Concept Map: Monoclonal Gammopathy of Renal Significance (MGRS)

http://www.nephronpower.com/2013/04/concept-map-monoclonal-gammopathy-of.html#comment-form

Complement and the kidney: What the nephrologist needs to know in 2006?

http://ndt.oxfordjournals.org/content/20/12/2613.full.pdf+html

Hypomagnesemia due to proton pump inhibitor

Last week I saw a patient on the consult service with severe hypomagesemia (Mg 0.6). Not on any diuretics, no diarrhea... but chronically on pantoprazole. 

I found this editorial in this month's KI, which gives a good review of Mg handling and the proposed mechanism of the PPI effect.  Some "pearls" from this editorial regarding PPIs and the kidneys:

• Renal issues with PPIs include allergic interstitial nephritis, interference with calcinurin inhibitor metabolism, hyponatermia (rare), and most recently, hypomagnesemia
• The mechanism of hypomagnesemia appears to be inhibition of active Mg absorption by the gut, likely due to increased gut luminal pH.
• Risk factors for hypomagnesemia due to PPIs include advanced age, longstanding PPI use (years), and concomitant diuretic use
• Treatment = discontinuation of the PPI, or if this is not advisable, oral magnesium replacement and discontinuation of any diuretics (to minimize renal Mg wasting).

The Treatment of Minimal Change Disease in Adults

Nice review

http://jasn.asnjournals.org/content/early/2013/02/20/ASN.2012070734.long

Measured GFR as a Confirmatory Test for Estimated GFR

Nice review by tufts

http://jasn.asnjournals.org/content/20/11/2305.full.pdf

'Tamponade' following cardiac surgery: terminology and echocardiography may both mislead.

http://www.ncbi.nlm.nih.gov/pubmed/15541977?dopt=Abstract

Mitigation of calcium channel blockerrelated oedema in hypertension by antagonists of the renin–angiotensin system

http://www.isdbweb.org/documents/file/1664_2.pdf