RE: A Case Of GN In Hepatitis C Positive Patient 2 hours ago

I agree with Dr. Rodby. The HCV infection may be co-incidental rather than causal in this case of pauci -Immune necrotizing and crescentic GN. I wo...

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RE: A Case Of GN In Hepatitis C Positive Patient 3 hours ago

No signs of cirrhotic liver disease on CT, T.Bilirubin 1.0, AST and ALT less than 30 each Pt is active smoker , with occasional alcohol consumption...

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RE: A Case Of GN In Hepatitis C Positive Patient 4 hours ago

LFTs and does liver appear cirrhotic on CT? As already stated by Dr. Rodby, in HCV-related (usually cryoglobulinemic) RPGN, immunosuppression +/- P...

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RE: Transplant Question 6 hours ago

Thanks a lot Bw --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Binder 6 hours ago

Interesting discussion of a common problem, two tangential points: 1) P binders given optimally, that is, every time a patient eats, and pretty m...

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RE: Binder 7 hours ago

@Stuart Sprague I wonder if XPhozah might be a better way to go, more continuous PO4 absorption blockade. Diarrhea may be limiting. @Mario ...

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RE: Binder 9 hours ago

For pediatric patients on continuous feeds, CKD,, and need.for.lower.phosphoris intake, we have protocols and recipes for decanting the formula wit...

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RE: A Case Of GN In Hepatitis C Positive Patient 9 hours ago

I was expecting a hepatitis C related lesion (Cryo typically) but that is not supported by the pathology and I suspect this is AAV with pauci immun...

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A Case Of GN In Hepatitis C Positive Patient 10 hours ago

Dear colleagues I appreciate your input A 71 Y/o man active smoker with no significant PMHx, transferred to my care after recent hospitalization ...

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RE: Transplant Question 11 hours ago

Current data suggest that HIF-PHIs are generally well-tolerated in kidney transplant recipients. No significant increase in graft rejection rates h...

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Transplant Question 14 hours ago

1/ can we use HIF inhibitors in transplant patients 2/ can we use glp agonist in transplant patients Thanks

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RE: Double positive ANCA MPO and GBM rapid progressive renal failure 15 hours ago

We will make the biopsy soon. ------------------------------ Liliana Cunha Hospital Prof. Dr. Fernando Fonseca Amadora --------------------------...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 20 hours ago

No NSAID --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 51377736 ---------------------------------

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RE: Binder 20 hours ago

With continuous tube feeding regimens in dialysis patients , hyperphosphatemia seems to be less common, but if it occurs, then phosphate binders ne...

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RE: Binder 22 hours ago

You should be able to control P by choice of a liquid tube feeding that is nutritionally adequate but that is low in P content. I think that concom...

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RE: Binder 22 hours ago

Thank you for your response. I am wondering if the binders have any impact with continuous feed since it's not a big bolus of food. ------------...

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RE: AKI and low C3 22 hours ago

Low hepatic synthesis rate of C3/C4 is postulated to explain the mild decrease in serum levels of C3/C4 seen in patients with severe Chronic or acu...

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RE: Renal Function in 55 yo male 22 hours ago

Cimetidine use will not lead to an increase in urinary creatinine excretion rate, as seen in this case. ------------------------------ Richard G...

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RE: KDIGO 2024 CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF AAV 22 hours ago

It is never advisable to perform kidney transplantation when serum anti-GBM antiboies are still elevated. A delay in transplantation for at least 6...

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RE: Binder 22 hours ago

In patients with ESKD on dialysis salivary phosphate excretion is greatly increases and when saliva is swallowed, this adds to the burden of phosph...

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RE: KDIGO 2024 CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF AAV 23 hours ago

“I would use dialysis requirement AND 100% crescents (zero normal glomeruli) AND oliguria AND absence of diffuse alveolar hemorrhage “- If patient...

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RE: Renal Function in 55 yo male 23 hours ago

Slight up and down fluctuation in SCr with normal cystatin C (assuming SCr and cystatin C were done simultaneously/were these two tests done at the...

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Binder 23 hours ago

Can phosphorus binders be effectively used with continuous tube feed? ------------------------------ Parvaneh Abtahi MD, FASN Nephrologist Readi...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

Is this patient on a NSAID? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: AKI and low C3 1 day ago

Patient with liver disease have low c3. Is there a reason for that ? Bw --------------------------------- Muhammad Soobadar MBChB UK ------------...

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RE: Double positive ANCA MPO and GBM rapid progressive renal failure 1 day ago

Dr. Cunha- you did not mention a kidney biopsy. Was one ever done? . In cases like this I am not sure how much a kidney biopsy really helps with tr...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

Agree, but if it's a male, those doses are likely to cause gynecomastia. For a male in this situation, I would go right to eplerenone at 50-100 mg,...

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RE: Double positive ANCA MPO and GBM rapid progressive renal failure 1 day ago

It is a bit unusual to see a an anti-GBM rebound after 14 PEX sessions, but I agree with Dr. rodby.. Don't give up. Ivwooukd taper steroids and sto...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

You have a lot of room to increase the aldactone From UpTODate "Spironolactone may be started at 100 mg daily and is often titrated, as needed,...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

20 yr,cr 130,ur 4,cl 90, k 2.5,HCO3 50,Na 130 Euvolemic He is on aldctone 25 mg of,Sando K 2 tab td BP 110/70 This patient has repeated admission...

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RE: Double positive ANCA MPO and GBM rapid progressive renal failure 1 day ago

Double positive has a better renal prognosis, but that may be because the vasculitis component may make the disease show up earlier. It also has...

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Double positive ANCA MPO and GBM rapid progressive renal failure 1 day ago

Hello, I really appreciate your help with this case. This is a 62 years old female patient with previous hipertension. she was admitted with...

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RE: Renal Function in 55 yo male 1 day ago

One other test you can do is maximal urinary concentrating ability after fluid withdrawal for 12 hours. If normal for age, TI Disease is unlikely. ...

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RE: Renal Function in 55 yo male 1 day ago

I do not think that this patient has kidney disease. The calculated 24 hr. Creatinine excretion is very high (30m/kg/d) which may mean an over coll...

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RE: "prpphylactic pre op HD in a PCKD patoent with egfr 12-16 1 day ago

Roger is asking for opinions & therefore here's IMO: our renal group works with one of the largest cardiac practices in the midwest & we have 5 CT ...

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RE: Renal Function in 55 yo male 1 day ago

With a normal Cystatin C and urinalysis That should indicate no renal disease. But usually these patients are fairly muscular. Still, I am not c...

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Renal Function in 55 yo male 1 day ago

Good evening everyone, I have a 55-year-old Caucasian male. Roughly 6'2 tall. Weighs around 80+ kilograms. Otherwise well with no significant ...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

I am curious, have you tried K sparing diuretics? They should increase the K AND decrease the HCO3. ------------------------------ Roger Rodby M...

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RE: Whether to biopsy for MGRS evaluation here? 1 day ago

with a "Creatinine 1.6 today and been 1.4-1.6 since October, 2023" i find it hard to believe he does not have CKD. The Albumin to creatinine rat...

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RE: "prpphylactic pre op HD in a PCKD patoent with egfr 12-16 1 day ago

It is a very limited literature, not compelling but some CV surgeons hang their hat on improved CV outcome if HD is done before CV surgery in a pat...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

Agree with Dr. Mohamed that Acetazolamide may worsen hypokalemia in this patient. Acetazolamide was used for treatment of metabolic alkalosis and r...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

The problem with Acetazolamide in this setting is worsening hypokalemia and further volume depletion. ------------------------------ M.N. Alhosa...

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RE: GN Case ( Anti-GBM With MAHA) 1 day ago

His SPEP /IF , UPEP and serum free light chain negative for monoclonal gamapathy. He had bone marrow biopsy at outside facility show no monoclonal ...

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RE: "prpphylactic pre op HD in a PCKD patoent with egfr 12-16 1 day ago

This issue has been extensively discussed on the Open Forum previously. The consensus is that prophylactic hemodialysis is not indicated in such a ...

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RE: GN Case ( Anti-GBM With MAHA) 1 day ago

Very strange case. I suppose that ANCA have been negative throughout the illness. Also no Diffuse Alveolar Hemorrhage ever documented The MAHA with...

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GN Case ( Anti-GBM With MAHA) 1 day ago

29-year-old male with history of - type 1 diabetes diagnosed at the age of 19 with a diabetic retinopathy - CKD baseline creatinine of 1.2 in Jan...

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"prpphylactic pre op HD in a PCKD patoent with egfr 12-16 1 day ago

I have a 48 y/o male with pckd and a gfr averaging around 15 who needs a mini mitral valve replacement surgery for mitral valve prolapse with regur...

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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago

Experience with Acetazolamide therapy for metabolic alkalosis in Bartter Syndrome is limited in adults. What are the long term benefits and risks? ...

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RE: Whether to biopsy for MGRS evaluation here? 2 days ago

Serum FLC is normal? What is the UPCR? With an eGFR of 47ml/min/1.73m2 and a normal UA and UACR he probably does not have CKD. - merely a reduced G...

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RE: Membranous nephropathy 2 days ago

If PLA2R Ab titter is still high, the assumption that Rituxan has failed and the explanation is the development of anti-rituxan antibodies and this...

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