nephrology

A Brief History of the Renin-Angiotensin System

December 29, 2018

If you’re here for the music you still might give this piece a glance. It’s on a subject of immense clinical importance that I’ve tried to present in a fashion accessible to layman while still having some content that might interest physicians. Some of the greatest work in medical pathophysiology has contributed to our current […]

Salt Intake in Chronic Kidney Diease

January 24, 2017

How much salt people should eat continues to be a murky issue. A paper in the February 2017 issue of the American Journal of Kidney Diseases examines the issue of salt (actually sodium) intake on the prevention of cardiovascular disease in patients with chronic kidney diseases (CKD) stages 2-4. It is a commentary on an […]

When to Start Dialysis in Patients with Acute Kidney Injury

May 22, 2016

When to start renal replacement therapy in patients with AKI has been a serious and incompletely answered question for as long as dialysis has been available to treat it. The seriousness of this disorder derives from its frequency, associated mortality, and cost. The JAMA contains a new study, Effect of Early vs Delayed Initiation of Renal […]

End Stage Kidney Disease: Costs and Treatment

March 16, 2016

About 1 million people in the US have End Stage Renal Disease (ESRD). Treatment is divided roughly 70/30 between dialysis and kidney transplantation. The annual cost of the ESRD program, almost all of which is funded by Medicare, is more than $48 billion. It costs about $89,000 a year to care for a dialysis patient. The […]

Kidney Disease and the Elderly

September 20, 2015

I hate to write this, but it appears that the New York Times may be more up to speed than your primary care doctor or even your nephrologist when it comes to kidney disease in the elderly. For Older Adults, Questioning a Diagnosis of Chronic Kidney Disease accurately describes a problem which has not received the […]

Acute Renal Failure

November 8, 2014

The PowerPoint slides of a talk given by me to the Fall Medical/Surgical Conference of the Lubbock-Crosby-Garza County Medical Society are below . The file can be downloaded by clicking on the link. It is a general review of the various forms of Acute Renal Failure also known as Acute Kidney Injury. Acute Renal […]

Hemodialysis Update

November 26, 2010

Two new articles discuss important aspects of hemodialysis in the US. One is in the lay press, the other in the New England Journal. The lay article, in the Atlantic Magazine, is an exercise in yellow journalism. If you or someone in your family needs dialysis it will scare you to death – perhaps literally. […]

Acute Kidney Injury and Clinical Outcomes

May 10, 2009

A paper in the Mayo Clinic Proceedings, Acute Kidney Injury Predicts Outcomes of Non–Critically Ill Patients, examines the effect of Acute Kidney Injury (AKI) on the clinical out comes almost 6000 patients at a community teaching hospital affiliated with Yale. AKI was deined as an increase in serum creatinine of at least 0.3mg/dL over 48 […]

Bicarbonate Therapy in Severe Metabolic Acidosis

March 9, 2008

This is a PowerPoint presentation of a talk given at the annual meeting of the Southern Society for Clinical Investigation – February 23, 2008. It can be used for any noncommercial purpose as long as the original source is acknowledged. Also listed below is a pdf file of a paper on the same subject that […]

Nephrogenic Systemic Fibrosis

February 28, 2008

As if the world weren’t dangerous enough new diseases keeping popping up like, well new diseases. Over the past few years, nephrologists have recognized a new skin disease that was previously called nephrogenic fibrosing dermopathy, but which has been rechristened Nephrogenic Systemic Fibrosis. The current issue of the NEJM describes another patient with this disorder. […]