UF Rate Multiplier will replace "Dry Wt" in the near future 1 hour ago

UF Rate prelude Routine casual nephrologist dialysis visits over middle 2 weeks of December 2025 at LNDC - WIDC - SDC of WFU-BMC Dialysis Units; ...

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RE: Challenging FSGS 2 hours ago

Although it appeared that there rituximab was not effective , I would not be so sure as the time to remission for primary NS is QUITE variable. whe...

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RE: Proteinuria after kidney transplant 3 hours ago

Thank you for your valuable input. I appreciate your insights and will take them into consideration. ------------------------------ Emad Odeh MD,...

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RE: Challenging FSGS 4 hours ago

Challenging case! I think early tapering of TAC is associated with early relapse and secondary resistance. I agree for steroids and I try (just s...

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RE: Hypokalemia , what is happening! 9 hours ago

Impaired urinary concentrating capacity is incompatible with extremely high urine creatinine concentration . Something does not fit in the lab resu...

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RE: Challenging FSGS 15 hours ago

Given his age, we discussed genetic testing, but because of lack of insurance that was not done… ------------------------------ M. Samih, MD, ...

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RE: Challenging FSGS 15 hours ago

------------------------------ M. Samih, MD, FACP, FASN, FASDIN Cayuga Medical Center Ithaca, NY, 14850 ------------------------------ Files At...

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RE: Challenging FSGS 15 hours ago

No kidney biopsy report attached. Please post a de-identified kidney biopsy report, including EM of available . Please also add Family history of k...

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Challenging FSGS 17 hours ago

Happy new year fellow nephrologists… I need your help on this very challenging case I have a 25-year-old international (white-middle Eastern) ...

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RE: Hypokalemia , what is happening! 18 hours ago

interesting , hmm, would her ability to push that osm to maximal concentratation be impacted probably by her low osm load(intake), also by hypokale...

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RE: Hypokalemia , what is happening! 19 hours ago

But the UOSM was "only" 660, a long way from maximal concentration, suggested by the Very high spot urine creatinine. Something doesn't fit here! ...

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RE: Hypokalemia , what is happening! 20 hours ago

All very educational thank you ! those were spot samples a week or so apart , no 24 hour urine unfortunately, I am also assuming very concentrate...

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RE: Gap Acidosis 1 day ago

I thought I had submitted a note yesterday, but I don't see it here. Re Dr. Glassock's question – the vast majority of cases of 5-oxoproline induce...

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RE: Hypokalemia , what is happening! 1 day ago

Interesting but not a straightforward case. 1. We need at least a VBG to determine if we are dealing with metabolic alkalosis or a compensated res...

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RE: Concomitant use of Patiromer and Sod. Zirconium 1 day ago

I guess the colon is the new Nepron --------------------------------- Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephr...

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RE: Concomitant use of Patiromer and Sod. Zirconium 1 day ago

When multiple treatments and rightly so, have been employed to treat HyperK, its hard to know relative contribution of each in resolution of Hyper-...

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RE: Hypokalemia , what is happening! 1 day ago

With the chronic diarrhea, one could consider a villous adenoma as a cause of electrolyte depletion. And though most villous adenomas will lead to ...

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RE: Intradialytic hypertension 1 day ago

thank you for the comment BIC - is a new tool , that measures real time SVR, Cardiac output , Cardiac index , Thoracic Fluid Content (TFC) and a...

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RE: Concomitant use of Patiromer and Sod. Zirconium 1 day ago

the creatinine remained stable during diuresis his urine volume averaged around 1.5-1.7 liters per day for last 3 days I had asked for Urine ly...

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RE: Intradialytic hypertension 1 day ago

Dr Dastoor Happy you are making headway Why not ultrafilter those 300 grams of volume gain? It is equivalent to around 3 grams of table salt and ev...

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RE: Concomitant use of Patiromer and Sod. Zirconium 1 day ago

Dr. Dastoor: Was urine output increasing and SCr decreasing as serum potassium decreased? Since patient was being treated for decompensated CHF, in...

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RE: Hypokalemia , what is happening! 1 day ago

Looks like a resolving metabolic alkalosis due to emeries with hypovolemia and secondary hyperaldo. since she is an outpatient must consider the t...

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RE: Intradialytic hypertension 1 day ago

Further to my previous post , we repeated " BIC - Bioimpedence Cardiography " - on his next dialysis His interdialytic weight gain was 0.3 kg an...

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RE: Concomitant use of Patiromer and Sod. Zirconium 1 day ago

After this question was published , i was always waiting for an opportunity to use both drugs simultaneously . Recently we had a 70 year old p...

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RE: IgA nephropathy with nephrotic syndrome 1 day ago

Thecsame is true with anti-APRIL and anti-APRIL .BAFF- when the drugs are stopped proteinuria returns and eGFR declines. No currently available dru...

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RE: IgA nephropathy with nephrotic syndrome 1 day ago

Thanks prof glassock For colleagues reading this thread This case is NOT STANDARD Ig A nephropathy I was looking into the question “does MMF wor...

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RE: Hypokalemia , what is happening! 1 day ago

Chronic hypokalemia causes chloride loss- NKCC2 inhibition in loop of henle --------------------------------- Dr. Hormaz Dastoor. MD, FASN Nephrol...

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RE: Hypokalemia , what is happening! 1 day ago

The urine creatinine concentration seems quite high. Are you sure these are correct (in mg/dL) What is the 24 hour urine volume? ----------------...

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RE: Hypokalemia , what is happening! 1 day ago

Nice explanation! I didnt factor in the supplements into the mix. That fits nicely! Thank you ------------------------------ Marwan Abu Minshar M...

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RE: Hypokalemia , what is happening! 1 day ago

Seems a case extra renal losses of potassium with persistent alkalosis due to post hypokalemia alkalosis ( chronically hypokalemic ) the urine ch...

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Hypokalemia , what is happening! 1 day ago

The questions 1. is this renal potassium loss ? 2. how can I explain an elevated urine chloride in setting of a serum bicarb of 31 49 female ...

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RE: IgA nephropathy with nephrotic syndrome 1 day ago

Yes- I think this is a valid study. MMF monotherapy added to Standard of care can have real benefits, but this trial dies not help much in identify...

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RE: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 1 day ago

Thanks- I would stop the hydralazine., even though it is not the cause of the IgM deposition disease. It is just too risky. . You have done what yo...

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RE: Gap Acidosis 1 day ago

Do u know if the liter of bicarbonate was in D5w ? On possible scenario, if this is a ketoacidosis ( starvation ) that quickly resolved with the ...

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RE: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 1 day ago

Hydralazine was initiated only after admission for acute GN (presenting SBPs >200s); no known prior exposure. Home meds before presentation include...

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RE: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 1 day ago

C3 123 mg/dL, C4 17 mg/dL, RF < 13 IU ------------------------------ Lawrence Kwon MD Westchester Medical Center Valhalla, NY (845) 330-3541 ----...

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RE: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 1 day ago

Thank you very much for your quick response. C3/C4 normal, RF negative. Cryoglobulins pending. Hep B/C and paraprotein workup negative. I'll consul...

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RE: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 1 day ago

I see now that SSA and SSB are negative... hard to buy this SS related with this information I'd still do C3 C4 and RF. and clearly MPGN oth...

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RE: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 1 day ago

IgM dominant non-cryoglobulinemic MPGN has been reported as a possible drug induced disease - any history of Hydralazine use? Was the Polytypism of...

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RE: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 1 day ago

the MPGN pattern in a pt with SS is highly suggestive of mixed cryo and is often a SS related lymphoma related to chronic lymphocytic stimulation. ...

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RE: IgA nephropathy with nephrotic syndrome 1 day ago

Thanks prof glassock. Appreciate your input and learn from you . JAMA Netw Open. 2023 Feb 6;6(2):e2254054. doi: 10.1001/jamanetworkopen.2022.5405...

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RE: IgA nephropathy with nephrotic syndrome 2 days ago

In open label (placebo controlled) trials where the patient knows what drug is being given, subjective adverse events,( pain .nausea, headache, fat...

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RE: IgA nephropathy with nephrotic syndrome 2 days ago

Thanks prof glassock . I was curious to look into why Rituximab does not work in IgA ( standard IgA cases not like in this case ) I then came acro...

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RE: Gap Acidosis 2 days ago

She was not on SGLT2i. When bicarb dropped to 13 on Day4, it didn't make any sense to me and requested Betahydroxybutyrate, Osmolal gap, and trigly...

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Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) 2 days ago

Subject: Steroid taper in IgM-dominant immune complex GN (Sjögren's uncertain) Dear colleagues, I would appreciate input on steroid strategy in t...

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RE: Proteinuria after kidney transplant 2 days ago

Please see Shamseddin M et al 2011; 6:1786-1793 for a very well done study of the expected levels of proteinuria shortly following kidney transplan...

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RE: Proteinuria after kidney transplant 2 days ago

Thank you all for sharing your thoughtful insights. To address the points raised sequentially: There was indeed gross hematuria immediately af...

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RE: Gap Acidosis 2 days ago

Thanks Dr. Emmett. How many days of use is required for Paracetamol use to deplete glutathione? Could a diabetic kidney transplant recipient be pre...

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RE: IgA nephropathy with nephrotic syndrome 2 days ago

Dr. Soobadar- it is still debated wihether a diffuse podocytopathy in "IgAN" is the consequence of an uncommon variant IgAN ir merely the consequen...

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RE: Gap Acidosis 2 days ago

Well these chemistries have me stumped. I converted the units on day 5 to mg% for our USA members (like me) who may be challenged by IU s. Na 133/K...

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