Being a parent is probably one of the most desirable and difficult tasks in life. While ESRD is associated with a high rate of infertility related to hormonal changes and anovulation, most patients undergoing renal transplantation resume menstrual…
A woman with no past medical history was admitted to the ICU service with acute kidney injury secondary to atypical HUS. She was early in pregnancy and we were consulted in order to start dialysis. The management of…
We recently discussed this issue in conference and I thought it might be worth sharing a few interesting points: Azathioprine is normally converted to the active metabolite 6-mercaptopurine. However, in pregnancy the placenta can metabolize azathioprine to thiouric…
While recently reading about hypogonadism in the dialysis population, I came across this review on the pregnancy outcomes in women on dialysis, summarizing observational studies published between 1995 and 2009. I have participated in only a few pregnancy-planning…
Here are some interesting points I picked up at an ASN review to reinforce Gearoids post discussing changes in reference values during pregnancy and Michael’s board review post which covers a lot of the physiology also. Kidneys increase…
When seeing consults on the maternity floor, figuring out the normal values at the various stages of pregnancy can be a frustrating experience. There are well recognized hemodynamic and biochemical changes which occur from the earliest stages of…
Each of the following choices is expected to occur during pregnancy except for A and D. Let’s go through each of the possible choices. A. This in partially incorrect. Hyperventilation (with resultant hypocapnea, not hypercapnea) occurs during pregnancy…
The best answer is D. Lifton et al. described a single gene mutation on the hormone-binding domain of the mineralocorticoid receptor (MCR). Individuals with this missense mutation develop early-onset hypertension with characteristic low renin and aldosterone levels. The…
A 26-year-old primigravid woman is admitted during her 34th week of pregnancy with severe, refractory hypertension. She was noted to have mild hypertension prior to pregnancy. Her family history is remarkable for pregnancy-related hypertension in her aunt. Her…
That cardiac biomarkers, including Troponin and BNP, can be elevated in CKD or ESKD without necessarily having clinical significance is familiar to most of us. Whether you believe that an elevated Troponin in ESKD is due to diminished…
