How do calcium channel blockers cause edema, and why it is worse in summer? 1/17How do calcium channel blocks (e.g., amlodipine) cause edema? I've known since medical school that amlodipine can cause edema, but I’ve never taken the time to examine the mechanism. The explanation is cool and has implications as the summer heat approaches……
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One-stop shop to catch up on advances in lupus nephritis treatment
Managing patients with lupus nephritis tests the best amongst us – starting from diagnosis, assessing disease severity, deciding treatment, dealing with toxicities, monitoring response, and worrying about when to stop the treatment! A wide-ranging review article in this month’s Kidney International covers these issues and should be required reading for those interested in the topic….
Benefits of simple intervention – Long-term improvement in survival rates with the use of mosquito nets early in life in a high malaria endemicity region.
We are all familiar with the devastating impact of endemic malaria. About 4-6 lakh people die of this killer disease every year around the world, the largest number in sub-Saharan Africa. Children are the most vulnerable of all population groups. For the last almost 30 years, a very simple solution – the use of insecticide-treated…
Timely referral to nephrology services – how to best identify the eligible population?
The role of timely referral to nephrologists in optimising the care of patients with chronic kidney disease often comes up in discussion. However, what is a ‘timely’ referral has been a matter of contention. Guidance has been provided by a number of organisations. There is unanimity that everyone with eGFR < 30 ml/minute/1.73m2 and those…
A simplified formula to calculate PD peritonitis rates
Peritonitis is the bugbear in PD treatment, as its most important therapy-related complication. Although it accounts for just about 5% of all deaths on PD, the fear of it dissuades many patients from getting on this potentially more patient-friendly form of dialysis. Given the critical nature of this event, monitoring PD peritonitis rates has been…
Something new on the diagnosis and treatment of membranous nephropathy
Bobart SA, Han H, Tehranian S, De Vriese AS, Roman JCL, Sethi S, Zand L, Andrades Gomez C, Giesen CD, Soler MJ, Bomback AS, Fervenza FC. Noninvasive Diagnosis of PLA2R-Associated Membranous Nephropathy: A Validation Study. Clin J Am Soc Nephrol. 2021 Nov 15:CJN.05480421. doi: 10.2215/CJN.05480421. Of all the primary glomerular diseases, membranous nephropathy has seen…
JAMA: COVID-19 Therapeutics for Non-hospitalized Patients
This JAMA Viewpoint paper provides a summary of currently available therapeutics for nonhospitalized patients with COVID-19 in the setting of the Omicron variant including principles for equitable allocation. An operative paragraph How Do Outpatient Therapies Compare? Each of the new therapies has potential advantages and disadvantages (eTable 1 in the Supplement). For most individuals, nirmatrelvir-ritonavir will…
More (or less) on which COVID vaccines do what
As the world scientific community plays catch up with COVID-19, which vaccines offer better protection had been a matter of constant debate. As the new variants keep cropping up, the conversation takes new turns.
Platform Trials : A new and more efficient way of evaluating emerging treatments
Almost all of the currently used treatment modalities for COVID-19 have emerged out of a relatively new way of evaluating treatment modalities, though what are called Platform trials (RECOVERY, SOLIDARITY, REMAP-COVID, PRINCIPLE, to name a few).
Fluoroquinolone use can increase the risk of sudden cardiac death amongst patients on maintenance hemodialysis
A recent JAMA Cardiology paper examined the association between the use of quinolones commonly used for the treatment of respiratory infections (levofloxacin and moxifloxacin) and sudden cardiac death (SCD) over the next 5 days and compared this with the risk associated with the use of amoxicillin-based (amoxicillin or amoxicillin with clavulanic acid) treatment in 264 968…