Panda Eyes
I recently saw an elderly woman in clinic. She had a background history of migraine headaches and had been investigated over the past 18 months for recurrent syncopal episodes. She had at least 5 episodes that began with…
Effects of Intensive Low-Salt Diet Education on Albuminuria: CJASN e-Journal Club
This month’s CJASN e-journal club was hosted at the Department of Nephrology at the Royal Infirmary of Edinburgh. It discussed a trial designed to investigate the efficacy of an intensive low salt diet intervention (weekly 30 minutes phone feedback…
Bardoxolone – The Final Chapter – Part 2
One of the issues surrounding the study of bardoxolone in animal models was that, because of the way that it is metabolized in rats and mice, it is highly toxic when given for long periods. This specific toxicity…
eJournal Club – Albuminuria and AKI
This month’s eJournal club concerns biomarkers of AKI. There has been considerable interest in developing novel biomarkers of AKI and CKD and a lot of effort has been focused on novel biomarkers such as NGAL, KIM-1 and IL-18….
Bardoxolone – Part 3
Last year, we had a post about Bardoxolone for the treatment of diabetic nephropathy. After one year of treatment, eGFR increased significantly in patients treated with Bardoxolone relative to controls. At the time, significant concerns were raised about…
Still mysterious: the elusive circulating factor for FSGS
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…
Under Pressure
As a medical student I was taught the CKD hypertension gospel straight from the good book of JNC VII: Thou shalt lower the blood pressure to less than 130/80! This was many years after David Bowe and Freddie…
Urine albumin and protein measurement
Continuing the theme of must knows regarding urinalysis: Urine albumin is detected by the urine dipstick via a reaction with tetrabromophenol blue. The reaction produces a colorimetric result depending on the amount of albumin present, which can be…
It is VITAL that you take your vitamins
The Renin-Angiotensin system is a major mediator of progressive renal injury In CKD and drugs that target the RAS have been shown to slow the progression of glomerulosclerosis, tubulointerstitial fibrosis and proteinuria. However, the effects of even maximal…
Proteinuria: The glomerulus isn’t always to blame
We usually associate proteinuria with a defect in the glomerular filtration barrier, but it is useful to remember that the proximal tubule (PT) also plays a role in resorption of proteins. Nate discussed this controversy in a prior…