Nephrogenic systemic fibrosis (NSF), originally described as “scleromyxedema‐like cutaneous disease,” is an entity that has emerged recently in patients with renal dysfunction.1 NSF is a rare but severely disabling disease that manifests as fibrosis of skin and viscera. Numerous reports have highlighted an association between NSF and gadolinium (Gd)‐based contrast agents (GBCAs) used for magnetic resonance imaging. The exact mechanisms underlying this association are still under investigation.2,3 There were apparently no reports of NSF prior to 1997, when the first cases were described.1 Clinical Pharmacology & Therapeutics (2011) 89 6, 920–923. doi:

Risk stratification of BC fistulas utilizing the above parameters could enable clinicians to identify accesses that are at risk for multiple re-interventions. Early identification of accesses that are at high risk for re-interventions at the cephalic arch might prolong access survival and reduce the cost for intervention by utilizing alternate strategies.

Vasopressin-2 receptor antagonists, collectively known as the 'vaptans', provide a new approach to the treatment of hyponatremia; therefore, an updated Review of the pathophysiology of hyponatremia is particularly timely. After briefly defining hyponatremia and introducing its clinical aspects and complications, we present an approach to the diagnosis and evaluation of hyponatremia that is based primarily on the often-underused concept of free water clearance and, more specifically, the electrolyte-free water clearance. Then we review the use of vasopressin receptor antagonists in the management of hyponatremia from the standpoint of their pharmacology, their mechanism of action, and available efficacy data from clinical trials.