Monday, June 18, 2018

Concept Map: Secondary IgA Nephropathy



A recent article in Kidney International discusses a forgotten concept in Nephrology, secondary causes of a particularly common GN- IgA nephropathy. While these disorders are associated with IgA nephroapthy, keep in mind this is by far the most common GN in the world- so might be true true and unrelated as well.

Wednesday, June 6, 2018

Monday, June 4, 2018

NephroWorldCup: Football and Nephrology: GOOAAALLLLLLL!!!

Image result for nephro world cupEvery four years the competitive world of sport comes to a stop. Millions of friends and family gather around the television in order to watch their most beloved nations compete in the largest sporting event on Earth: The FIFA World Cup.

From a team of international nephrologists, here comes a game to play along as you watch FIFA world cup for soccer(football). 

More often that in the World Cup, nephrologist and other professional around the world gather in meetings, congresses, symposia, etc. The objective is to learn about the latest research and meet the brightest minds in our medical field.  As in football, controversies arise, people choose sides, they root for their chosen trial, and they engage in small methodological skirmishes with the “referees” (the moderators at round tables).

Overall, both activities (football and nephrology) develop  camaraderie, foster learning, and generate personal fulfillment. 

Nephrology has grown its presence on social media and we decided to bring a new educational initiative into the world of nephrology social media. The ISN education team is very happy to announce that the combination football (soccer) and nephrology, and the creation of The Nephrology World Cup 2018.

Thirty-two (32) countries selected from the same roster as the 2018 FIFA World Cup will face off against each other in a first-of-its-kind educational experiment. The Nephrology World Cup Organizing Committee has selected a nephrology research paper published by a team of professionals from each country, especially if this paper was published by the local nephrology society. The selection criteria allows us to showcase some of the amazing scholarship and research that is being done around the world.  The ISN team has added user interactivity to make the Nephro World Cup both educational and fun.  

The friends from @ISNeducation bring you this educational initiative.  Feel free to root for your country and cultivate conversations amongst your colleagues and friends. The work has been done using open source tools and the game is free to play.

For rules and how to win prizes, see below for manual.

If you want to know more about this (rules, prizes, etc.) please follow any one these links:
Instruction Manual: https://goo.gl/Cx5Cun
Registration and Group Play:  https://goo.gl/rHj9e9
Facebook Conversations:  https://goo.gl/1LYEzT

Play the 2018 Inaugural Nephrology World Cup!  Good luck and may the best nation win!

Monday, May 7, 2018

Topic Discussion: Intravenous Fluids and the Kidney


Specific fluid
Fluid Type
Effect on the kidney
Evidence
Lactate Ringers
Crystalloid

None
SMART  and SALT-ED trial, NEJM 2018 and SPLIT trial JAMA 2015

0.9% Saline
Crystalloid

? more metabolic acidosis, ?AKI
SMART and SALT-ED trial, NEJM 2018 and SPLIT trial JAMA 2015

Albumin
Colloid
None to our knowledge

Hydroxyethyl starch

Colloid
Bad, AKI, osmotic nephrosis leading to more RRT


Pentastarch( low molecular weight Hydroxyethyl starch)

Colloid
Bad, AKI, osmotic nephrosis leading to more RRT

Dextrand

Colloid
Bad, AKI, osmotic nephrosis

PlasmaLyte

Crystalloid
None



Tuesday, April 24, 2018

Topic Discussion: Renal Cell Cancer for the Nephrologist

An amazing review just published in Kidney International is a must read for all nephrologists. It takes us from an oncology and urology world and how the world of RCC ties into the renal hands.

The first part of the review focuses on the genetics and molecular aspects of RCC
In the risk factor section, besides genetics, it is important to remember some of the other non genetic risk factors such as Chronic end-stage renal disease on dialysis, Obesity,Smoking,Hypertension
Exposure to dry cleaning solvents,Exposure to trichloroethylene,Diuretics( this is interesting), Radiation therapy,Phenacetin,Arsenic,Cadmium,Sickle cell trait and disease,Nephrolithiasis
Chronic hepatitis C infection( another interesting point).

A bidirectional link is discussed with CKD and RCC that is very important to remember


The best part of the paper is how one approaches a patient with RCC and potential for AKI or CKD post.


Unfortunately, the treatment options for RCC post nephrectomy are potentially also nephrotoxic-- anti VEGF agents, TKIs, and now check point inhibitors. 

http://www.kidney-international.org/article/S0085-2538(18)30139-X/fulltext

A must read for all!

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