RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 3 minutes ago

https://www.nejm.org/doi/full/10.1056/NEJM199005033221806 Have you checked , what the patient is doing during the blood draw . Some patients prefe...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 11 hours ago

This patient's colon is intact. Does that make it unlikely that the high serum K is due to deficient bowel secretion of K.? ---------------------...

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RE: Role of Acthar in secondary FSGS 12 hours ago

I presume that her serum albumin is normal. If so, then ACTHAR gel would not be useful (or approved by the FDA). It might even be harmful via aggra...

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RE: Resistant hypertension 14 hours ago

Additionally how labile is his BP. If the average is 140/90, this may just be acceptable fot the next week or o. No hurry to get to 130 systolic; d...

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RE: Resistant hypertension 14 hours ago

Hb went from 15 to 12 g/dL reflecting about 2 unit of whole blood loss, iie a loss of 20% of hi circulating blood volume. Replaced with? non colloi...

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Role of Acthar in secondary FSGS 15 hours ago

I have a 19 yrs Caucasian young lady with obesity with BMI close to 40, normal renal functions and NS range proteinuria. Renal biopsy showed featur...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 15 hours ago

Patients with bowel resection especially colon tend to have some degree of hyperkalemia is my understanding. This is because about 10-15% of daily ...

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RE: Resistant hypertension 15 hours ago

thank you for suggestion and comment Today his bp is 140 90 , we got hydralazine added and started on 25mg tds dose We don't have minoxidil. And ...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 16 hours ago

Mohamed but with normal kidneys without ?k secretion defect even if problem with bowel K should not rise Does not matter how much K one consume K...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 16 hours ago

I checked an ABG — pH was 7.42, PaCO₂ 38 mmHg, HCO₃⁻ 24 mEq/L — so no respiratory acidosis or acid-base disorder. She’s not on any thermogenic agen...

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RE: Resistant hypertension 17 hours ago

I agree with Dr Rodby and Dr Campese. The rule is HTN in CKD/ESRD is due to excess volume, whether you can detect it clinically or not, but there a...

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RE: Resistant hypertension 17 hours ago

Touche ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 ------------------------------

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RE: Reclast And Recurrent AKI 17 hours ago

I agree. Dr. Mellas. Reclast should be used with great caution in patients with reduced eGFR and never when estimated creatinine clearance is less ...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 17 hours ago

Please measure the pCO2 and pH. I have seen several patients with respiratory acidosis causing mild hyperkalemia. Qais Al-Awqati --------------...

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RE: Resistant hypertension 18 hours ago

How about combining in them for the mother in law !! --------------------------------- Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha ...

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RE: Resistant hypertension 18 hours ago

Agree totally. Never combine Minoxidil with cyclosporin, particularly in females. ------------------------------ Anatole Besarab MD ABesarab Con...

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RE: Reclast And Recurrent AKI 18 hours ago

I have a patient, 75 yo female, CKD with eGFR 35 ml/min received reclast by primary care physician for Rx of osteoporsis. Creatinine rose to 4.5 ...

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RE: Reclast And Recurrent AKI 21 hours ago

Reclast and Zometa are identical agents with equal nephrotoxicity they are just used to treat different conditions , so the names and labels are di...

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RE: Reclast And Recurrent AKI 22 hours ago

Thanks Dr Glassock Dont know the dose will check Good to know that different formulations of zoledronic acid So probably Reclast more Nephrotoxic ...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 1 day ago

Although uncommon , consumption of herbal remedies containing dried frog skin (containing a potent digitalis like alkaloid) should be considered an...

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RE: Case of Ig Nephropathy with triple postive autoimmune markers(GBM, dsDNA, and PR3) 1 day ago

Yes I saw that it's ruled out .. just put my 2 cents on a case of dual positive AAV and antiGBM , which are rare .. thank u. --------------------...

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RE: Case of Ig Nephropathy with triple postive autoimmune markers(GBM, dsDNA, and PR3) 1 day ago

The kidney biopsy ruled out anti-GBM disease and pauci-immune crescentic GN due to ANCA. ------------------------------ Richard Glassock MD, FASN...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

Yes , as long as they are from migrant workers from Abudhabi, they can be referred to me ... They can always contact us on 9712- 7117467 or WhatsAp...

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RE: Reclast And Recurrent AKI 1 day ago

Reclast and Zometa are different formulations of the same drug-Zoledronic acid (a bisphosphonate ) . Reclast is approved for therapy of osteoporosi...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 1 day ago

I am not sure , about the statement to leave her alone . There could be legal consequences , if something untoward were to happen to the patient , ...

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RE: Case of Ig Nephropathy with triple postive autoimmune markers(GBM, dsDNA, and PR3) 1 day ago

I would have to agree with Prof Glassock.. it's just noise . However would like to point out that we had a case of dual positive Anca and GBM dise...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

Thanks for the info. We have a lot of migrant workers from our state in the UAE. This might help them. Will pass on the information ------------...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

Dr. Balan. Pegcetacoplan is given to migrant workers , as long as they have a valid visa and residency status in the Emirate ( state ) of Abudhabi....

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Reclast And Recurrent AKI 1 day ago

Seeing a patient 88 year-old who came exactly one year ago on 5/2024 with acute kidney injury with Creatinime of 16 At that time, it wasn’t clear ...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

Pegcetacoplan is available for use , not officially approved for C3G , pending either European or FDA approval. We present each individual case to ...

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RE: Case of Ig Nephropathy with triple postive autoimmune markers(GBM, dsDNA, and PR3) 1 day ago

I think the serological findings are likely to be "false positives " or of little clinical relevance. In addition, he should be placed on a RASI or...

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RE: Case of Ig Nephropathy with triple postive autoimmune markers(GBM, dsDNA, and PR3) 1 day ago

In my opinion, this is IgA Vasculitis ( *formerly Henoch -Schonlein Purpura ) and should be managed accordingly, despite the serology of uncertain ...

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Case of Ig Nephropathy with triple postive autoimmune markers(GBM, dsDNA, and PR3) 1 day ago

I have a 44-year-old male patient with a history of leukocytoclastic vasculitis, microscopic hematuria, and proteinuria, who was referred to me for...

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RE: Resistant hypertension 1 day ago

As any nephrologist worth his her weight in salt (no pun intended) knows, volume plays a huge role in HTN associated with renal insufficiency. N...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

Is Pegacetocopan approved for use in C3G in the UAE. It is not yet approved for this indication in the USA (yet) ------------------------------ ...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

@Hormaz Dastoor Do you get pegcetacoplan and others even for migrant workers without insurance? It would be good to know ---------------------...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

I agree , but we can't really complain , as long as we still have access to Pegcetacoplan for all patients . Genetic testing is something we can li...

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RE: Resistant hypertension 1 day ago

1. Are you measuring Intra arterial BP reading?? 2. May need a medication reconciliation to start with. 3. In the old days we tried Minoxidil 4....

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RE: Dialysis Questions 1 day ago

Both Low dialysate K & high dialysate Ca have been undeniably implicated in card arrhythmia during HD & sudden card arrest. There was even a recent...

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RE: Resistant hypertension 1 day ago

I feel that I miss some data What were his chronic bp meds and how was he controlled before ? What was added ? What was his potassium ? ...

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Research award opportunity from the Association of German Renal Centres 1 day ago

Hi all, Please see a message below about an international award named the Bernd Tersteegen Award. This award is given by the Association of Ge...

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RE: C3 Inhibitor - Pegcetacoplan for C3G and RPGN 1 day ago

You state that "The quirks in our system are such that as an outpatient, with a poor insurance, they are not entitled to Genetic testing or testing...

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Research award opportunity from the Association of German Renal Centres 1 day ago

Hi all, Please see a message below about an international award named the Bernd Tersteegen Award. This award is given by the Association of Ge...

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Research award opportunity from the Association of German Renal Centres 1 day ago

Hi all, Please see a message below about an international award named the Bernd Tersteegen Award. This award is given by the Association of Ge...

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RE: Membranous Nephroapthy - Obi vs Rituximab 1 day ago

the hoops that have to be jumped through are reflected in " i will definitely screenshot this reply and send it to our PTC committee to use it " si...

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RE: Dialysis Questions 1 day ago

Agree with comments to date by Drs. Glassock and Rodby. I have used "high Calcium dialysate" only for Hungry bone syndrome post parathyroidectomy a...

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RE: Resistant hypertension 1 day ago

With CKD, ADPCKD and DM one must assume there is a volume component. Measurement of the actual extracellular volume is notoriously inaccurate and t...

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RE: Resistant hypertension 1 day ago

How did you determine that there was no aneurysm present? What was his admitting BUN and Cr? Why did he need 3% Na infusion even if transient? ...

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RE: Resistant hypertension 1 day ago

Intracerebral bleeding can cause dysautonomia and very difficult to control and labile BP. Antiadrenergic drugs and vasodilators are necessary. T...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 1 day ago

Those further details are useful. Is there any hydronephrosis on ultrasound? An obstructive nephropathy can cause hyperkalemia without much rise in...

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