Interesting transplant case: A 35 year old man with a history of acute myelogenous leukemia, status post a bone marrow transplant from his sister eight years ago and now cured, who developed chronic kidney disease as a result…
The differential diagnosis of renal disease in an HIV patient is fairly long. Perhaps the most well-known amongst the list is HIV-associated nephropathy (HIVAN), which involves massive protein wasting, collapsing FSGS, and rapidly-progressive renal failure. Another entity on…
The results from the Acute Renal Failure Trial Network (“ATN Study“) are revealed in the most recent issue of the New England Journal of Medicine. The study was a randomized control trial in which ICU patients with acute…
We all know that FSGS can exist in both primary and secondary forms. In both cases light microscopy identifies partially (“segmental”) sclerotic glomeruli in a variable (“focal”) distribution in the biopsy. How can you tell the different between…
The situation: a 53 year old ESRD patient shows up with vomiting. She is normally dialyzed Monday, Wednesday and Friday and now [ Her Na level is 111. What to do? There are several reports of central pontine…
Friday we did two biopsies on the Consult Service…one of which turned out to be a fairly interesting diagnosis of fibrillary glomerulonephritis. The case in brief: a 71 yo woman with a history of HTN and no diabetes…
The classical teaching about Dense Deposit Disease (DDD) usually begins with its classification as type II Membranoproliferative Disease. However, in the most recent edition of the NephSAP “Glomerular, Vascular, and Tubulointerstitial Diseases” module, the case is made that…
Sclerosing encapsulating peritonitis is a rare but severe complication of long-term peritoneal dialysis (PD). It may occur even years after a patient has stopped PD, and is characterized by calcifications along the peritoneum and small bowel loops (see…
Electron microscopy of biopsy specimens from patients with membranous nephropathy demonstrate subepithelial deposits, leading to the hypothesis that immune complexes form in situ against antigens that are present on the podocyte foot process plasma membrane. Perhaps the strongest…
Rapamycin (sirolimus) is a commonly used immunosupressant deriving from the bacterium Streptomyces hygroscopicus, originally found on Easter Island. It was originally developed as an antifungal agent but later found to have potent immunosuppressive and antiproliferative properties. Although effective,…
