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Yearly Archives: 2023

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Approach to Evaluation of Renal Cysts

Kidney cysts are commonly found on imaging and are a common cause of anxiety for patients. This overview will provide context with the aim of being able to minimize patient anxiety, avoid unnecessary referrals and triage patients for appropriate referral to nephrology or urology. The main question to ask yourself when a kidney

By |2023-12-08T14:00:22+00:00October 18th, 2023|Kidney Disease|0 Comments

Dermatologic Conditions in ESRD

There are certain dermatologic conditions unique to ESRD that the nephrology practitioner should be aware of.  These include: Uremic pruritus Calciphylaxis - calcific uremic arteriolopathy Perforating Dermatosis - Kyrle Disease Nephrogenic Systemic Fibrosis Uremic Pruritus Pruritus is a common complaint in ESRD.  It may be localized or generalized. Pathogenesis.  It is often attributed

By |2023-12-08T14:00:43+00:00October 11th, 2023|Kidney Disease|0 Comments

Immunosuppression in Kidney Diseases and the 80-20 rule

When writing this article I felt a need to add more and more information, to be comprehensive.  I had a fear of leaving something out. I need to stop.  The intention of BCNephro is not to be an encyclopedic nephrology resource. The intention is to share my experiences in a way that makes

By |2023-12-08T14:00:37+00:00October 4th, 2023|Kidney Disease|0 Comments

Glomerulonephritis: Hematuria and the Nephritic Syndrome

What is glomerulonephritis? Glomerulonephritis is inflammation of the glomerulus.  This is may be manifest by: Clinical Findings: Glomerular hematuria Variable proteinuria (typically sub nephrotic may be nephrotic) Leukocyturia (variable) Impaired kidney function (variable) Hypertension (variable) May be renal limited or associated with systemic inflammation (vasculitis) Pathologic Findings: Glomerular hypercellularity Crescents (indicate more severe

By |2024-03-13T13:16:19+00:00September 27th, 2023|Kidney Disease|1 Comment

Hypernatremia

Hypernatremia like hyponatremia is all about water. Hyponatremia indicates intracellular water excess (overhydration). Hypernatremia means the opposite, too little water.  (At least too little water relative to sodium).  This is dehydration.   It indicates intracellular dehydration. This article will address: Pathophysiology Approach to Diagnosis Renal Causes of Hypernatremia Diagnostic Algorithm Treatment Pathophysiology What happens

By |2023-12-09T00:48:26+00:00September 20th, 2023|Hypernatremia|0 Comments

Dialysis Round Primer- Hypertension and Volume Status

Hypertension is a prevalent issue in dialysis patients. Mechanisms of Hypertension in ESRD patients Sodium and Volume Overload Sympathetic Overactivity Renin Angiotensin System Activation Sodium and Volume Overload The cornerstone of blood pressure control is volume management. In non ESRD patients with hypertension (HTN), sodium/ volume overload is a reason for an inability

By |2023-12-10T20:04:04+00:00September 13th, 2023|Dialysis|0 Comments

Amyloidosis

Amyloidosis is another relatively common systemic condition that causes nephrotic syndrome with unique kidney pathology.  Approximately 2% of native kidney biopsies will show amyloidosis. What is amyloidosis? Amyloidosis is a syndrome where proteins deposit in tissues in a specific misfolded pattern forming what is called beta pleated sheets.  These protein deposits result in

By |2023-12-10T20:09:54+00:00August 30th, 2023|Kidney Disease|0 Comments

Hypercalcemia

Hypercalcemia is of interest to both nephrologists and endocrinologists. Why nephrology? Hypercalcemia may cause acute kidney injury (AKI) Hypercalcemia, in specific primary hyperparathyroidism, is associated with nephrolithiasis (kidney stones). Secondary and Tertiary hyperparathyroidism is a complication of chronic kidney disease (CKD) and end stage renal disease (ESRD) primarily managed by nephrologists. Bottom line: 

By |2023-12-12T23:25:41+00:00August 17th, 2023|Hyperkalemia|0 Comments

Dialysis Rounding Primer – Mineral Bone Disease (CKD-MBD)

Mineral bone disease in dialysis patients refers to assessment and management of Phosphorus, Calcium, and Parathyroid Hormone (PTH) Pathophysiology The kidney normally is responsible for excretion of phosphorus and conversion of inactive -  25- hydroxyvitamin D to active - 1,25-hydroxyvitamin D via the enzyme 1 alpha-hydroxylase. Therefore with kidney failure there is: Impaired

By |2023-12-12T23:33:43+00:00August 9th, 2023|Dialysis|0 Comments
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