Therapeutic plasma exchange (PLEX) is a type of therapy where a patient’s plasma volume is removed over a period of a few hours, through a process of centrifugation of blood with subsequent separation of its constituents, and replaced…
The recently published paper in the NEJM entitled “Survival Benefit with Kidney Transplants from HLA-Incompatible LiveDonors” caused a huge impact on Brazil’s media. Our main broadcast TV devoted few minutes explaining it, suggesting as a real breakthrough. Patients…
There has been lots of new data in the AAV literature of late. We have new nomenclature, including the dropping of Freidrich Wegeners name for the more generic but descriptive granulomatosis plus angiitis (GPA), by the Chapel Hill…
Important new findings were recently published in relation to proteinuria and FSGS, which are definitely of interest to our community. First, the punch line: There is new evidence for a “circulating factor” in recurrent FSGS in a fascinating…
Acute humoral or antibody-mediated rejection (AMR) is attributed to the presence of alloantibodies against the graft, which could be either antibodies against human leukocyte antigens (HLAs) Class I and/or II , non-HLA antigens or endothelial antigens. Diagnosis of…
I would like to direct your attention to a landmark paper in transplantation just published on the NEJM two weeks ago. We have previously discussed the terms used to characterize sensitized patients and the most common protocols to…
Interesting case for the weekend: young woman with known lupus, baseline normal kidney function; admitted initially with headaches and “feeling more lupusy than usual”, found to have a creatinine of 2.5 on admission with some dysmorphic RBCs on…
RPGN is a nephrologic emergency, and one of the more exciting consult cases for nephrologists to participate in. Much like dealing with a stroke or heart attack, delays in initiating therapy can lead to substantially worsened outcomes. Prompt…
There are many indications for plasma exchange in nephrology: some common ones include antibody-mediated rejection of a kidney transplant, Goodpasture’s, ANCA-associated vasculitis, and TTP–all of which are commonly associated with loss of renal fellows’ sleep–that is, you may…
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)…
