The optimum dosage and preparation of renin-angiotensin system inhibitors (RASi) for slowing the progression of progressive proteinuric CKD remains somewhat uncertain, although…
The relationships between tissue and circulating advanced glycan end-products (AGEP) maintained on chronic hemodialysis (HD) for kidney failure are uncertain. Serum levels of AGEP and…
Patients with autosomal dominant polycystic kidney disease (ADPKD) and advanced chronic kidney disease are not uncommonly considered as candidates for elective or emergent bilateral nephrectomy (BN) because of…
Percutaneous biopsy (PB), of either native or transplanted kidney, is commonly performed using a variety of needle sizes (14, 16 or 18 G), according to the preferences, training, and experience…
The selection of donor kidneys for optimal post-transplant outcomes is an important issue, and discarding kidneys based on clinical criteria decreases the availability of organs. Pre-implantation biopsies of potential donor…
Focal and segmental glomerulosclerosis (FSGS) is a histological glomerular lesion, not a specific disease. Primary forms of FSGS, presumably due to a circulating permeability factor (or factors), can be recognized…
Recurrent focal segmental glomerulosclerosis (FSGS) in a kidney allograft performed in a patient with kidney failure presumed to be due to primary (permeability factor-related) FSGS is a common…
Lupus nephritis (LN) continues to be a challenging disorder for both nephrologists and rheumatologists. This topic is an ever-changing one and the pace of change appears to be accelerating as…
It is generally observed that creatinine is secreted by the proximal tubule (via an organic anion transporter) in subjects with normal or even modestly impaired function leading to…
The benefits of renin-angiotensin system (RAS) inhibition for slowing the progress of diabetes-related CKD with overt proteinuria is well established. The utility (efficacy and safety) of adding…
Mannose-binding lectin, complement components 3 and 4d, IgG4 and PLA2R antigen (and/or thrombospondin 7A; THSD7A) are frequently co-deposited or hyperexpressed in the glomeruli of patients with primary membranous nephropathy. Strong…
Traditionally, thrombotic micro-angiopathy (TMA) is believed to mainly be a consequence of events paying out at the interface of the endothelial cells of the vascular tree and the circulation, including…
IgA nephropathy (IgAN) is a common disorder that progresses to kidney failure in about 30% of patients followed for 2 decades or more. It also commonly recurs in transplanted kidneys….
Little doubt exists that progressive chronic kidney disease (CKD) imposes added risks of mortality, mainly from cardiovascular disease (CVD). This relationship is a very complex one involving a multitude of…
Observational data have strongly implicated excessive ultrafiltration rates (UFR) as a possible contributor to adverse outcome in hemodialysis treatment of kidney failure. Many variables can affect this association, including…
Acute decompensated heart failure (AHF) is commonly associated with renal functional impairment and diuretic resistance. The assessment of “spot” [Una+] may be useful in identifying diuretic resistance and the need…
The COVID-19 pandemic has presented many challenges in treatment and organ support. The “cytokine storm” commonly associated with severe forms of COVID-19 raises the possibility of using extracorporeal blood purification…
Several reports, going back 5–7 years, noted increased levels of an estimated glomerular filtration rate (eGFR) in a variable number of patients with severe sepsis or trauma admitted to the…
Kidney biopsy in patients with diabetes mellitus (typically type 2; T2DM) and CKD (proteinuria with or without reduced GFR) is often performed to evaluate the possibility of the presence of…
ANCA-associated vasculitis (AAV) preferentially affects an older population of adults. The use of potent immunosuppressive agents (such as cyclophosphamide [CYC] or rituximab [RTX]) for treatment might expose these older patients…
Obesity and its association with CKD is well described but prediction of the incident CKD from a description of obesity is understudied. As a modifiable risk factor such an analysis…
March 31, 2020
Fate of Sodium in Sodium Bicarbonate Infusions in Acid-Base Disorders – A New Analysis of Old Data
It is well known that the space of distribution of bicarbonate anion (HCO3–) following intravenous infusion of hypertonic sodium bicarbonate is independent of blood pH but is highly correlated with…
The adverse effects of iodinated contrast media (CM) on kidney function continues to be very controversial. It is likely that the effects of CM have been overstated in the past….
The information concerning the impact of primary membranous nephropathy (MN) on the mother and fetus in pregnancy is scanty. Liu et al. have at least partially filled this gap with…
The calculated plasma osmolality (Posm=2 X plasma [Na+] = serum urea nitrogen/ 2.8 + serum glucose/1.8) is higher in hemodialysis patients (averaging 307 ±9 mOsm/kg H20) compared to…
Several randomized and controlled studies have documented that “acute kidney injury” (defined by a rising level of serum creatinine) can accompany intensive blood pressure control regimens designed to achieve systolic…
Radio-contrast media volume may have an important influence on the risk of contrast-associated acute kidney injury (AKI). Zahler et al. have carried out a retrospective, observational (and uncontrolled) study to…
The mortality and occurrence of cardiovascular (CV) events appears to be similar between…
Typically, IgG deposition is scanty or absent (“pauci-immune”) in antineutrophil cytoplasmic antibody (ANCA) vasculitis but…
The optimal treatment strategy for induction of a remission in antineutrophil cytoplasmic antibody-associated (ANCA) vasculitis with severe renal involvement is…