma Nephrology

The following is a list of major pharmaceutical companies, ranked by total revenue. The numbers are staggeringly high. #1 overall is Johnson & Johnson ($ 63,747,000,000 in 2008 total revenue), followed by Pfizer and Bayer. A few of…

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Stranded on a Lifeboat

We all know that if you are stranded on a lifeboat in the middle of the ocean, you are not supposed to drink the salt water.  Why is this the case–shouldn’t the kidney be smart enough to retain…

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Transvaginal Nephrectomy

Recently two separate groups have reported the successful carrying out of the first-ever human transvaginal nephrectomy–one report coming from the Cleveland Clinic and another from Venezuela. The surgery is being developed as an even less invasive surgical approach…

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Chronic Pain in ADPKD

About 60% of all ADPKD patients are estimated to have a chronic pain syndrome, and often this is the initially presenting symptom of an ADPKD patient that brings them to medical attention. An excellent review of this field…

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Two-Hit Hypothesis & ADPKD

One of the really interesting aspects of autosomal dominant polycystic kidney disease (ADPKD) is that only about 1% of all nephrons form cysts. You can do the math: if you have about 1 million nephrons per kidney, and…

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A better way for CKD staging?

Presently the KDOQI Staging system for CKD (see figure) is what is used most commonly to classify the severity of reduced renal function. This is based purely on an estimation of the GFR, using equations such as the…

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The Erythropoietin Receptor

As we all know, erythropoietin is secreted predominantly by the kidney (85% from the kidney, 15% from the liver) in response to hypoxia and its function is to stimulate erythropoiesis in the bone marrow.  What  is the receptor…

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Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) accounts for a significant fraction of renal artery stenosis. The distinction between fibromuscular dysplasia and atherosclerotic renal artery stenosis is important as the former tends to respond much more readily to interventional therapy than the…

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