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Abstract

Clinical Nephrology – Case Studies, Vol. 7/2019 (51-53)

Case report: Patiromer-induced hypercalcemia

Michael R. Wiederkehr, Ankit N. Mehta, and Michael Emmett

Texas A&M Health Science Center, College of Medicine, Baylor University Medical Center at Dallas, Division of Nephrology, Department of Internal Medicine, Dallas, TX, USA
Patiromer is a novel potassium-binding compound which has recently received FDA approval. This ion exchange resin releases calcium when it binds potassium. We describe the development of hypercalcemia after initiation of patiromer. The calcium levels fell when the drug was stopped but recurred when it was later resumed. Patiromer was again discontinued, and the serum calcium level fell back into the normal range. We believe this patient manifested patiromer-induced hypercalcemia.Correspondence to:
Michael R. Wiederkehr, MD, FACP, FASN, Baylor University Medical Center, 3500 Gaston Avenue, Dallas, TX 75246, USA
Email: [email protected]

Abstract

Clinical Nephrology – Case Studies, Vol. 8/2020 (85-90)

A young man with recurrent kidney stones and renal failure

Jasmeet Gill¹ and Michael R. Wiederkehr¹,²

¹Baylor University Medical Center, Division of Nephrology, Department of Internal Medicine, and ²Texas A&M Health Science Center College of Medicine, Dallas Campus, Dallas, TX, USA
Dent disease is an inherited proximal renal tubulopathy leading to low molecular weight proteinuria, hypercalciuria with nephrocalcinosis and nephrolithiasis, and progressive renal failure. Two genetic mutations have been identified. The disease usually presents in childhood or early adult life and may be associated with other proximal tubular defects, which can lead to significant morbidity, especially in children. The disorder can extend to interstitial and glomerular cells, which contributes to progression to end-stage kidney disease. The pathophysiologic process remains incompletely understood, and no specific treatment is available. Dent disease is likely under-recognized. It needs to be included in the differential, especially in young males, presenting with recurrent kidney stones, proteinuria, and impaired renal function.Correspondence to:
Jasmeet Gill, MD, Baylor University Medical Center, Department of Internal Medicine, Nephrology Fellowship, 3500 Gaston Avenue, Dallas, TX 75246, USA
Email: [email protected]

Abstract

Clinical Nephrology, Vol. 97 – No. 3/2022 (141-149)

Association of the COVID-19 pandemic with increased adherence among prevalent hemodialysis patients 

Jasmeet Gill¹, Stevan A. Gonzalez³, Michael R. Wiederkehr¹#², Catalina Hanson², Bernard V. Fischbach², Harold M. Szerlip¹#², and Richard C. Fuquay²

¹Baylor University Medical Center, Division of Nephrology, Department of Internal Medicine, ²Dallas Nephrology Associates, Dallas, Texas, and ³Baylor Simmons Transplant Institute, Fort Worth, TX, USA
Background: During the COVID-19 pandemic, there has been a reduction in emergency department visits and hospital admissions. We hypothesized that hemodialysis patients were decreasing their hospital visits and increasing their dialysis adherence during the COVID-19 pandemic.
Material and methods: This is a retrospective analysis of hemodialysis patients treated in the seven American Renal Associates (ARA) dialysis centers in the Dallas-Fort Worth metropolitan area. We conducted a “before-and-after” study using existing clinical data to examine patient adherence with hemodialysis between January 1 and March 14, 2020 (pre-COVID) and March 15 to May 18, 2020 (COVID) time periods. Data points included missed treatments, shortened treatments, post-dialysis weight, and hospital visits. Finally, we conducted an anonymous survey in which patients reported their hemodialysis adherence.
Results: Data analysis was performed on 556 patients. Significantly fewer patients missed a single treatment in the COVID vs. pre-COVID time periods (44.1 vs. 58.6%; p < 0.001). Significantly fewer patients finished their treatment with a post-dialysis weight more than 1 kg above their estimated dry weight in the COVID vs. pre-COVID time periods (31.7 vs. 38.9%, p = 0.01). Finally, there was a reduction in total hospital visits during the COVID vs. pre-COVID periods (12.6 vs. 19.4%; p = 0.002). The anonymous survey showed patients reporting increased adherence with hemodialysis and restriction of salt and water intake.
Conclusion: The COVID time period was associated with increased adherence with hemodialysis and decreased hospital visits, and patients were conscious of these changes.Correspondence to:
Harold M. Szerlip, MD , Director
Nephrology Training Program
Baylor University Medical Center
411 N Washington Ave #7000
Dallas, TX 75246, USA
Email: [email protected]

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