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Nathan Hellman

Refeeding Syndrome

The clinical entity of refeeding syndrome was first described in U.S. POWs in Japan who had been starved for many months to years, then developed extreme electrolyte abnormalities upon the reintroduction of food. The most common electrolyte abnormalities…

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Beer Potomania

One of the admittedly rare causes of hyponatremia is beer potomania–the excessive consumption of beer in the absence of much food. How does beer potomania work? Beer has a very low content of sodium and protein–and if an…

SGK1 Polymorphisms

The most recent issue of NephSAP (“Fluids, Electrolytes, and Acid-Base Disturbances”) features a mini-review describing the role of the kinase SGK1 in the regulation of various nephrology-related disorders, such as salt-sensitive hypertension, metabolic syndrome, and renal fibrosis. How…

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Renal Adaptations to Hyperkalemia

Are ESRD patients “protected” from the arrhythmogenic effects of hyperkalemia if they are chronically exposed to elevated potassium levels? I’m not sure if there is a clear answer to this question, but it is certainly a relevant question….

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Outside Hospital

At the risk of offending community hospitals out there…I present to you “Outside Hospital”, a video I helped make during my residency in Internal Medicine parodying some of the outside hospitals from which we used to receive patient…

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Underuse of ACS Therapy in CKD

A recent paper in AJKD by Patel et al describes a curious but well-documented phenomenon: the finding that patients with CKD who are hospitalized with acute coronary syndrome (ACS) are less likely to receive therapies known to be…

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Uremic Pruritis

Recent review in the latest issue of Nature Clinical Practice Nephrology entitled “Skin problems in chronic kidney disease.” They tackle the usual suspects (calciphylaxis, nephrogenic systemic fibrosis) as well as some lesser-known dermatologic conditions which appear with a…

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Urinary Ascites

An unusual cause of ascites is urinary ascites: this occurs when there is rupture of either the ureter or bladder, leading to leakage of urine into the peritoneal space. In adults, this is almost always due to either…

There’s No “N” in ATN

Just like there’s no “I” in team…there’s no “N” in ATN.   I heard this expression at our Renal Grand Rounds today featuring pathologist Isaac Stillman at nearby Beth Israel Hospital.  It’s not completely accurate, as in many…

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Fish Oil for IgA Nephropathy?

Unfortunately, other than blockade of the renin-angiotensin system via ACE-inhibitors and angiotensin receptor blockers, there are not a lot of evidence-based treatment options for IgA Nephropathy. One other potential addition to the therapeutic regimen for IgA Nephropathy–depending on…

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