Some Nephrolog

Randomized controlled studies consistently demonstrate that normalizing the Hb level
of patients with CKD with ESAs is associated with poorer outcomes than a Hb target in
the 9.0 to 11.5 g/dL range.

The characteristic lipid profile of patients with chronic kidney disease consists of high
triglycerides and low high-density lipoprotein (HDL) cholesterol concentrations,
whereas total and low-density lipoprotein (LDL) cholesterol are normal or even low.

Membranous nephropathy occurs as an idiopathic (75% of cases) or secondary disease
(autoimmune diseases, infection, and malignancies), where up to 70% of patients will
have nephrotic syndrome at the time of presentation. It is a chronic disease, with spontaneous
remission and relapses clearly documented.

 Current data suggest that new therapeutic agents such as rituximab and synthetic
adrenocorticotropic hormone (ACTH) are effective in reducing proteinuria while having
few adverse effects.

. MN can recur after kidney transplantation in approximately 42% of patients, causing
proteinuria, allograft dysfunction, and graft failure. Recurrence most often occurs during
the first year.

 Immunoglobulin A (IgA) nephropathy is the most common biopsy-proven primary
glomerulonephritis in the world.

 The classical presentation is painless gross hematuria 2 to 3 days after an upper respiratory
infection.

Hyponatremia

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Nephrolog

*Use of loop diuretics should be limited to the management of patients with volume
overload and not for AKI or oliguria per se.

* It is not necessary to wait until severe uremia develops to initiate dialytic support; renal
replacement therapy should be used as a supportive therapy in the presence of progressive
azotemia and oliguria, rather than a rescue therapy for late manifestation of AKI.

*It is well established that individuals with CKD have a 10- to 20-fold increased risk for
cardiac death compared to age-matched and gender-matched controls without CKD.

*The weight loss drug orlistat rarely may cause acute kidney injury and nephrolithiasis
because its use may lead to intestinal malabsorption and enteric hyperoxaluria.

*. The antiseizure and migraine drug topiramate is a carbonic anhydrase inhibitor that is
associated with proximal renal tubular acidosis and calcium phosphate stone formation.

*The natural history of the primary nephrotic syndrome depends on the underlying cause.
Thus, patients with minimal change nephrotic syndrome (MCNS) have an excellent
long-term prognosis, in contrast to those with primary focal segmental glomerulosclerosis
(FSGS), in whom nearly 50% will progress to end-stage renal disease (ESRD) over 5 to
10 years of follow-up, and 25% to 30% of these patients may experience recurrent
disease in a kidney transplant.