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The latest Nephrology Self-Assessment Program (nephSAP) issue, Volume 23: Issue 2 (Jun 2024): Electrolytes and Acid-Base Disorders is now available online.
RE: is it indicated to undergo parathyroidectomy? 1 hour ago
With a high 24 hour urinary calcium isn't FHH completely ruled out? ------------------------------ Satish Balan MD DM DNB Nephrologist Kerala I...
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RE: Post-partum HELLP v. aHUS 2 hours ago
The concept that the creation of "virtual teams" to facilitate management of complex case of TMA will have very broad impact accrisss the entire sp...
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RE: Post-partum HELLP v. aHUS 3 hours ago
Thanks for the update, Dr. Landry. Encouraging to hear about the pt's response. The concept of developing TMA teams is very close to my heart and s...
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RE: Solute diuresis - post obstructive diuresis how long does it last? 3 hours ago
Great pic. Thanks. We need a little humor to lighten up the conversation on this site. ------------------------------ Richard Glassock MD, FASN ...
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RE: Post-partum HELLP v. aHUS 4 hours ago
Thank you Dr. Java for this timely review. An update on our patient: Eculizumab administered Tuesday afternoon with peak LDH 3500 now down to 500, ...
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RE: Solute diuresis - post obstructive diuresis how long does it last? 5 hours ago
On the lighter side, the visual equivalent: https://www.edvardmunch.org/the-scream.jsp#google_vignette ------------------------------ Sheldon Hir...
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RE: Solute diuresis - post obstructive diuresis how long does it last? 6 hours ago
Strong words, but very good advice, in my opinion. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----...
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RE: Post-partum HELLP v. aHUS 7 hours ago
PLEX and steroids are used if suspicion for TTP is high. In that case, you could PLEX until ADAMTS13 is back. However, these treatments are not ver...
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RE: Solute diuresis - post obstructive diuresis how long does it last? 7 hours ago
This scenario makes me want to scream. iatrogenic polyuria, originally was post obstructive appropriately getting rid of salt and water and urea ac...
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RE: is it indicated to undergo parathyroidectomy? 8 hours ago
Dr. Jebur, I agree this is very likely primary hyperparathyroidism. However, patients with apparent mild-to-moderate hyperparathyroidism, could pos...
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RE: Solute diuresis - post obstructive diuresis how long does it last? 10 hours ago
Dr. Zapata: Convincing your colleagues to abruptly stop full oral + IV fluid replacement may be difficult. Please ask them to limit total fluid int...
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RE: is it indicated to undergo parathyroidectomy? 10 hours ago
Dr. Jebur: I am aware that your patient doesn't have CKD/ESKD. Her DEXA-documented osteopenia is most likely due to primary HPT. I was just trying ...
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RE: Post-partum HELLP v. aHUS 16 hours ago
Thank you all for the very fruitful discussion One question In such scenario, any role for PLEX/ plasma infusion and /or steroids till we get th...
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RE: is it indicated to undergo parathyroidectomy? 17 hours ago
Thanks for your replies. I think what might prompt decision to proceed is the risk of malignant lesion as well --------------------------------- W...
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RE: is it indicated to undergo parathyroidectomy? 17 hours ago
And she is post menopausal --------------------------------- Wael Jebur MD, FASN drwaellatif@hotmail.com Dubai ---------------------------------
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RE: is it indicated to undergo parathyroidectomy? 17 hours ago
Dear Dr.Venkat renal function is normal and she has no renal reported. --------------------------------- Wael Jebur MD, FASN drwaellatif@hotmail....
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RE: Solute diuresis - post obstructive diuresis how long does it last? 18 hours ago
Then I completely agree with Dr. Hirsch. There is usually no need for IV fluids unless you're using them to address a pathologic diuresis (i.e., el...
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RE: IgA Vasculitis in an adult 19 hours ago
Dr. Vaidya: Please post today's SCr ASAP. Very interested to see if SCr is continuing to improve following methylprednisolone boluses even before y...
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RE: IgA Vasculitis in an adult 20 hours ago
Yes. This should be sufficient. If this is truly a hydralazine Vasculitis, repeated dosing of RTX may not be needed. ---------------------------...
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RE: Monitoring Response After Rituximab 20 hours ago
Correct. Don't know for sure about Obi but I want to agree w you because Obi is 'humanized' form of RTX. PremChandran
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RE: IgA Vasculitis in an adult 21 hours ago
Thank you everyone for your valuable inputs. Rituximab 1 g x 2 doses 2 weeks apart ? ------------------------------ ChiragVaidya ---------------...
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RE: membranous nephropathy 22 hours ago
Dr. Venkat -fully agree with you. But AKI secondary to bilateral RVT was not really a consideration in this case. ------------------------------ ...
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RE: IgA Vasculitis in an adult 23 hours ago
Now I understand the significance of the anti-dsDNA antibody and anti-MPO ANCA - this is almost certainly Hydralazine induced Vasculitis superimpos...
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RE: IgA Vasculitis in an adult 1 day ago
Mild petechial lesions in left shin which are fading away. He is on Hydralazine for HTN ( Can cause drug induced lupus) No drug use See renal ...
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RE: membranous nephropathy 1 day ago
Dr. Glassock: I absolutely agree with you that AKI due to bilateral acute RVT or acute RVT in a solitary functioning is very rare. However, if this...
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RE: IgA Vasculitis in an adult 1 day ago
Thanks. Can you provide any more details on the cutaneous findings in this case (*mentioned in the Biopsy Report)? The kidney pathology is consiste...
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RE: IgA Vasculitis in an adult 1 day ago
Can you please post recent creatinine trend? Have you repeated UPr/Cr and/or UAlb/Cr? ------------------------------ K.K. Venkat MD Troy MI (248)...
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RE: Solute diuresis - post obstructive diuresis how long does it last? 1 day ago
The patient's bacteremia has cleared, and their hemodynamics are stable. The continuation of IV fluids is recommended by the primary attending and ...
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RE: IgA Vasculitis in an adult 1 day ago
Attached pls find the biopsy report ------------------------------ ChiragVaidya ------------------------------ Files Attached DocumentRE: I...
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RE: Solute diuresis - post obstructive diuresis how long does it last? 1 day ago
Is there any other reason why fluids are being administered as described? Does he continue to have a clinical picture of active infection / sepsis?...
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RE: membranous nephropathy 1 day ago
In my experience, AKI due to bilateral RVT in MN in Adults is exceedingly rare, but I agree that imaging for RVT makes sense in this rare occurrenc...
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RE: membranous nephropathy 1 day ago
In the unlikely setting of AKI due to acute RVT which may necessitate thrombolysis, documentation that there is thrombosis I the renal vein(s) is o...
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RE: is it indicated to undergo parathyroidectomy? 1 day ago
Is this 50-year-old lady post-menopausal or not? "Osteopenia" in fhis patient is almost certainly from primary HPT and not from early stage of comm...
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RE: is it indicated to undergo parathyroidectomy? 1 day ago
In response to Prof Glassock's comments, questions. An experienced surgeon greatly influences my decision to proceed with surgery and I am opposed ...
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RE: Treatments Of Primary Membranous Nephropathy 1 day ago
Is CHF well controlled? How long ago was the baseline SCr of 1.5 - 1.8 mg/dL documented before recent AKI/CKD? Kidney US findings (length/echogenic...
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RE: Nephrotic range proteinuria, steroid resistant FSGS ? Genetic, steroid treatment cessation 1 day ago
Thanks Dr. Sundaramurthy: Thanks for posting the genetic testing report. Parental testing you refer to: Is this testing for proteinuria/renal funct...
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RE: Nephrotic range proteinuria, steroid resistant FSGS ? Genetic, steroid treatment cessation 1 day ago
Thanks Dr Glassock --------------------------------- Dhivya Sundaramurthy MD, MBBS Des Moines IA (989) 964-9508 ---------------------------------
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RE: Treatments Of Primary Membranous Nephropathy 1 day ago
I would be inclined to treat with RTX now. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------...
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RE: is it indicated to undergo parathyroidectomy? 1 day ago
Thanks Dr.Sprague. The diagnosis of Primary hyperparathyroidism due to a parathyroid adenoma seems pretty clear. How would the availability (or lac...
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RE: membranous nephropathy 1 day ago
Yes, I agree that in the event of a recurrent VTE , in the face of full anti-coagulation (and compliance with the DOAC prescription, a likely call ...
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RE: is it indicated to undergo parathyroidectomy? 1 day ago
It is a bit of a tough call. was the distal radius obtained with the DEXA, if that is decreased, then likely significant hyperpara and would procee...
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RE: Treatments Of Primary Membranous Nephropathy 1 day ago
The patient just had Anti-PLA2R done that is 28.5 with reference lab range 0-19. Positive > 19. She was not able to get the test sooner as she ju...
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RE: membranous nephropathy 1 day ago
In the event of of recurrent thromboembolism from unremitting proteinuria & urinary loss of anti- thrombin 3, a qstn will arise as to there is the ...
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RE: Nephrotic range proteinuria, steroid resistant FSGS ? Genetic, steroid treatment cessation 1 day ago
The patient is a compound heterozygote for NPHS2-related FSFS. I don't think that any further genetic analysis is needed, except for genetic counse...
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RE: membranous nephropathy 1 day ago
The patient is on a DOAC for his VTE. Does it make any difference if the source for the PE was a RVT compared to a non-RVT anatomic site?. The lack...
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RE: membranous nephropathy 1 day ago
Agree he needs therapy as soon as possible. Does he have renal vein thrombosis, is that the source of his pulmonary embolism? I presume he's alread...
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RE: Nephrotic range proteinuria, steroid resistant FSGS ? Genetic, steroid treatment cessation 1 day ago
Dr Glassock and Dr Venkat, Both mutations were heterozygous as per attached report. Parents non-consanguineous. He was tested for COL mutations a...
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is it indicated to undergo parathyroidectomy? 1 day ago
Hi I had a consultation with a patient for second opinion. A 50 year old lady was found to have hypercalcemia on routine check up.She is not hy...
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RE: Keto acid analogue in incremental hemodialysis and peritoneal dialysis patients 1 day ago
Thank you for the insight Dr Glassock ------------------------------ Yasmine Wardoyo MD Cipto Mangunkusumo Hospital jakarta +628119760555 -------...
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RE: Monitoring Response After Rituximab 1 day ago
Peripheral blood CD19+ B cells are only one of the discrete pools of pathogenic B cells. What about such B cells residing in Lymph Node germinal ce...
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