RE: ocular disequilibrium syndrome in hemodialysis any clinical experience 1 hour ago

Back in the late 70's, mannitol was frequently used for the prevention of dialysis disequilibrium. As nephrologists followed the principle that "ha...

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RE: ocular disequilibrium syndrome in hemodialysis any clinical experience 2 hours ago

Very interesting. I don't have a strong opinion that it's a good idea (and I would be surprised if it's available on an outpatient basis ???), bu...

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C3GN in a patient with VEXAS s/p SCT and metastatic SCC on immunotherapy 2 hours ago

Hi! Need input on this case of C3GN: 62 y.o. male with h/o metastatic SCC (on Cemiplimab), VEXAS syndrome s/p SCT in July 2022, lichen planus of...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 5 hours ago

@Richard Glassock My AI consultant and the meta-analysis which I have attached, do clearly state that the incidence of colon cancer is increas...

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RE: AI Workshop and ASN Community: Join Us! 5 hours ago

I fully agree with @Melissa West. This is an excellent opportunity for fellows to gain practical, hands-on exposure to AI in nephrology and to enga...

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RE: Negative IF and EDD on EM from paraffin block 5 hours ago

agreed would be useful. I though they were done, but I realize the report said immunoperoxidase stain not pronase on the repeat stains. Unless opti...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 5 hours ago

Thanks Dr. Rubin. Very interesting results from an AI consultation. I have a question- since the incidence of distal colorectal cancer is not not i...

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RE: Hemodialysis Associated Headache 5 hours ago

When do the headaches begin relative to the start of the hemodialysis session? Are they the migranous or non-migranous in character ? Why don't you...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 6 hours ago

@Richard Glassock Please see the attached summary from AI (ChatGPT) which includes good references. I think the message is clear and I agree 100%...

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RE: Negative IF and EDD on EM from paraffin block 6 hours ago

What about a "concealed" monoclonal gammopathy of renal significance. Is Pronase digestion and IF an alternative here? --------------------------...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 6 hours ago

If there are no causal inferences for a role of Immunosuppression in colon cancer post transplantation, what would be the justification for discont...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 6 hours ago

@Mark Lerman Can you please provide reference 3 as shown in the paragraph that you posted. If I understood you correctly, based upon this single ...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 6 hours ago

Colorectal cancer has a relatively low SIR in transplant recipients (approximately 0.76-3.60), suggesting it is not strongly driven by immunosuppre...

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Hemodialysis Associated Headache 7 hours ago

Dear colleagues , May I consult you regarding this 55 years old male patient with ESRD on HD via AVF three times daily for the last 3 years. He is ...

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RE: Is this Lupus MN or Idiopathic Membranous Nephropathy 7 hours ago

@Richard Glassock thank you , i think we will pursue with C2, i am not sure if we have functional C4 assay. Would treatment of C2 def lupus favor a...

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RE: Negative IF and EDD on EM from paraffin block 7 hours ago

Also, sometimes old burnt out GN's can show some persistent electron densities but essentially negative IF. ------------------------------ Jonat...

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AI Workshop and ASN Community: Join Us! 7 hours ago

Hello Nephrology Fellows, AI has become a daily conversation topic. The ASN Partnership for Responsible AI in Kidney Health was established by ASN...

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RE: Negative IF and EDD on EM from paraffin block 7 hours ago

EM studies from re-processed tissue can be difficult to interpret due to varying degrees of artifact from the re-processing process as was noted in...

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RE: Is this Lupus MN or Idiopathic Membranous Nephropathy 8 hours ago

Thanks Dr. Dastoor. These findings ((reduced total serum hemolytic activity and normal or elevated serum C3 and C4 protein can suggest a congenital...

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RE: Is this Lupus MN or Idiopathic Membranous Nephropathy 15 hours ago

This patient subsequently had a complement profile done ( attached), it shows activation of classic and alternate pathway, in the setting of Normal...

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RE: 25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

Yes. See the short table below depicting 1 year graft survival. Fo additional details, see the latest report from the Organ Transplant Network and ...

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RE: 25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

The number of pancreas transplants in the US has declined (see below) and, as a result, the selection process has become more strigent. The 3 cente...

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RE: 25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

Fair enough, but I find this young black type 1 diabetic to frequently have an especially malignant form of type 1 diabetes, eg they are often VERY...

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RE: 25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

We are not given enough information (such as HbA1c, BP control, BMI, abnormal physical findings, etc.) to render an opinion regarding SPK, PAK, etc...

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Negative IF and EDD on EM from paraffin block 1 day ago

37 female post partum Haematoproteinuria, CKD stage 3, recent pregnancy (first presentation of renal disease) Immunology screen negative egfr sta...

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RE: 25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

Requiring 5 anti HTN-ives, 12 grams of proteinuria, this is malignant diabetic nephropathhy IMO and will progress to ESRD before you know it. The...

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RE: ocular disequilibrium syndrome in hemodialysis any clinical experience 1 day ago

Ocular disequilibrium syndrome occurs in patients with glaucoma as the dyssynchronous osmotic changes of dialysis treatment lead to uncompensated a...

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RE: 25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

THANKS ------------------------------ Farnaz Mohammadi MD Lima Memorial Hospital Lima OH (617) 510-5791 ------------------------------

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RE: 25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

62 year old female , DKD , 6 grams proteinuria , on ARB After 3 years eGFR ( Jan 2026- though image is a year old) holding stable at 21-22 ml/mi...

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RE: renal limited microangiopathy 1 day ago

While we refer to diseases of the " Alternate pathway" such as TMA , Anca Vasculitis , IgA - it is important that the trigger for these diseases is...

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RE: Proteinuric Patient With Normal Blood Pressure 1 day ago

Before he passed away Dr. George Bakris came to lecture us in Abu Dhabi. Interesting comment he mentioned was that ARB and Spironolactone- have a...

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25 y/o with type 1 dm with 12 gm proteinuria 1 day ago

Patient is 25 y/o black female with Type 1 DM and biopsy proven DM nephropathy, serum creatinine 2.5,mg/dL , eGFR 32 ml/min, has 12 gm of proteinur...

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RE: Anti Gbm Case 1 day ago

This is the classic renal presentation (no lung) and I would eat my hat if he recovered any renal function, but aren't you kinda obligated to plex ...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 1 day ago

The discontinuation of MMF in the setting of post-transplant neoplasia (PTLS, skin cancer, others such as colon cancer) is the suggested approach. ...

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Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 1 day ago

Dear Panel, 35y old male LNR Renal Tx 2003 - on CyA 75mg BD/ MMF 500mg BD / Prednisone 5mg OD. ESRF due to congenital Reflux disease Th...

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RE: Anti Gbm Case 1 day ago

Had a similar patient with 100% cellular crescents and 30 % IFTA . he had dual antibody positive , anti GBM and pANCA. Though he had biopsy proven...

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RE: simultaneous liver kidney transplant 1 day ago

SCr of 2.1 mg most likely from incoomplete recovery of ATN. Need to exclude technical problems with Doppler ultrasound. Repeat serum oxalate level?...

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RE: Anti Gbm Case 1 day ago

Cigarette smoker? Exposure to hydrocarbons? Prodromal respiratory infection symptoms? If these risk factors for pulmonary hemorrhage (PH) are absen...

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RE: lupus membranous nephropathy treatment 1 day ago

i do not see any value in monitoring CD 19 levels with OBI if you plan to use a fixed dose ,fixed interval regimen. The onlyvbantigens in Class V L...

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RE: Anti Gbm Case 1 day ago

Judgement call. Very low probability of recovery with therapy, , but not zero and still at risk for DAH. How much IFTA and fibrous crescents.? How ...

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RE: lupus membranous nephropathy treatment 1 day ago

Cd19 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Anti Gbm Case 1 day ago

20 year old anti gbm positive only . Creatinine 20 at presentation . Kidney biopsy linear ig g with 100 cellular crescent . Oligoanuria no pH Wou...

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RE: lupus membranous nephropathy treatment 1 day ago

Prof glassock can we check c19 counts in this context and dose obi for 18 -24 month then watch with protieinuria/ albumin Is there any antigen th...

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RE: simultaneous liver kidney transplant 1 day ago

Respected faculty further to our SLKT pt. POD 11- LFT. S creat stuck at 2.1 mg% UO about 2.5 lit daily graft biopsy- No evidence of rejection ,...

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RE: ocular disequilibrium syndrome in hemodialysis any clinical experience 2 days ago

ocular dysequilibrium syndrome, sounds awful. I think I would try an amp of D50 right when the symptoms begin and see if this helps, It should be...

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RE: Proteinuric Patient With Normal Blood Pressure 2 days ago

Thanks really helpful Kind regards prof rodby --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Proteinuric Patient With Normal Blood Pressure 2 days ago

My experience is that if a patient has renal disease (even proteinuria alone) that their BP does not typically drop with RAASi used to lower protei...

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Proteinuric Patient With Normal Blood Pressure 2 days ago

Would full dose of ACE and ARB cause low bp in young and middle aged patients ? What about elderly and frailer? Many thanks

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RE: anti gbm/mpo +ve in young female 2 days ago

Thanks everyone . Really helpful @ prof rodby mcv 74(78-100) Cxr normal . Hb stable after blood transfusion . Would you do CT chest or CT TAP. Not...

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RE: ocular disequilibrium syndrome in hemodialysis any clinical experience 2 days ago

If memory serves me well, Iremsmberca few patients who developed ocular pain and reduced vusion (ocular crusis) during standard hemodialysis. All o...

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