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Thrombotic Microangiopathies

Thrombotic microangiopathies (or TMA for the cool kids or the occasional phonetically-challenged fellows like myself) have always been a little tricky so I decided to do a quick review today to help clear things up a bit. First I’ll start with some questions and try to jump into the meat of things. Question 1 A…
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FDA Tells 23AndMe to Halt Marketing

  The Mountain View based 23AndMe, a personal genome service (PGS) that offers genome sequencing was ordered to stop marketing its service. The FDA report stated that 23AndMe did not demonstrate that they had “analytically or clinically validated the PGS for its intended uses” and the “FDA is concerned about the public health consequences of…
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Nephrology Board Review – Membranous Nephropathy

1.) How many histologic stages of Membranous Nephropathy are there? A. 2 B. 3 C. 4 D. 5   2.) The stages correlate with the clinical manifestations of MN. A. True B. False   3.) Which of the following are podocyte antigens? A. suPAR B. Neutral endopeptidase (NEP) C. Paxillin D. Phospholipase A1 Receptor (PLA2R)…
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Factors Associated with Worse Renal Survival in Membranous Nephropathy

At the moment we don’t have clinically available serologic markers of disease activity for membranous nephropathy (PLA2R is in the pipeline) so we have to rely on clinical factors to predict prognosis. Above is a chart that lists the factors associated with Progression and strength of the associated (PPV). Source: Comprehensive Clinical Nephrology, 4th Edition.

CKD and Dietary Recommendations

Typical Dietary Recommendations for Chronic Kidney Disease Patients Protein: 0.6-0.8 g/kg/day Sodium: <2 g/day (<6 g/day of salt) Potassium: 40-70 mEq/day Phosphate: 600-800 mg/day Calcium: 1400-1600 mg/day (not to exceed 2000 mg/day) Free water (in excess of urine output): 1-1.5 L/day Here is a great chart of dietary recommendations by the Cleveland Clinic’s Disease Management…
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PTH Targets

  Here is a quick PTH reference I made. Remember than PTH is standardized at all labs and that the overall trend is more important.

Dietary Restrictions for Patients With Nephrotic Syndrome

“What should I eat?” And “Should I avoid protein since I’m losing it in my urine?” These are questions that I often hear my patients with nephrotic syndrome ask. So today I decided to do a quick review to answer those questions in the clinic and on the wards. Sodium Sodium restriction has been shown…
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A Hepatorenal Syndrome Review

Here is great presentation on HRS by former fellow Damadar Kumbala.  

Differential Diagonosis of Day (3D) – Glomerular Causes of Hematuria

Today is a quick review of glomerular causes of hematuria without proteinuria, renal insufficiency, or RBC cast. IgA Nephropathy Thin Basement Membrane Nephropathy Hereditary Nephritis (Alport’s) Histologically normal glomeruli Nonetheless, the role of renal biopsy in the evaluation of asymptomatic hematuria in patients without proteinuria, hypertension, or kidney insufficiency is unclear. But it appears that…
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