Gadolinium Beliefs
Poll results from last week: The majority of individuals (60%) felt that it was definitely unsafe giving gadolinium to ESRD patients, with 45% of individuals also agreeing that it was unsafe in CKD stage 4. As is consistent…
Cool New Cell Paper Demonstrates Molecular Basis for Thyroxic Hypokalemic Periodic Paralysis
The periodic paralysis syndromes are characterized by episodic attacks of acute muscle weakness, typically due to rapid fluxes in the serum potassium concentration, based on an abnormality in intracellular potassium shift. While there have been several instances of…
The Undocumented ESRD Population
Although it is difficult to provide exact number, there are approximately 11 million illegal immigrants residing within the United States. Many of these individuals come from Mexico and other Latin American countries; since there appears to be a…
Pre-Op Cardiovascular Testing for Kidney Transplant Recipients
One of the challenges of taking care of your ESRD patients on the kidney transplant list is deciding on what kind of cardiovascular workup to perform. For obvious reasons, you don’t want to be performing a major abdominal…
Up To Date: The Nephrology Textbook of Today?
The Poll Results from last week were relatively convincing: Up To Date is the most commonly used current reference system for rapidly obtaining nephrology knowledge, with 67% of respondents declaring Up To Date as their top source. I…
Differential Diagnosis of Granulomatous Kidney Disease
Although it’s not common (somewhere between 0.5 – 0.9% of all native kidney biopsies according to published case series), one of the fellows produced an interesting case of granulomatous interstitial nephritis in Renal Grand Rounds today. The case,…
Carotid Endarterectomy for CKD Patients
Cardiovascular complications are the major cause of morbidity and mortality in patients with CKD and ESRD. Although myocardial infarction and sudden cardiac death get a lot of attention, stroke is also extremely important in this population. How should…
Hypercalcemia of Malignancy
Cancer-associated hypercalcemia is the #1 cause for hypercalcemia in the inpatient setting (in the outpatient setting, the main cause is primary hyperparathyroidism). In general, hypercalcemia of malignancy portends a poor prognosis, and there are three main mechanisms by…
Favorite Renal Consult Topics
Poll results: the most appealing Nephrology Consult scenario chosen, perhaps not surprisingly, was workup of new-onset glomerulonephritis (44%). I would contend that many individuals choose Nephrology because they are interested in issues such as glomerulonephritis, interesting electrolyte and…
Differential Diagnosis of Hypomagnesemia
Why do we care about hypomagnesemia? And why are cardiologists so eager to replete the serum magnesium above 2.0 mg/dL? Very low serum Mg can result in serious cardiovascular and CNS effects. Specifically, hypomagnesemia can cause QRS widening…