Challenges encountered to creating a renal biopsy program at a tertiary care academic institution in the United States.

Biopsy is the gold standard for diagnosing renal pathology and the procedure is required to be learned per ACGME guidelines for Nephrology Fellowship graduation. We describe the process for the planning and development of a new Nephrologist directed native renal biopsy program to increase the opportunity to train Nephrology fellows in this procedure. The article outlines the barriers, complications and lessons learned to developing the program, highlighting the key challenges and progress that has been made within a single American tertiary academic medical center.

A basic solution for a complex problem: does treatment of metabolic acidosis slow CKD progression?

Purpose Of This Review: Metabolic acidosis is frequently encountered in patients with chronic kidney disease (CKD), with increasing prevalence as kidney function worsens. Treating electrolyte disturbances is the sine qua non of Nephrologists, and alkali therapy to normalize serum bicarbonate levels and slow progression of kidney disease has been embedded in clinical practice guidelines for decades on the basis of animal models and controversial clinical trials. This review will critically appraise the literature base for this recommendation and determine whether the available evidence supports this common practice, which is a timely endeavor considering the impending demotion of metabolic acidosis treatment from recommendation to practice point in forthcoming KDIGO guidelines.

Treatment of hypokalemia with amiloride unmasked hypercalcemia and hyperparathyroidism: A case report.

Colonic pseudo-obstruction, also called Ogilvie's syndrome, occurs due to impaired intestinal propulsion, and may be caused by electrolyte imbalances such as hypokalemia and some endocrine disorders such as hyperparathyroidism. Secretory diarrhea due to intestinal pseudo-obstruction can cause hypokalemia. Diuretics such as amiloride can be used to treat hypokalemia, however in this case, treatment with amiloride induced hypercalcemia and unmasked hyperparathyroidism.

Implications of climate change on acute kidney injury.

Purpose Of Review: Climate change is an active and growing threat to human health. This review examines the evidence linking climate change to kidney diseases, with a focus on acute kidney injury (AKI).

Recent Findings: A growing body of evidence documents the adverse impact of various environmental and occupational exposures on kidney health.