Immunohistochemistry in Kidney Disease: A Cautionary Tale

Larsen et al

In 2013, the New England Journal of Medicine published a widely discussed article by Yu et al that observed podocyte B7-1 (CD80) immunostaining in one patient with primary focal segmental glomerulosclerosis, and 4 patients with recurrent focal segmental glomerulosclerosis after kidney transplantation.  This staining was interpreted as disease-related B7-1 induction and treated with abatacept, a CTLA4-immunoglobulin fusion protein that targets B7-1 and […]

Brain Atrophy in Peritoneal Dialysis Patients


Patients with ESRD treated with hemodialysis (HD) have previously been described to have progressive brain atrophy. Whether this is due to kidney disease or unique features of HD (intradialytic hypotension, exposure of blood to an artificial membrane, etc.) is unknown. In an article recently published in AJKD, Tsuruya et al report their study of Japanese […]

Conservative Care – A Conversation To Be Had


“I can’t remember [staff] ever suggesting or saying that there is a third option – of not having dialysis.” (Man on dialysis, aged 82 years) This quotation is from a recent article published in AJKD by Tonkin-Crine et al, who conducted semi-structured interviews with patients over 75 years old to explore their perspectives on choosing […]

Dialysis, Cognition, and Mortality


Dialysis patients face a multitude of metabolic challenges, including metabolic bone disease, volume overload, and electrolyte abnormalities. However, cognitive impairment may be an independent predictor of death, and presents several opportunities for doctors to affect care in ESRD and CKD patients. In the a recent article published in AJKD, Drew et al performed a longitudinal […]

Managing Nephrology Outpatient Clinic as an Entrustable Professional Activity

Yuan et al Table S1

Recently, medicine educators have shifted their approach to training fellows in order to identify when trainees are “ready for unsupervised practice” in the six core competencies: medical knowledge, patient care, interpersonal communication skills, professionalism, practice-based learning and improvement, and systems-based practice. With the development of milestones, the ACGME has provided lengthy definitions and examples of […]

Atenolol Versus Metoprolol Tartrate and Kidney Function in Older Patients: Which One to Choose?


Physiologic disturbances associated impaired elimination of drugs and their metabolites is common in older patients with chronic kidney disease. In a recent article published in AJKD, Fleet et al performed a population-based matched retrospective observational investigation in 75,257 older patients (mean age, 75 years) recently initiated oral atenolol or metoprolol tartrate. The study examined 90-day […]

Summary of #NephJC 12 Tweet Chat: Should Patients With Abdominal Pain and Suspected Kidney Stones Have an Initial US or CT?

NephMadness top influencers

This comparative effectiveness research article attracted a lot of attention, and has been covered in by the #UroJC crew (who run an extremely successful, asynchronous, discussion over 48 hours) in addition to the #NephJC team. A Storify of the #UroJC discussion was created by Dr. Joel Topf @kidney_boy and is available here. In addition, this […]

Crossword: Acid-Base Basics

acid-base-basics crossword

Given the acid-base theme this month in AJKD, this is an acid-base crossword on basic physiology. Fill the crossword out online at (there is a link for instructions at the top right). If you prefer to print the crossword, please click here for a PDF version. Click here for the Answer Key   Post […]

NephJC: CT Scan or Ultrasound for the Diagnosis of Suspected Kidney Stones

The next installment of the online twitter journal club for nephrology (#NephJC) is the recently reported paper in NEJM by Smith-Blindman et al that examines how to image patients in the ED with suspected kidney stones. This article is also being discussed by the urology online twitter journal club (#UroJC). Go to for a quick tutorial […]

Palliative Care Nephrology: A Call for Action in Fellowship Training

Palliative care (PC) training and experience of US adult nephrology fellows was not known. It was also not clear whether nephrology fellows in the US undergo formal training in PC medicine during fellowship. End-of-life care for the CKD and ESRD patients is an uncomfortable topic for many nephrologists and nephrology fellows, and a 2003 survey published in AJKD highlighted the […]


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