RE: finerinoneh 14 hours ago

To reframe your question is that you use Finerenone per trials for CKD patient with an entry eGFR > 25 ml/min but now the eGFR is drift below 25 ml...

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RE: finerinoneh 17 hours ago

The FIDELIO DKD trial included diabetic patients with rGFR down to 25 mL/min/1.73 m², but did not establish efficacy below that threshold. Your p...

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RE: are foamy cells in kidney biopsy synonymous with fabry disease? 21 hours ago

Thanks prof glassock. Very helpful as usual . Proposed donor excluded. Albumin in donor 33 slightly below normal ( not sure of genetic fsgs can ...

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RE: Proteinuria 23 hours ago

How tall is she? 9.5 cm kidney could be small for tall person. Zoledronic might be innocent by stander. If she has FSGS, which is expected, will be...

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RE: Urine Sodium In Hyponatremia 1 day ago

"My main question is that if we assume any patient , is volume depleted , will his Urine Na reflect his volume depleted status ie low Una or will h...

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RE: Proteinuria 1 day ago

Thank you very much for your advice. ------------------------------ Soroush Shojai MD Associate Professor University of Alberta Edmonton AB 0044...

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RE: Proteinuria 1 day ago

Thank you for your advice. We haven't repeated her US recently but her kidney was 9.5 Cm on the latest US. I am not aware of her birth eight but ...

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RE: Proteinuria 1 day ago

The other symptoms reported are consistent with zoledronic acid induced systemic inflammation, a well reported phenomenon, and I wouldn't necessari...

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RE: Proteinuria 1 day ago

Yes her serum Albumin is normal and she doesn't have any oedema. Thank you very much for your advice. ------------------------------ Soroush S...

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RE: Proteinuria 1 day ago

Thank you for your advice. I agree ATIN is a possibility and it was discussed among our team. However, the consensus was even if the biopsy shows A...

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RE: Proteinuria 1 day ago

Hi Thank you for your reply. She doesn't have any glycosuria. ------------------------------ Soroush Shojai MD Associate Professor University ...

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RE: Proteinuria 1 day ago

Reviewed labs - could follow for now on present meds- reserve biopsy if eGFR decreases or becomes nephrotic ( serum albumin normal if read table co...

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RE: Urine Sodium In Hyponatremia 1 day ago

I completely agree with Dr. R. Rodby. This is not salt wasting nephropathy, but typical SIADH. Hence the use of the 2 % saline just allowed the ser...

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RE: MCD-IgA nephropathy 1 day ago

Ok- good luck keep us informed ! ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pa...

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RE: Are International Kidney Disease Guidelines Equally Applicable Across Different Healthcare Settings? 1 day ago

I do not have any good answers to your questions. guideline writers try to take into account the global heterogeneity of availability of drugs to t...

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RE: finerinoneh 1 day ago

I can't find any published information that answers your question. We will gave to rely on the opinion of someone who has experience with treating ...

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RE: MCD-IgA nephropathy 1 day ago

He's been on it for a while, I stopped it during this last visit. I am planning to start tapering steroids by next 2 weeks. He does have some ste...

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RE: MCD-IgA nephropathy 1 day ago

"He takes hydralazine, hydrochlorothiazide, bumex and metformin." suspect rash not steroids but agree with referred to dermatology for possible s...

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RE: Proteinuria 1 day ago

Pamidronate is associated with FSGS while zolindronte is associated with ATI. Solitary kidney is not an absolute CI for kidney biopsy so I would pr...

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RE: Proteinuria 1 day ago

any glucosuria present on UA ? --------------------------------- Edgard Wehbe MD, FASN Wichita Nephrology Group Wichita KS (316) 993-6580 ----...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 1 day ago

Agree with Dr. Glassock and i think all lesions can be explained by LN even the TMA so my plan to wait for OBI plus SOC (MMF and PRD) to work befor...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 1 day ago

Thanks It is a complicated case of a patient presenting with 2 major thrombotic events . His biopsy shows class 4 lupus Nephritis There is a sug...

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RE: Proteinuria 1 day ago

What is the size of the solitary Kidney by US ? Do you happen to kniw her birth weight?. What is her systolic BP and ABOM (nocturnal dipping) ?. Wh...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 1 day ago

Dr-Dastoor- Given the findings in this complex case of LN, I have difficulty understanding the rationale for using anti -C5 MoAb -can you succinc...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 1 day ago

Genetic testing done Obi given last night Eculizimab planned for tomorrow, Ravulizumab as an outpatient --------------------------------- Dr. Ho...

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RE: are foamy cells in kidney biopsy synonymous with fabry disease? 1 day ago

I would do genetic studies for Alport and Fabry Disease on potential donor and intended recipient in this case. Interstitial foam cels are abnormal...

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Proteinuria 1 day ago

I would like to ask my colleagues' opinion on this patient. 61 years old female with solitary kidney ( Donated her kidney 12 years ago), presente...

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RE: MCD-IgA nephropathy 1 day ago

he does have microscopic hematuria, persistently 17-26 RBCs on UA. ------------------------------ Sarah Al Zoubi MD John Stroger Hospital of Cook...

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RE: MCD-IgA nephropathy 1 day ago

He takes hydralazine, hydrochlorothiazide, bumex and metformin. I think it is more drug eruption from steroids. he was referred to dermatology fo...

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RE: Urine Sodium In Hyponatremia 1 day ago

On 28th October his Pna was 118 . He was placed on 2% saline for 24 hours . His Una was 160 and Uosm was 550 while on 2% saline . On 29th October ...

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RE: Urine Sodium In Hyponatremia 1 day ago

"His serum creatinine is 28 umol/l or 0.4 mg/dl, urea is 4 mmol/l ( 12 mg/dl) uric acid 72 umol/L" Dr. Dastoor: Were these the presenting values be...

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RE: are foamy cells in kidney biopsy synonymous with fabry disease? 1 day ago

should i check for Fabry disease? ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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are foamy cells in kidney biopsy synonymous with fabry disease? 1 day ago

59 F coming foward to be considered as live donor for nephew PMH: 3 previous C sections - one under GA and 2 under spinal : Nil issues Frozen ...

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RE: Urine Sodium In Hyponatremia 1 day ago

exactly why a measured urine sodium assuming no diuretics for several days would have been informative ------------------------------ [Mark] [Ler...

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RE: Urine Sodium In Hyponatremia 1 day ago

I attached the aforementioned article about the value of the Una over the physical exam for euvolemia v hypovolemia in HypoNa. TO me this is a clas...

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RE: Urine Sodium In Hyponatremia 1 day ago

Was urine sodium measured when pNA was 118? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Directo...

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RE: Urine Sodium In Hyponatremia 2 days ago

Please see attachment . On 28th October :patient on 2% Ncal , which has 308 osmoles of Na - Uosm is 160 On 29th October : patient is 10 hours of...

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RE: Urine Sodium In Hyponatremia 2 days ago

The calculation is made from the original patient's U Na of 160 and U osm of 585. Assuming the Na content of the excreted urine is unchanged a U ...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 2 days ago

This is aggressive course of active lupus for sure based on clinical serollogical and histopathology but yes i would agree wigh dr dustoor to rule ...

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RE: Urine Sodium In Hyponatremia 2 days ago

"if the U osm was 118 the U Na would be 32 mmol/L" -how was this calculated without measuring spot urine sodium? ------------------------------ [...

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RE: MCD-IgA nephropathy 2 days ago

interesting-why with favorable response so far to steroids and no evidence at least posted of significant steroid toxicity-why switch to RTX which ...

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RE: Urine Sodium In Hyponatremia 2 days ago

If the U osm was 118 the U Na would be 32 mmol/L. This suggests euvolemia but may overlap with modest hypovolemia. Under the influence of ADH the N...

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RE: Urine Sodium In Hyponatremia 2 days ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC12332142/ This addresses the question of the post, which I believe asks whether the kidney that perceive...

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RE: Urine Sodium In Hyponatremia 2 days ago

Very interesting presentation. While several diseases can present with hyponatremia and salt wasting, the most important one is cerebral salt wasti...

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RE: Urine Sodium In Hyponatremia 2 days ago

I find the above signs - turgor / sunken eyeballs not particularly reliable measures of volume status vs JVP and edema. Perhaps measuring fractiona...

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finerinoneh 2 days ago

Good evening For patients with stable GFR around 20mls/min and K [More]

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RE: Urine Sodium In Hyponatremia 2 days ago

Interesting case. It certainly sounds like the kidneys are not sensing a hypovolemic state or decreased effective circulating volume, even if he is...

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RE: Urine Sodium In Hyponatremia 2 days ago

I think you have to trust the kidneys assessment of effective circulating volume. He may appear volume depleted (i prefer this terminology over deh...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 2 days ago

I agree , but our rheumatologist is highly suspicious of antibody negative APLS and there are fibrin thrombi in the kidney biopsy which may be sugg...

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Urine Sodium In Hyponatremia 2 days ago

Was reviewing a patient with hyponatremia and Pna 118 on admission . It was felt that he was dehydrated and was started on 2% Nacl , not 0.9% Nacl....

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