Nephrologist

A journey through veins: discovery to modern therapy

Vascular access is the cornerstone of successful hemodialysis, serving as the lifeline for millions of patients with end-stage kidney disease. Since the inception of maintenance dialysis in the 1960s, the development of reliable vascular access has undergone significant evolution, reflecting advancements in medical technology, surgical techniques, and an improved understanding of access-related complications. This review traces the historical progression of vascular access, beginning with the pioneering Scribner shunt, followed by the emergence of arteriovenous fistulas, arteriovenous grafts, and central venous catheters....

A journey through veins: discovery to modern therapy Vascular access is the cornerstone of successful hemodialysis, serving as the lifeline for millions of patients with end-stage kidney disease. Since the inception of maintenance dialysis in the 19…

Normal Glomerulus The glomerulus is composed of a glomerular tuft that lies within Bowman’s capsule. Bowman’s capsule is lined by parietal epithelial cells, which are flat endothelial-appearing epithelial cells. The glomerular tuft is composed of the central branchingmesangial matrix that contains mesangial cells, invested by capillaries lined by endothelial cells and covered by epithelial cells or podocytes.These cell types are most easy to identify at the periphery of the glomerulus…...

Renal Pathology Normal Glomerulus The glomerulus is composed of a glomerular tuft that lies within Bowman’s capsule. Bowman’s capsule is lined by parietal epithelial cells, which are flat endothelial-appearing epi…

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Bleeding from AV Fistula post-HD? Don’t panic—act smart!A quick guide to assess & manage persistent bleeding. 🩸🔄 Skin? ✔️ Antiplatelets?✔️ Anticoags? ✔️ Venous pressure? For a full pdf, write on drswalay.com

Abstract: The Human Leukocyte Antigen (HLA) system forms the central part of the immune system and is crucial in the recognition and elimination of “non-self” antigens. While this role of the HLA system is essential in the effective defense of the organism against pathogens, it is undesirable in organ and tissue transplantation because it enables the recognition of mismatched HLA molecules of the donor as being foreign and stimulates the graft rejection reaction....

Development of the Crossmatch Test in Kidney Transplantation Uptothe Virtual Level Abstract: The Human Leukocyte Antigen (HLA) system forms the central part of the immune system and is crucial in the recognition and elimination of “non-self” antigens. While this role of the HLA s…

An arteriovenous fistula or graft is essential for hemodialysis (HD). It involves connecting a high-resistance artery to a low-resistance vein, which increases cardiac output (CO). In the early days of HD, patients with end-stage kidney disease (ESKD) were typically younger, and their HD access was located in the distal forearm. However, in the modern era, ESKD patients are often the elderly, with many being the very elderly (over 80 years old)....

Management of high-flow arteriovenous access An arteriovenous fistula or graft is essential for hemodialysis (HD). It involves connecting a high-resistance artery to a low-resistance vein, which increases cardiac output (CO). In the early day…

Anatomy of Parathyroid Glands The parathyroid glands develop from endodermal epithelial cells, in conjunction with the thymus. The superior parathyroid glands are derived from the fourth branchial pouch. These glands are closely associated with the lateral lobes of the thyroid and have a short line of embryologic descent [1]. The inferior parathyroid glands are derived from the third branchial pouch. These glands are closely associated with the thymus and have a longer line of embryologic descent, which leads to more variability in their anatomic position [1]....

Parathyroid Glands in Chronic Kidney Disease Anatomy of Parathyroid Glands The parathyroid glands develop from endodermal epithelial cells, in conjunction with the thymus. The superior parathyroid glands are derived from the fourth branchial …