Nephrology Merit Badges, an update

Nephrology Merit Badges, an update

Six months ago I proposed nephrology merit badges: One of the common resident complaints regarding nephrology is that it’s too hard. The nephrologist response to this complaint  is usually to deny the difficulty, because its not hard for the ...

Tolvaptan, a cost benefit analysis

Tolvaptan, a cost benefit analysis

I have a patient who is enrolled in the ongoing TEMPO 4:4 trial. This is another randomized placebo controlled trial of tolvaptan similar to the ground breaking Tempo 3:4 released at Kidney Week 2012. The principle differences seem to be, enrolling people ...

200 calories on a plate

Each one of these pictures is a plate with 200 calories. Interesting to see the amazing diversity in caloric density. ...

Cool Wikipedia page of the day: Epidemiological transition

Cool Wikipedia page of the day: Epidemiological transition

Came across this page as I was putting the finishing touches on an editorial on KDIGO. Apparently, epidemiological transition is a way to understand population dynamics and how they change with increasing medical and societal advancement. The link at the ...




I am a board certified clinical nephrologist in Detroit.

I am a partner at St Clair Nephrology and am part of the faculty that teaches the nephrology fellows, residents, and medical students that use St John Hospital and Medical Center to hone their clinical skills.

I am an Assistant Clinical Professor at Oakland University William Beaumont School of Medicine and have been teaching M2s about sodium, potassium and acid-base balance since there was M2s at that medical school (2011).

I have an offices at St Johns Moross, Roseville and Farmington Hills.

I am the medical director of St Clair Nephrology Research where we enroll patients with hypertension, CKD and ESKD to participate in clinical trials in order to improve the care we are able to provide to patients.

MedEd Maker


I am  @Kidney_boy.


I began writing this blog in May of 2008. This was the third nephrology blog after Kidney Notes and Renal Fellow Network (PBFluids was only a few months behind Nate Hellman’s Renal Fellow Network)


I am the co-creator, with Matt Sparks, of NephMadness


I am the co-creator, with Swapnil Hiremath, of NephJC

NSMC Internship

I am the program director of the Nephrology Social media Collective Internship.

Visual Abstracts

I am a member of CJASN’s Visual Abstract Editorial Team. I also contribute visual abstracts to AJKD and American Journal of Nephrology

Nephrology Secrets

I am a co-editor, along with Matt Sparks and Edgar Lerma, of the forthcoming, fourth edition of Nephrology Secrets

Fluid, Electrolyte and Acid-Base Companion

I am the co-author of this now (unfortunately), out-of-print, programed text.


I am an instructor for the Fluid and Electrolyte MedMastery section.

Conflicts of Interest

I have an ownership stake in a few Davita run dialysis clinics and a vascular access center. Takeda Oncology made a donation to MM4MM the program that is taking me to Mount Everest in 2018.

The Electrolyte Book

During residency, Sarah Faubel, and I wrote this programmed text on electrolytes. The process galvanized my interest in nephrology. The Acid Base and Electrolyte Companion is a highly styled book with a picture on every page along with simple questions at the bottom of each page to make sure you understand concepts before mindlessly flipping the page. It is highy regarded with 5 stars at Amazon. You can download the entire book (591 pages!) as a single PDF (28 mb). More info and a link to the free download here.

Now updated with the introduction, colophon, credits, dedication and table of contents.



For some of my lectures I like to use a technique I call “Seder Style.” I adopted the style from the greatest teaching success I know, the teaching of the exodus of Egypt during the Passover holiday. If you ask a typical secular American Jew about Rosh Hashanah or Purim he will be able to give you a short answer about its meaning and underlying story, but if you ask about Passover they will be able to give a detailed and in-depth explanation that could fill out most of 10,000 word research tome. Why is Passover different? It’s because of the Passover Seder, a multi-media, interactive teaching experience performed one or two times during Passover. This is what I try to re-create during my small group sessions. Each student reads a paragraph or two and I comment, question and stimulate interaction. The study guide we read from is called the Haggadah.

You can download the handouts in one of three formats.

  1. The Pages document is the native, editable file so you can customize the handout to your preference. You will need Pages for iOS or Mac OS X to open these files. If you make signifigant changes send me a note at I always enjoy hearing how people modify and enhance the material.
  2. PDF. This is a straight copy of the primary document which is perfect for printing or viewing on an iPad.
  3. PDF booklet. This is a PDF with the pages reordered so that when printed double sided can be folded into a cute little booklet perfect to slip into a white coat pocket.

Click for the full list of handouts


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