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The authors proffer their response to the question previously posed by Joanne Bargman inNature Clinical Practice Nephrology: “Why are rheumatologists treating lupus nephritis?” They argue that rheumatologists are often the first point of call for patients presenting with systemic lupus erythematosus, and that they are also more adept than nephrologists at assessing certain extrarenal manifestations of the disease. Thus, the rheumatologist is ideally placed to design and monitor treatment, with the aid of a nephrologist.
Tuberculosis is a serious opportunistic infection in renal transplant recipients. Post-transplantation tuberculosis most commonly occurs within the first few years of receipt of a renal allograft, but Ram et al. present the case of a 27-year-old male who presented with isolated skin ulcers caused by Mycobacterium tuberculosis 12 years after kidney transplantation. They review the literature on post-transplantation tuberculosis and discuss treatment options.
There are several renal syndromes that are unique to patients with cancer, being caused either by the cancer itself or by its treatment. This Review provides nephrologists—who are essential members of the multidisciplinary team that cares for patients with malignancy—with an overview of these syndromes. The article is divided into sections that deal with the renal impact of different cancer types, interventions, and commonly used chemotherapeutic and biological agents.
Until recently gadolinium chelates were thought to be safe when used as contrast agents for MRI. These compounds are now known to be associated with artifactual results of laboratory tests, acute kidney injury and nephrogenic systemic fibrosis, complications that seem to exclusively affect people with impaired renal function. Penfield and Reilly provide the information that physicians need to determine the relative risks and benefits of administering gadolinium to patients with chronic kidney disease.