A question which comes up not infrequently during nephrology fellowship is whether or not to perform pheresis on patients with multiple myeloma. Once very much in vogue, the results of a fairly recent (Annals of Internal Medicine, 2005)…
A quick one before the July 4th Weekend… Peritoneal dialysis solutions are often color-coded based on the dextrose concentration. Dextrose is used as the osmotically-active agent. As it is partially absorbed, patients with diabetes have to watch out…
Not all peritoneal membranes are created equally. The peritoneal equilibration test (PET) is a standardized method for assessing peritoneal membrane function, and is used for tailoring an appropriate, individualized PD prescription. The test is based on the fact…
A recent JAMA article (Parienti et al, JAMA 2008) was presented in journal club today which involved a randomized control trial looking at infectious and other complications seen in patients with acute kidney injury in an ICU who…
Although mutations in the gene HNF-1beta (or TCF2) were originally discovered in patients with mature-onset diabetes of the young (MODY), patients with these mutations more commonly present with a variable renal phenotype. Interestingly, a study by Egdhill et….
Hepatitis B–a disease which in the U.S. is on the decline due to regular childhood vaccinations–has a variety of interesting associations with renal disease. There are three distinct glomerular diseases with which the hepatitis B virus is associated….
Staghorn calculi are upper urinary tract kidney stones which involve the renal pelvis and involve at least two of the calyces. They are formed in the setting of an alkaline pH and urease-producing micro-organisms, which leads to the…
I reviewed a paper in our Renal Journal Club today–Tumlin et al, Efficacy and Safety of Renal Tubule Cell Therapy for Acute Renal Failure in a recent 2008 issue of JASN–which tests a novel device termed the “Renal…
The DCOR Trial was a Genzyme-funded randomized control trial–somebody recently told me the largest ever conducted in a dialysis population–designed to compare the phosphate binder sevelamer (Renagel) with Ca-containing phosphate binders (calcium acetate a.k.a. Phoslo or calcium carbonate)….
When somebody receives a kidney transplant, the current strategy is to hit them hard with immunosuppression initially–using potent medications such as thymoglobulin, Cell-Cept, steroids, and tacrolimus at higher levels–and that medication can generally be tapered to much lower…
