RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 5 hours ago

Pure exertional Rhabdo unless profound and pt dehydrated or compartment syndrome usually does not cause AKi Here I suppose contribution of NSAID by...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 9 hours ago

Good evening This is Mugdha, I am second year nephrology fellow at University of Cincinnati. it is an awesome opportunity and I would love to vol...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 17 hours ago

Agree I presume that the exertion/NSAID was some time ago and that the CPK was much higher several days ago, we're just catching it on its way do...

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RE: Hypercalcemia management in a patient with Sarcoidosis 17 hours ago

Thank you both for the prompt response. I appreciate it. I will present both options to the patient and decide. Thank you -----------------...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 17 hours ago

I would not biopsy, Myoglobinuric AKI can take a while to recover. Although I am a little surprised of this level of AKI with this level of CK. ...

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RE: Hypercalcemia management in a patient with Sarcoidosis 17 hours ago

HydroxyChloroquin has also been used see attached ------------------------------ Roger Rodby MD, FASN Professor of Medicin...

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RE: High dose Rosuvastatin and non glomerular proteinuria 17 hours ago

"Tubular damage is increased in patients receding high-dose Rosuvastatin. " Do we have anything other than an association? Do we have any idea...

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RE: High dose Rosuvastatin and non glomerular proteinuria 17 hours ago

Few comments: Love "Cardiologists have tunnel vision, there is nothing they wont do to decrease CV risk. We need to temper them a bit". Tubule ...

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RE: Hypercalcemia management in a patient with Sarcoidosis 17 hours ago

The addition of ketoconozole to therapy in this patient may help to ameliorate the hypercalcemia due to beneficial effects on Sarcoidosis itself an...

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Hypercalcemia management in a patient with Sarcoidosis 18 hours ago

I have a 69-year-old Caucasian male with biopsy-proven pulmonary sarcoidosis, diagnosed after he initially presented with acute kidney injury and h...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 20 hours ago

I see no need for a kidney biopsy based on the information provided , other opinions welcome. ------------------------------ Richard Glassock MD,...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 20 hours ago

What about urinary myoglobin and serum electrolytes. He must receive large amount of IV fluids (3-4L) and iv calcium.. ---------------------...

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Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 20 hours ago

Patient: 31-year-old previously healthy male Presentation: • Prolonged exertion (2h swimming in heat) • Took Cataflam (diclofenac, NSAID) prior ...

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RE: follow up case 21 hours ago

Thank you. ------------------------------ M Kaisar Nephrologist Brisbane ------------------------------

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RE: High dose Rosuvastatin and non glomerular proteinuria 1 day ago

Dr. Campese . I fully agree with your warnings about use of high dose rosuvastatin but the distinction between hematuria, hemoglobinuria and myoglo...

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RE: High dose Rosuvastatin and non glomerular proteinuria 1 day ago

The PLANET II trial (NCT00296400) studied rosuvastatin and atorvastatin in patients with proteinuria but without diabetes. It found that atorvastat...

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RE: Follow up on patient with lupus nephritis 2 days ago

Thanks so much for your kind words. I was very surprised too. ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein ...

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RE: Follow up on patient with lupus nephritis 2 days ago

This anecdote represent support for the use of Benlysta to control both renal and extra-renal Lupus,especially to allow for steroid-free management...

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RE: Follow up on patient with lupus nephritis 2 days ago

Since she had many others lupus related symptoms (alopecia, discoid skin changes, fatigue and arthralgias) it seemed that Benlysta would be a benig...

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RE: Follow up on patient with lupus nephritis 2 days ago

Dr. Fein- It is interesting that you chose to add Benlysta, as the RCT involving thus drug did not show any benefits in use of Benlysta Class ...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

20 years ago I participated in preparation of a publication on statins and adverse kidney events, using FDA voluntary reporting data. We found that...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 2 days ago

According to the values listed the UACR is 452mg/gm creatinine and theUPCR is 1464mg/ gm creatinine.(conventional units. ). The UACR/UPCR ratio is ...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

Rosuvastatin on the other hand less toxic to muscles and less drug interaction Recently saw an AA 40 years of age with Rhabdo due to his normal ...

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RE: Follow up on patient with lupus nephritis 2 days ago

I couldn't agree more with you Dr Fein. Insistent pharmacologic approach at any cost in lupus nephritis is reminiscent of the days before the arriv...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

I agree with the epidemic. Have seen multiple cases and reported several to the FDA. Have been educating my local cardiologists about the package i...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

I agree with your concerns. My experience is of more worrying nature. In the last three years , I have encountered 5 instances of Rhabdomyolysis wi...

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RE: High dose Rosuvastatin and non glomerular proteinuria 3 days ago

I agree- ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

I agree. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

Dr Glassock my interpretation was pts with scleroderma associated TMA 10-15% had underlying complement abnormalities -----------------------------...

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RE: High dose Rosuvastatin and non glomerular proteinuria 3 days ago

Rosuvastatin Pandemic initiated by Cardiologists last year Unfortunately MAX dose of 40 mg Rosuvastatin has become a "routine Rx" by most cardiol...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

So 50% or more of patients Scleroderma who do not have SRC but are hypertensive can have non-C associated TMA lesions in the kidney, is this a corr...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

This is from one article Thrombotic microangiopathy can occur in up to 50% of patients with hypertensive emergency and 10-15% with scleroderma Gene...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

There seems to be a growing movement that all TMA is causally related somehow to C activation (usually alternate pathway). Is this true? I do not k...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 3 days ago

The majority of this thread is focused on whether or not there's any role of renal biopsy. But this was based on the assumption that was clear that...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 3 days ago

someone else checked in April, 2015, Keppra was 1060 and lambda 27.42 and GFR 112. After that, Kappa to lambda ratio in June, 2024 was 33.67 when E...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 3 days ago

I am pasting the note of haematologist oncologist below. "Advised nephrologist to get 24 urine protein and IFE. At this time, per criteria he doe...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 3 days ago

On January 27, 2025 when last tested urine for albumin and protein, urine spot creatinine was 47.9 mg/dL, urine microalbumin was 216.9 ug/mL and ac...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

It would be exceptional for CM-TMA. But I could envision RL-TMA in a pt with earlier PET + SSc-myositis overlap syndrome presenting with isolated p...

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RE: Would you give empiric rituxan for pulmonary renal syndrome? PLEX not available 3 days ago

we gave it. Her Anti GBM came back negative. No cocaine use as far as I know ------------------------------ Nimra Sarfaraz (516) 637-3820 ------...

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RE: High dose Rosuvastatin and non glomerular proteinuria 3 days ago

By any chance Not started on Fenofibrate --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH (513) 8...

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RE: High dose Rosuvastatin and non glomerular proteinuria 3 days ago

Would love to hear everyone's answers. Just yesterday did a new consult on a t2 diabetic 5 yrs duration, well controlled HPT on carvedillol and ram...

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Follow up on patient with lupus nephritis 3 days ago

Last year I posted a case of a 25 yo female with class V lupus nephritis since age 12. She had particularly severe NS with persistent serum albumin...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

Interesting idea - but the patient does not have "malignant " hypertension, no systemic MAHA and normal GFR- it seems unlikely that this is C media...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

While you await complement testing, might reexamining kidney tissue for C5b-9 staining (the ex vivo C5b-9 deposition test on endothelial cells if a...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

Since this is not SRC I think that it will make no difference if you use ACEi or ARB for BP control. I agree with stopping MMF. I would avoid stero...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 3 days ago

Thanks Dr Glasock Will discuss with Rheumatology and will proceed with Rituximab especially also symptomatic Myositis So will stop Cellcept Any r...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN Saturday, April 26 @ 5:20 AM

Below is a small study that showed value of repeat biopsy relapsing MN and that in absence of fresh deposits can be treated with conservative thera...

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RE: MMF/Myfortic/cyclosprin/proton Pump Inhibitor Saturday, April 26 @ 12:53 AM

PPI interfere with GI absorption of Mycophenolic acid (MMF and MPA. They have no effects on Mycophinale metabolism. PPI Lower the acheuvement of th...

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RE: High dose Rosuvastatin and non glomerular proteinuria Saturday, April 26 @ 12:42 AM

Tubular damage is increased in patients receding high -dose Rosuvastatin. ------------------------------ Richard Glassock MD, FASN Laguna Woods ...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy Saturday, April 26 @ 12:39 AM

With a normal serum creatinine this is not SRC, but rather renal limited TMA in the presence of Scleroderma-overlap syndrome Type. Treatment is not...

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