Nephrology

The pathophysiology, diagnosis, and management of proteinuria

Danielle Kruger, RPA-C, MS Ed April 02, 2012

Routine testing has led to more frequent identification of proteinuria, and PAs need an  approach that will distinguish benign forms from disease requiring treatment.

Urinary tract infection: Consistent therapy to  reduce resistance

Roy A. Borchardt, PA-C, PhD, Kenneth V. I. Rolston, MD March 13, 2012

A recent update to the clinical practice guidelines for the treatment of UTI hopes to establish a long overdue consensus regarding optimal approaches to this common infection.

Renal artery stenosis: A correctable cause of resistant hypertension

Stephenie Dupler, BS, Paul M. Zack, MD; Abdulfatah Osman, MD March 12, 2012

A patient whose blood pressure had previously been well-controlled on a beta-blocker  and an ACE inhibitor experiences rising BP levels and dyspnea on exertion.

C-reactive protein: A clinically useful biomarker in renal cell carcinoma

Timothy V. Johnson, MD, Jennifer DeLong, PA; Viraj A. Master, MD, PhD January 16, 2012

Biochemical markers of inflammation, specifically CRP, serve as adjuncts to TNM staging  to help identify patients at increased risk for recurrence of kidney cancer.

Hepatorenal syndrome: Progressive renal failure in patients with cirrhosis

Matthew Dameron, MPAS, PA-C November 03, 2011

Prompt detection and treatment of this poorly recognized condition can be lifesaving, but the diagnosis can be made only after other forms of renal failure have been ruled out.

Can an ACE inhibitor reduce the risk of  developing progressive renal disease?

Lauren Jewett, MMS, PA-C, Mark E. Archambault, DHSc, PA-C September 15, 2011

Using CCBs to treat hypertension in African Americans based on the perception that they have increased efficacy may do little to prevent ESRD.

Hyperphosphatemia: Understanding the role of phosphate metabolism

Daniel Podd, MPAS, PA-C July 07, 2010

An elevated phosphate level is an indicator of serious disease. Diagnosis is based on which other test results are abnormal.

Community-acquired pneumonia (CAP) in adults

William C. Kohlhepp, DHSc, PA-C May 14, 2010

The cause of this common infectious disease may not be identified. However, PAs should be able to initiate effective treatment promptly.

Acute respiratory illness leads to  the discovery of renal disease

Tamara Moutsatson, DO; Ahmad Hakemi, MD; Keir Todd, MEd, PA-C; Manjit Grewal, MD; John Lopes, MS, DHSc, PA-C May 13, 2010

The patient presented with a sore throat, runny nose, and a cough. When his condition worsened despite treatment, further workup revealed chronic nephropathy.

Polycystic kidney disease (PKD) and nephrotic syndrome

Zachary Hartsell, MPAS, PA-C March 19, 2010

The clinical features, assessment of, diagnosis, and treatment of PKD and nephrotic syndrome are outlined in a quick review format.

A review of giant cell arteritis and chronic renal disease

Amy M. Klingler, MS, PA-C January 29, 2010

Clinical features, diagnosis, and treatment for an inflammatory disease of the blood vessels in the head and kidney disease are discussed.

Stone-induced ruptured calyx in a patient with a horseshoe kidney

Capt Donald Adams, MPAS, APA-C; Col Michael W. Restey, MD, USAF (Ret), MC; Kevin Dwyer, MD; Maj Elena Schlenker, MSHS, CPRN, USAF, NC August 31, 2009

A soldier in Afghanistan reports bloody urine, dysuria, and diffuse abdominal pain, leading to discovery of a congenital anomaly.

What caused this UTI in a 3-year-old girl?

Julie Vajnar, PA-C, RT August 01, 2007

The patient is a 3-year-old girl whose mother was worried because the child was eating poorly and seemed irritable. The mother also noticed strong-smelling urine in the diaper over the past few days. A urine sample demonstrated positive leukocyte esterase and nitrites compatible with a urinary tract infection (UTI).

Recognizing the elusive signs and symptoms of PSGN

Natalie Benudiz, MPT, MPAP, PA-C June 01, 2007

In children, poststreptococcal glomerulonephritis usually resolves spontaneously. In adults, however, it is a serious condition and in most cases has a poor prognosis.

Improving outcomes in renal disease

Ray Galley, PA-C, MPH September 01, 2006

CKD often progresses to ESRD despite clinicians' and patients' best efforts. But its progression can be delayed, enabling patients to postpone renal replacement therapy and kidney transplantation.

Specialty Update - May 2006

May 01, 2006

PAs in cardiology; Association of Physician Assistants in Cardiology (APAC); The role of PAs in nephrology; American Association of Nephrology Physician Assistants (AANPA)