RE: can loop diuretics causes hyponatremia 42 minutes ago

Furosemide impairs free water excretion during a water diuresis, this effect will increase the likelihood if developing hyponatremia free water con...

View Discussion

RE: can loop diuretics causes hyponatremia 1 hour ago

Agree wuth the comments. The lowest U osmolality I ever saw in a patient receiving furosemide or other loop blocker was about 180mOsm but patients ...

View Discussion

RE: can loop diuretics causes hyponatremia 1 hour ago

A good point, Dr. Rodby. While furosemide is known to lower urine osmolality, the extent of the decrease can vary. Some studies indicate a reductio...

View Discussion

RE: can loop diuretics causes hyponatremia 4 hours ago

The answer really depends on what the loops diuretic is being used for, for instance If I were to take a loop diuretic and lose enough Na, and I re...

View Discussion

RE: can loop diuretics causes hyponatremia 5 hours ago

Yes, furosemide can cause hyponatremia, and the underlying pathophysiology was discussed in Dr. Glassock's post. In brief, while loop diuretics pr...

View Discussion

RE: can loop diuretics causes hyponatremia 8 hours ago

hi, sometimes in these situations, hypertonic saline bolus (3% saline 100ml) can be helpful provided some sodium load to help with some blood pr...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 10 hours ago

"The pathomechanism of edema of CCBs will not be mitigated by any diuretics as it is distributional and not retentional." Comment; I concur with ...

View Discussion

RE: can loop diuretics causes hyponatremia 10 hours ago

I agree with Dr Glassock's very nice description. In general loop diuretics inhibit urine concentration, hence maintain H2O clearance and thiazides...

View Discussion

RE: can loop diuretics causes hyponatremia 20 hours ago

"can loop diuretics worsen hypo-natremia if used in . . . decompensated heart failure?" YES but; You need to stop Spironolactone You need to st...

View Discussion

RE: can loop diuretics causes hyponatremia 1 day ago

I agree with you. I have seen hyponatremia down to PNa < 128 mEq/L ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsd...

View Discussion

RE: can loop diuretics causes hyponatremia 1 day ago

My impression is that the uncommon development of hyponatremia with use of loop-acting diuretic is largely due to augmentation of thirst and consum...

View Discussion

can loop diuretics causes hyponatremia 1 day ago

greetings to all community members my question is can loop diuretics worsens hyponatremia if used in volume excess states specifically decompensa...

View Discussion

RE: Effect of Starvation/Malnutrition on Kidney Health 1 day ago

Thank you for the teference. Yes starvation tend to occur during periods of war, but it can happen during periods of peace, In the mid 1930's ov...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 1 day ago

The pathomechanism of edema of CCBs will not be mitigated by any diuretics as it is distributional and not retentional. Spironolactone by its anti...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 1 day ago

I did not know that Spironolactone was effective in drug-induced alopecia. Do you have a reference? ------------------------------ Richard Glasso...

View Discussion

RE: Effect of Starvation/Malnutrition on Kidney Health 1 day ago

It is historically important to remember that much of the pathophysiology and medical management of starvation and re-feeding were studied immediat...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 1 day ago

Can add spironolactone 100 mg if K ok for hair loss Should also help w edema --------------------------------- Shahzad Safdar MD Mt. Auburn Neph...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

Could use topical minoxidil to mitigate the hair loss. --------------------------------- Graham Abra Redwood City CA -----------------------------...

View Discussion

RE: Fibrillary GN 2 days ago

Because FGN can occasionally undergo a spontaneous remission , I am very skeptical of case reports claiming efficacy for any therapy, including ste...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

Agree to stop Nifedipine as it is the cause of pedal edema and increasing urinary albumin excretion. Pedal edema from DHP-CCBs can occur few days ...

View Discussion

RE: Fibrillary GN 2 days ago

Regarding the question of searching for secondary causes in DNAJB9-associated FGN, I think in most cases of glomerular diseases, we screened for au...

View Discussion

RE: Fibrillary GN 2 days ago

A case report of 2 cases with primary FGN showed great reduction of proteinuria and stabilization of kidney function with pulse MPD followed by ora...

View Discussion

RE: Fibrillary GN 2 days ago

Addendum- so far as I know Pegacetocoplan or Iptacopan have not been studies for efficacy and safety in FFN . I would not recommend their use in th...

View Discussion

RE: Fibrillary GN 2 days ago

In the broadest sense, all DNAJB9 deposition disease (FGN) is idiopathic. The use of the term "idiopathic" adds little to the description of DNAJB9...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

I'm very sorry for the confusion. I just realized that I had already stopped the nifedipine and replaced it with losartan about six months ago. Tha...

View Discussion

RE: Fibrillary GN 2 days ago

DNAJB9 deposition is seen in both "Primary and Secondary" FGN. The use of the terms Primary and Secondary in tge context of FGN are confusing and d...

View Discussion

RE: Fibrillary GN 2 days ago

Or it is present in both idiopathic and secondary FGN --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt -------------...

View Discussion

RE: Fibrillary GN 2 days ago

Isn’t DNAJB9 only found in primary fibrillary GN? So why do we look for secondary causes? --------------------------------- Alaa Nabih Abdalla nep...

View Discussion

RE: Fibrillary GN 2 days ago

No one really knows. Either would be OK in this case, if you want to use a maximally agressive therspy , with some attendant risks of AE. It is a j...

View Discussion

RE: Fibrillary GN 2 days ago

CD19 of zero mean that peripheral B cells have been adequately depleted but probably we need tissue B cells depletion so I suggest if you have acce...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

Thanks a lot as Dr Glassok said Nifedepine should be stopped and you should increase losartan to maximum tolerated dose . Very rare MMF induce...

View Discussion

RE: Fibrillary GN 2 days ago

Thanks very much much CD19 zero Immunoglobulin assay : IgG ,IgM IgA all were low So my question can l strat cyclophosphamide now or not ?? ...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

She's been on nifedipine for several years-could this side effect really present only now? I'll go ahead and stop it nonetheless. Also, any thought...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

Sorry, I forgot to mention-creatinine was 1.18 mg/dL, 24-hour creatinine clearance was 92 mL/min, and urinalysis showed 0–3 RBCs/HPF. -----------...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

The edema is due to Nifedipine - not MMF. It should be stopped. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 38...

View Discussion

RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

What happened to eGFR and hematuria?There are no FDA approved assays for gdIgA and the value of such monitoring in therapy if IgA remains unproven....

View Discussion

MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

Clinical Question: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 55-year-old woman with biopsy-confirmed IgA nephropathy (October 20...

View Discussion

RE: Effect of Starvation/Malnutrition on Kidney Health 3 days ago

During the winter of 1944–1945, the Nazi occupying forces imposed embargo on transport of food to the western Netherlands as a revenge for attacks ...

View Discussion

RE: Fibrillary GN 3 days ago

I agree fully with Dr. Rodby. If autoimmune, infections and cancer causes have been reasonably excluded , therapy of FGN is highly uncertain, but o...

View Discussion

RE: Fibrillary GN 3 days ago

It seems you have ruled out any secondary cases of Fib GN , cancer, paraprotein, hepatitis, I'm not sure everyone is always this diligent, well don...

View Discussion

RE: Effect of Starvation/Malnutrition on Kidney Health 3 days ago

Dr Soleimani, Thank you for your thoughtful comments on starvation and renal disease. I suspect you are correct that these multifaceted renal eff...

View Discussion

Fibrillary GN 3 days ago

Thanks our members community for helping us in difficult cases I need your help in this case A 52 year old female patient ,hypertensive 10 year...

View Discussion

RE: Effect of Starvation/Malnutrition on Kidney Health 3 days ago

A good article on the impact of malnutrition on the incidence of AKI. Xiang Xiang 1,✉, Xinchen Zhu 2, Lijuan Zhang 1 Int J Clin Pract. 2023...

View Discussion

RE: Kidney transplantation in a patient with monoclonal C3G Wednesday, July 30 @ 4:43 PM

The efficacy of CAR-T depends on continual presence of chimeric cells direct to abnormal clones of CD19 clonotyoe . The immunosuppression required ...

View Discussion

RE: FSGS with progressive worsening of renal function Wednesday, July 30 @ 2:36 PM

He did have PVR's of 500-700 per urology office , when they placed foley, the retention was not long enough to cause hydro. would not be able to at...

View Discussion

RE: FSGS with progressive worsening of renal function Wednesday, July 30 @ 2:33 PM

His cr already at 3.5 in may'25 when he was started on this short course of abx. subsequent assessment was 5.9 in Jun'25- when he was admitted -...

View Discussion

RE: Kidney transplantation in a patient with monoclonal C3G Wednesday, July 30 @ 1:40 PM

In addition to the points made by Dr Venkat, I would add that a disease like monoclonal C3GN will continue to fester with even a miniscule amount o...

View Discussion

RE: FSGS with progressive worsening of renal function Wednesday, July 30 @ 11:58 AM

Although there is history of BPH and PVR was 500 mL, there was no hydronephrosis and SCr did not improve with placement of a Foley catheter. Subseq...

View Discussion

Effect of Starvation/Malnutrition on Kidney Health Wednesday, July 30 @ 11:45 AM

The topic discussed in this post should not be viewed as a political issue. Instead, its purpose is to discuss this issue in the context of the Ame...

View Discussion

RE: Bartter's syndrome vs primary hyperaldosteronism Wednesday, July 30 @ 11:08 AM

Thank you for the reference. hCina has an advantage for these kind of studies since Health care and data are centralized in large data sets, so get...

View Discussion