RE: X linked Alport syndrome In Female 18 minutes ago

Dr. Campese is absolutely correct that the evidence concerning a long term beneficial effects of RAS inhibition in Alport Syndrome is not based on ...

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RE: MPGN/Lupus/DKD - biopsy. 1 hour ago

I would wager a bet that the proteinuria response is probably due to Foundational CKD therapy. Having said that only a repeat biopsy would conclusi...

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RE: MPGN/Lupus/DKD - biopsy. 5 hours ago

Apologies for delayed response. In terms of timeline: I first met her in Dec 2023 - already on max Perindopril, Dapa with Cr 111umol/L, Urine...

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RE: Role of Acthar in secondary FSGS 8 hours ago

Thank you Dr. Glassock and Dr. Rodby. Appreciate your valuable input. ------------------------------ Zakir Shaik MD MHA FACP Beaumont, TX 409-89...

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RE: Resistant hypertension 9 hours ago

Thank you all for suggestion. And healthy discussion. His bp is now maintaining 130 80 reducing oral antihypertensive, iv is off . We don't ha...

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RE: Role of Acthar in secondary FSGS 11 hours ago

You probably will have to ask the pathologist who reviewed the biopsy and ask for an evaluation of glomerular size. I know of no study , in humans,...

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RE: Role of Acthar in secondary FSGS 11 hours ago

Renal biopsy: RENASIGHT: Negative Referred to bariatric surgeon already. GLP1-A in my understanding very hard to get approved if pt is not a d...

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RE: Resistant hypertension 13 hours ago

SO THE RULE OF THIRDS APPLIES. IF EXTRAPOLATED TP DIALYSIS PATIENT, EDW IS WRONG 2/3 OF THE TIME ------------------------------ Anatole Besarab M...

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RE: Role of Acthar in secondary FSGS 13 hours ago

I think that is a good point, glomerulomegaiy as the tie breaker. ------------------------------ Roger Rodby MD, FASN Professor of Medicine R...

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RE: Role of Acthar in secondary FSGS 15 hours ago

If glomerulomegaly is present in the kidney biopsy and the Family History is negative for kidney disease I probably would not do genetic testing . ...

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RE: Resistant hypertension 15 hours ago

We did a study in new transplant patient when they had stable and good creat at 2 weeks we assumed the correct DW was with a good functioning ki...

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RE: X linked Alport syndrome In Female 16 hours ago

Thanks Still not clear why like any proteinuric condition ACEI/ ARBS are used to reduce hyperfiltration and proteinuria Why in Alport only ACEI me...

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RE: Resistant hypertension 18 hours ago

the statement that the most ardent supporters are " .mainly from those who are eager to sell it in my country" A true statement if ever I heard one...

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RE: Resistant hypertension 18 hours ago

What is the gold standard for total body volume Is it Watson volume again?. ------------------------------ Anatole Besarab MD ABesarab Consultin...

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RE: Resistant hypertension 18 hours ago

Thanks for the response. I would presume that at low levels or renal disease when there is no Significant accumulation of extracellular Na and W...

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RE: Resistant hypertension 18 hours ago

I agree. Thanks

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RE: Resistant hypertension 18 hours ago

I have also heard about this coming publication ...mainly from those who are eager to sell it in my country. I am afraid that even the most a...

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RE: The patient who keeps on giving 18 hours ago

------------------------------ Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephrology Consultant- SSMC,PureHealth LLC. A...

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RE: X linked Alport syndrome In Female 19 hours ago

The alleged benefits of ACEi and ARBs in Alport's syndrome are based primarily on animal studies. The evidence in humans is based on retrospective ...

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RE: Resistant hypertension 19 hours ago

In terms of the Calf bioimpedance I don't believe they validated their total body water results with other bio Impedance devices There are no d...

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RE: Resistant hypertension 19 hours ago

The study was in a primary care setting, so likely a very low incidence of CKD They are in the process of publishing the data and hopefully analyzi...

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RE: Resistant hypertension 19 hours ago

Not to keep going on the same subject, but I believe it is an important area of pathophysiology…when I eyeball the abstract you attached I see that...

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RE: Resistant hypertension 19 hours ago

Yes I do. Volume is the most important variable and we are terrible at estimating the ideal EDW for our patients. . Mu experience is that blood ...

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RE: Role of Acthar in secondary FSGS 19 hours ago

19 seems a bit young for ORG? Maybe get genetic testing looking for podocin mutation? Or is that silly given BMI of 40. UPToDate: Indi...

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RE: Resistant hypertension 20 hours ago

Michael, What was the renal function in this cohort of some 21,000 pts. The findings may apply to non CKD. With CKD of various degree or at stag...

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RE: The patient who keeps on giving 20 hours ago

Insurance in Abudhabi, is a mix of German and US systems . German in the sense that it is managed by German insurance professionals and the system ...

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RE: Resistant hypertension 20 hours ago

Dear Dr. Besarab, Are you saying that you agree with me that genesis of hypertension in advanced CKD is essentially volume retention and that sus...

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RE: Resistant hypertension 20 hours ago

NICAS is FDA approved and very well validated you can see the validation information and studies on their website https://www.ni-medical.com/ -...

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RE: Resistant hypertension 20 hours ago

In the studies about 1/3 of Patients are hyperdynamic and not just young people like believed by many See figure 1 Once high cardiac power/C...

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RE: Resistant hypertension 20 hours ago

The genesis of hypertension in the dialyzed patient is multifactorial and complex, but Scribner long ago emphasized the importance of hypervolemia....

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RE: The patient who keeps on giving 21 hours ago

Interesting case. Was pronase IF performed on the FFPE tissue to exclude masked deposits in this case? Should be considered in any case of C3 domin...

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RE: The patient who keeps on giving 21 hours ago

I keep seeing this statwment to often. It obviously appears in so many nations. "(fill in your favorite phrase) " Depending on his insurance , it w...

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RE: The patient who keeps on giving 21 hours ago

Given rapid response of SCr, proteinuria and C3 hypocomplementemia to steroids, should we consider possibility of an antibody to C3 complement-regu...

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RE: Resistant hypertension 22 hours ago

This is an interesting concept raised by Dr. Germain. I thought it was well accepted that chronic hypertension is always the result of sustained in...

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RE: X linked Alport syndrome In Female 22 hours ago

Based on weak evidence the general consensus is that ACEi (Ramipril, Enalapril) are preferred for therapy of Alport Syndrome -------------------...

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RE: Reclast And Recurrent AKI 23 hours ago

Great point - treating reduced BMD in advanced CKD with long acting bisphosphonates is not a good idea!!! ------------------------------ Richard...

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RE: X linked Alport syndrome In Female 23 hours ago

Thanks Dr Glassock GFR 110 creat is 0.8 Will post Genetic report Why UpToDate mention ACEI only not ARBS believe does not matter ---------------...

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RE: The patient who keeps on giving 1 day ago

We have requested genetic studies ... Depending on his insurance , it will either be done or not done . If we decide to use a complement blocker , ...

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RE: The patient who keeps on giving 1 day ago

I would definitely wait until you have the results if the DNAJB9 stain. Did you also due genetic studies to evaluate the very low CFH levels ----...

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RE: The patient who keeps on giving 1 day ago

Yes , I agree, even though we have requested Ravulizumab, this patient has C3G . He can qualify for C3 or Factor B blockers . His insurance will on...

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RE: The patient who keeps on giving 1 day ago

This certainly looks like C3GN. The results of thecDNAJB9 sating will be crucial, as Fibrillary deposits should not occur in C3GN e. If the DNAJB9 ...

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RE: X linked Alport syndrome In Female 1 day ago

She has Alport Syndrome of the heterozygous X-linked variety. Father very likely had hemizygous X-linked Alport Syndrome which cannot be transmitte...

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X linked Alport syndrome In Female 1 day ago

X linked Alport syndrome 26-year-old female nurse with history of microscopic Hematuria at least since 2015 and recently found to have 255 mg of pr...

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RE: Membranous Nephroapthy - Obi vs Rituximab 1 day ago

Interesting case. As noted above, PLA2R does seem to correlate with relapses. As the patient keeps to depopulate and induce remission with ritu...

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The patient who keeps on giving 1 day ago

60 year old male from the Sudan. CC: Lower limb edema . Referred to us with S.Cr : 250 umol/l and uPCR of 1.2 g/g Initial hospital labs revealed ...

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RE: Resistant hypertension 1 day ago

Thank you for this information, Michael. How available is impedance Cardiography? As you know, we can "estimate " total body water and then estimat...

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RE: Resistant hypertension 1 day ago

Though this is not well known, impedance Cardiography is very helpful In determining what class of medication will work the best Impedance cardio...

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RE: Reclast And Recurrent AKI 1 day ago

I also agree. The bigger issue here is treating pts with advanced CKD for osteoporosis. Just because they have a low BMD does not mean they have os...

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RE: Persistent Hyperkalemia with Normal Renal Function & Prior Bowel Resection 2 days 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 2 days 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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