One of the interesting ongoing protocols at the Massachusetts General Hospital Kidney Transplant Program is the combined kidney/bone marrow transplant protocol. The idea here is to transplant both kidney & hematopoeitic stem cells from the same donor, which…
Lithium, a very effective medication in the treatment of bipolar disorder, has a variety of well-documented renal side effects, including interstitial nephritis and nephrogenic diabetes insipidus. A less well-recognized complication is an increased prevalence of hyperparathyroidism in chronic…
The water deprivation test is useful in the workup of patients with polyuria under certain situations. The differential diagnosis of polyuria often comes down to the following: does the patient have diabetes insipidus (either central or nephrogenic), psychogenic…
I was recently alerted to a great lecture series on acid-base & electrolytes by Mitch Halperin and colleagues which are published in the Quartery Journal of Medicine (QJM). They are generally case-based articles which use an imaginary physician…
A few basics about the prostaglandins, a major player in renal hemodynamics. Prostaglandins are fatty acid-based compounds which carry out a variety of cellular effects. The pathway begins with phospholipid within the plasma membrane, which is converted to…
Today is the 1-year anniversary of the Renal Fellow Network. I started it towards the end of my 1st (clinical) year of nephrology fellowhip on April 23, 2008…and since this is the 320th post, I’ve done a reasonably…
It is important to realize the difference between HYPOVOLEMIA and DEHYDRATION, two terms which are often used interchangeably but in fact reflect different things. Read the Up-To-Date entry « Dehydration is not synonymous with hypovolemia » by Burton…
Trick question: where was the 9th Banff Conference on Allograft Pathology in 2007 held? Hint: it wasn’t Banff (the beautiful national park in western Canada). Answer: La Coruna, Spain. At this conference a consensus regarding the histopathologic classification…
One logical way to classify the different etiologies of hypocalcemia is to break them down into LOW PTH STATES and HIGH PTH STATES. Today I’ll review the HYPOCALCEMIA WITH LOW PH STATES, or in other words, the causes…
I remember learning about Lesch-Nyhan and thinking it was fascinating early on during a college course on neurology & behavior: affected children with this X-linked disorder develop the bizarre but highly characteristic behavior of self-mutilation, intentional biting of…
