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
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
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
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
The decision whether to give bicarbonate (HCO3-) for metabolic acidosis can be confusing. In some conditions, such as lactic acidosis, bicarbonate has not been shown to be beneficial, may be harmful, and is reserved for very severe acidosis. In other conditions such as Chronic Kidney Disease (CKD) treatment with alkali is recommended to
Infection associated glomerulonephritis. Patient presents with Acute Kidney Injury (AKI) and active urine sediment in the context of a current or recent infection. Pathophysiology and Clinical Presentation Antigen antibody immune complexes form with the antigen from the infection and the antibody from the immune response. These immune complexes deposit in the glomeruli
Nephrologists generally use the physiologic approach to diagnosing acid base disorders. Check out this article for an overview of the physiologic approach. Understanding Acid Base Disorders | BCNephro However, there are two other approaches to diagnosis of acid base disorders. Base Excess Physicochemical (Stewart) The Base Excess is routinely reported with blood gas
What is rhabdomyolysis? Rhabdomyolysis is a condition where there is muscle necrosis with release of intracellular muscle contents into the systemic circulation. Most notably: CK (creatine kinase): detected in blood Myoglobin: detected in urine Others AST/ALT If severe: Potassium, Phosphorus, Urate, Lactic acid In rhabdomyolysis the CK is markedly elevated. When is the
