Thrombotic microangiopathy (TMA) comprises conditions that are of importance to nephrologists as they are: Associated with renal manifestations including acute kidney injury Frequently require treatment with plasmapheresis, a procedure which is often managed by the nephrologist Pathophysiology - What is it? A pathologic condition characterized by platelet microthrombi in the microvasculature. This
Overview This describes a small vessel vasculitis with antibodies against the glomerular and/or alveolar basement membranes in capillaries. Glomerular Basement Membranes (GBM) and Alveolar Basement Membranes contain type 4 collagen with α 3,4,5 chains In this syndrome autoantibodies are formed against the non collagenous domain of the α3 chain of type IV collagen
Immunosuppression is required for kidney transplantation. The foreign antigens on the kidney allograft are recognized by the patient's immune system. Without immunosuppression this will lead to rejection of the kidney. Immunosuppression is composed of induction and maintenance. The immunologic risk of rejection is highest immediately after transplant and decreases with time. Most cases
Kidney transplantation involves the introduction of foreign antigens that are recognized by the patient's immune system. For this reason immunosuppression is required to prevent rejection. Cross matching is required to determine if a transplant is compatible. HLA testing informs the long term prognosis of the allograft. Matching People may think the donor kidney
The following alcohols can be ingested and lead to toxicity: Ethanol Ethylene glycol Methanol Propylene glycol Diethylene glycol Isopropanol Although ethanol intoxication may be obvious and levels are readily available, diagnosis of other alcohol toxicity is more difficult. Levels are often send-out tests with results not available in a manner timely enough to
Thiazide (and thiazide like) diuretics are important medications for the treatment of hypertension (HTN). Thiazide diuretics contain a benzothiadiazine core (hence the name thiazide). Thiazide-like diuretics have the same physiologic effect of blocking the Na+Cl- cotransporter in the distal convoluted tubule, but do not contain the benzothiadiazine core. This article will use the
NSAIDS are known to be nephrotoxic. 1-5% of NSAID users have an adverse kidney event Patients with kidney disease are often advised to refrain from NSAIDS. The thing is NSAIDS work. I’m a nephrologist who takes NSAIDS while advising my patients with CKD to avoid them. What gives? I recently was asked what
Hypotonic Hyponatremia In most cases of hyponatremia there is an excess of H20 relative to Na in the body. This decreases the tonicity (osmolality) of the serum. Water then moves from the extracellular to intracellular space down this osmotic gradient. This causes cellular swelling. Cellular swelling in the brain explains the adverse CNS
Lupus can affect the kidney in many ways. The pathologic classification of lupus nephritis is based on kidney biopsy. Lupus can also affect the kidney in other ways outside of the classification system. This article will provide an overview of pathologic and clinical findings associated with the different types of lupus nephritis. General
This article will provide an overview of diuretics including: Mechanism of action Clinical uses Adverse effects The majority of sodium that is filtered by the glomerulus is reabsorbed in the tubules. If you have normal kidney function and normal diet, less than 1% of the filtered sodium is excreted in the urine. Diuretics
