RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 hour ago

CRAB - calcium (hypercalcemia, renal (kidney dysfunction), anemia, bone (usually radiographically apparent bone lesions). -----------------------...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 2 hours ago

There was no Vomiting . 1-2 days of nausea and stomach discomfort resolved after admission . The only Diuretic that he may be using as outpatient w...

View Discussion

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

How would a biopsy change the therapy? ------------------------------ John Mellas MD Nephrology and Hypertension Specialists St Louis MO 31453723...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 4 hours ago

Any history of repeated vomiting or high dose diuretics use? What doses of NaHCO3 he was on per day? Agree to look for RAS or PA in this setting. ...

View Discussion

RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 16 hours ago

I suppose that Diabetic Nephropathy is also in the differential diagnosis , but he stilll needs therapy for MM ------------------------------ Ric...

View Discussion

RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 16 hours ago

He has Multiple myeloma which largely excludes a "diagnosis " of MGRS. He likely has a renal complication of MM, either AL Amyloid or LC Cast Nephr...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 17 hours ago

Time of flight MRA of renal arteries found today. Limited exam demonstrates normal caliber and appearance of proximal and mid portions of both...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 17 hours ago

Empagliflozin and Sodium Bicarbonate were discontinued on admission. 24HR 24 HOURS WC LB #218979 Collection time: Mar 28, 2025@15:59 Test ...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 17 hours ago

Today the Creatinine is 3.7 but he also had Spironolactone started 25 mg daily on 26th of March. ------------------------------ Sadeem Ali MD Bri...

View Discussion

whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 18 hours ago

White gentleman age 77 with history of BPH, type 2 diabetes(last A1c 8.0 in January, 2025 compared to prior 9.6 in August, 2024), hypertension, COP...

View Discussion

RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 1 day ago

Due to the age of the patient and expected life expectancy, effort to preserve renal tissue is needed. I agree with Dr. Rodby that this is LN with ...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 1 day ago

I agree with Prof Glassock, not sure it will do much, but may be worth a try if Mg is low, which is unusual in ESRD pts -------------------------...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 1 day ago

If he shows up for follow-up, how much and how many anti-hypertensive medications he needs to control BP will be interesting to document. If his BP...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 1 day ago

Thanks for your response. Does he have LVH and HR? Severity? ------------------------------ Ella Koifman-Zeltzer MD Tel-Aviv ------------------...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 1 day ago

Interesting suggestion. This patient has very little or no functioning parathyroid tissue, so magnesium repletion will not have much effect on hypo...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 1 day ago

@Stuart Sprague if serum Mg was found to be low and treated, does this will help increase serum PTH? --------------------------------- Hayder Aled...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 1 day ago

I agree 100% with Dr. Sprague . Patients with hypoparathyroidism secondary to total parathyroidectmyv And ESKD are very difficult to manage. ---...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 1 day ago

Our PT most definitely has severe HTN that appears to be controlled on meds but when he stops meds his BP it becomes severely elevated. It seems th...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 1 day ago

My default is partial PTX, I would want to totally avoid total PTX. ------------------------------ Stuart Sprague DO, FASN Director of Research,...

View Discussion

RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 1 day ago

I truly thank you all, for your valuable time. Our thought is for the patient to receive treatment for lupus, and we will monitor the response. In ...

View Discussion

RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 1 day ago

Dear colleague, yes she is Greek but not from Cyprus ------------------------------ Dimitrios Xydakis MD PEANIA +302810368443 -----------------...

View Discussion

RE: Renally limited MPO-vasculitis 1 day ago

Thank you, good to know that not all MPO-Ab are pathogenic. For my education: what would be principle difference between low dose Rituximab (I cons...

View Discussion

RE: Renally limited MPO-vasculitis 1 day ago

It is clear that not all anti-MPO antibodies are pathogenic ( largely dependent on the nature of the epitopes that react with the autoantibody) ...

View Discussion

RE: Renally limited MPO-vasculitis 1 day ago

Kidney Biopsy 9/2020 Kidney, right, biopsy: Focal ANCA-associated crescentic glomerulonephritis, see comment. Acute tubular epithelial i...

View Discussion

RE: Renally limited MPO-vasculitis 1 day ago

Kidney biopsy findings please (if done)? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 1 day ago

"Monday morning off all his meds SBP 140s" @Jonathan Slater: How did this patient markedly increase his BP and sustain severely elevated BP long ...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 1 day ago

" do you think hypertension likely to reoccur after transplant?" Based on my own experience of managing renal transplant, patients for almost 40 ...

View Discussion

Renally limited MPO-vasculitis 1 day ago

Looking for advice please: 76 yo male diagnosed with MPO-renally limited vasculitis when presented with AKD on 9/10/20 and was dialysis dependent a...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 1 day ago

@Stuart Sprague Since your default is not reimplantation, is it subtotal PTH-ectomy, or total PTH-ectoimy and only if pt becomes hypoCa you ini...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 1 day ago

well done persistence ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicag...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

The combination of sodium bicarbonate and glucoretic (SGLTI) could certainly explain the hypokalemia and hyperbicarbonatemia. Anything that reduces...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

Is a rise in SCr from 2,2 to 3.3 /dL over 4 months rally AKI in a patient with CKD? Just curious. ------------------------------ Richard Glassoc...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

I think you should consider bilateral renal arteries stenosis which can lead to uncontrolled HTN, hypokalemia and worsening renal function (he alre...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 2 days ago

This is truly a once in a lifetime( i hope) management decision. I was discussing this case report with colleagues, and a couple of questions poppe...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 2 days ago

I agree with Dr Rodby's comments, it is unlikely that the PTH will recover. I am personally very opposed to reimplantation procedures. Frequently t...

View Discussion

RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 2 days ago

Do you have UAlb/Cr and UPr/Cr ratios on sample of urine (or urine protein electrophoresis)? Puzzled by absence of proteinuria (and only few segmen...

View Discussion

RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 2 days ago

I think Dr. Rodby's analysis is spot on. This patient has SLE and should be managed accordingly. The C3 dominance raises the issue of Iptacopan. Li...

View Discussion

RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 2 days ago

I see you are in Greece. Is your pt (Greek) Cypriot by chance? https://academic.oup.com/ndt/article-abstract/28/2/282/1862913?redirectedFrom=fullt...

View Discussion

RE: management of ESRD patient post-parathyroidectomy 2 days ago

The surgery was done 2 months ago, Doesn't seem like reimplantation took! Why was the patient admitted now? Symptomatic Hypocalcemia? @S...

View Discussion

RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 2 days ago

We are now considering C3G a "pattern of injury" with many pathophysiologies more than a distinct disease. The key is finding the underlying cause....

View Discussion

management of ESRD patient post-parathyroidectomy 2 days ago

I am seeing an ESRD patient who underwent a parathyroidectomy with right forearm reimplantation on 1/27/25. His pre-operative PTH was 1500-2000pg/m...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

Repeat urine analysis today found only two red blood cells and no casts found. No white cells. ------------------------------ Sadeem Ali MD Bridg...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

Yes Sodium bicarbonate was discontinued already and AntiPLA2R and monoclonal testing ordered and result will take about a week at least . Last mono...

View Discussion

C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 2 days ago

Esteemed colleagues, I would like to share with you a clinical problem that has concerned our department, and I would greatly appreciate your assi...

View Discussion

RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

your title suggests this is a electrolyte problem but it appears to be a proteinuria problem? You urine protein and albumin units dont make sense b...

View Discussion

RE: superimposed podocytopathy? 2 days ago

Thank you, Dr. Balan. C3, C4, SIFE normal. FLC ratio minimally up at 1.7 c/w his CKD ------------------------------ Ira Meisels MD New York...

View Discussion

AKI, urinary K Wasting and uncontrolled HTN 2 days ago

White gentleman age 84 with history of chronic kidney disease G3 B, A3, anemia of chronic kidney disease, with positive ANA and elevated IgG, and l...

View Discussion

RE: superimposed podocytopathy? 3 days ago

Biopsy showing features of chronic thrombotic microangiopathy with nephrotic range proteinuria suggests a TMA as the main pathology. What are the c...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 3 days ago

Occam's razor. The simplest solution is often the correct one. ------------------------------ John Mellas MD Nephrology and Hypertension Specia...

View Discussion

RE: " Super" Severe Resistant HTN in CKD 4 patient 3 days ago

In line with the above mentioned new data, I have a trivial question (may be missed the data): was there any evidence of TOD (target organ damage) ...

View Discussion