RE: Central diabetes insipidus with a nephrogenic component? 2 hours ago

The Fenske study suggests that hypertonic saline can help differentiate between polydipsia and central DI better than water deprivation alone when ...

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Low value care in nephrology 2 hours ago

I am working on a talk about low value care in nephrology; that is, things we do as routine in nephrology that have no proven value or that have be...

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RE: Central diabetes insipidus with a nephrogenic component? 3 hours ago

I would consider allowing his usual salt and protein intake to get insight into what has been going on at home The important thing now is to hold...

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RE: Central diabetes insipidus with a nephrogenic component? 4 hours ago

READY. I'M GOING TO BE ADMITTED TO TAKE THE WATER DEPRIVATION TEST AND REDO THE 24-HOUR COLLECTION. THIS WAY I CAN ALSO LIMIT SODIUM AND PROTEIN IN...

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RE: AAV 4 hours ago

I don't disagree with the "full court press" as suggested by Dr. Rodby, but we need to recognize that PLEX is associated with an increased risk of ...

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RE: Central diabetes insipidus with a nephrogenic component? 4 hours ago

Boy!!! This case had been very instructive for me. Read the post carefully. Be suspicious when data don't fit. Starting all over as suggested by Dr...

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RE: Clot/ Debris In Right Jugular Vein 4 hours ago

Although it could be a clot , it is difficult to tell based on this image alone. A clip would be helpful. The possibility is that the near-field ga...

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RE: Central diabetes insipidus with a nephrogenic component? 5 hours ago

ALL WERE COLLECTED FROM 24H URINE ------------------------------ Thaisa Valverde MD, MSc ARACAJU 557999911168 ------------------------------

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RE: AAV 5 hours ago

Thank you ------------------------------ Toni Sabbouh MD, FASN Philadelphia PA (703) 717-1666 ------------------------------

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RE: AAV 6 hours ago

Did he have sinus issues for long time before his presentation? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Professor of...

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RE: Central diabetes insipidus with a nephrogenic component? 7 hours ago

I assume all urine tests were done on spot urine samples and preferably to de done on 24 hour urine sample to have accurate assessment of osmolar l...

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RE: AAV 7 hours ago

I would use the attached (retrospective uncontrolled) regimen with rituximab and oral CYC. I have no problem with the plex, even if unproven, see a...

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RE: Central diabetes insipidus with a nephrogenic component? 7 hours ago

Agree 100% with @Sheldon Hirsch. These cases get murky and you have to start from scratch Off DDAVP for a day at least a day overnight wate...

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RE: Central diabetes insipidus with a nephrogenic component? 8 hours ago

IMO, a lot of the data presented here seems hard to interpret and/or inaccurate--for example, you can not have a sOsm of 247 with a Na of 144 as re...

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RE: Central diabetes insipidus with a nephrogenic component? 9 hours ago

Of course Dr. Mellas is correct . The serum Sodium and Posm are incompatible with each other. I chose the Posm, but thus was likely a biased choice...

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RE: AAV 10 hours ago

Thanks for your replies ------------------------------ Toni Sabbouh MD, FASN Philadelphia PA (703) 717-1666 ------------------------------

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RE: Central diabetes insipidus with a nephrogenic component? 10 hours ago

"The first examination of the patient without using the ddavp was urine osmolarity of 58 (urine volume of 19.6 liters), sodium 144, calcium 10.5, a...

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RE: Central diabetes insipidus with a nephrogenic component? 11 hours ago

The initial low Uism is compatible with both CDI or polydipsia . The initial low Posm is not compatible with CDI snd strongly suggests polydipsia ....

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RE: AAV 17 hours ago

The comparative efficacy and safety of CYC vs RTX regimens were not tested in the landmark RAVE trial which excluded patients with this level of Sc...

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RE: AAV 17 hours ago

RTX is the preferred agent in ant-PR3 AAV. Perhaps a combination of RTX and low dose, short term (8 weeks) of oral CYC might be useful. ---------...

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RE: AAV 19 hours ago

Only 1 dose of Ritux. No DAH, no Anti GBM. Yes bx pauci immune gn. Wouldn't cytoxan be a preferred agent with this degree of AKI? (I am also aware ...

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RE: AAV 20 hours ago

How many doses of RTX did he receive?. . I would probably restart RTX and add Avacopan with rapid steroid taper after finishing the IVMP Pukses. No...

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AAV 20 hours ago

A previously healthy 50 yo patient, presented end of December w AKI, creatinine 1.7 w GN features. Found to AAV c-ANCA + and elevated PR3 titers. W...

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RE: Central diabetes insipidus with a nephrogenic component? 22 hours ago

Certainly Sodium restriction along with preventing polydipsia (a very difficult task. I am much less sure about the need for Amiloride and/or thiaz...

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RE: Central diabetes insipidus with a nephrogenic component? 22 hours ago

In this case, would the treatment be amiloride hydrochlorothiazide and sodium and water restriction? ------------------------------ Thaisa Valver...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 22 hours ago

This thread still has some LIFE to it! thank you for ongoing discussion and input. Patient was not on any VEGF inhibitor therapy. He did receive RI...

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RE: Central diabetes insipidus with a nephrogenic component? 23 hours ago

According to published studies MRI imaging of the Pituitary (T1 imaging) is neither sensitive or specific for Central DI . I would disregard the MR...

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RE: Case For Thought 23 hours ago

Thanks really helpful --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Central diabetes insipidus with a nephrogenic component? 23 hours ago

A 'false positive " test, I presume. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------------...

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RE: Low Potassium 23 hours ago

Thanks so much Just to clarify last part 40/14 ( 40 mmol in 1 litre added to 14 litres ) total volume =15 litres Assuming concentration = amou...

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RE: Case For Thought 23 hours ago

The lower age limit for live kidney donor is age 18 years. There is no upper age limit, so long as the donor is healthy and willing to donate free ...

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RE: Central diabetes insipidus with a nephrogenic component? 23 hours ago

In this case, how can we explain the finding on MRI? ------------------------------ Thaisa Valverde MD, MSc ARACAJU 557999911168 ----------------...

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RE: Correcting bicarb or PH? 1 day ago

Can't agree anymore. Even without stroke, giving bicarb or bicitra to patient with respiratory alkalosis has detrimental effects and it is the PH, ...

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RE: Case For Thought 1 day ago

Thanks so much Any cut off age in young donors and age cut off in USA for older donors assuming normal kf , blah Urine sediment and relatively Goo...

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RE: Correcting bicarb or PH? 1 day ago

With normal kidney function the response to central nervous system driven hyperventilation is urinary excretion of HCO3. In ESRD this renal compens...

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RE: Central diabetes insipidus with a nephrogenic component? 1 day ago

The initial findings in this case are quite incompatible with a diagnosis of central DI but are compatible with a combined excessive water and solu...

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Correcting bicarb or PH? 1 day ago

I saw this 72-year-old female patient with ESRD on dialysis , respiratory failure post tracheostomy on mechanical ventilation developed acute ische...

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RE: Case For Thought 1 day ago

I fully agree with Dr. Venkat - donor selection is all about the balance of benefits and harms- to both the donor and the recipient. The Dr. Giving...

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RE: Case For Thought 1 day ago

A 60 year old live donor is fine, so long as the birth weight of the donor was not below 2.5 Kg. ------------------------------ Richard Glassock ...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

Todays Rush University Kidney Biopsy Conference described a case of MCD who developed dialysis dependent AKI superimposed on a severe steroid-resis...

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RE: Case For Thought 1 day ago

Regarding using an older donor: From recipient's point of view a younger donor kidney will be better as pointed out by Dr. Glassock. However, from ...

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RE: Case For Thought 1 day ago

Thanks . So to push this a bit further So a 60 year old dad fit and well no kidney disease normal kf is ok to donate to son who is 30 Years old say...

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RE: Applications Now Open for the 2025 Kidney TREKS Program! 1 day ago

Hi all, This is a reminder that applications for the 2025 Kidney TREKS program are due on Wednesday, January 22, 2025. Please visit the program w...

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RE: Applications Now Open for Kidney TREKS – A Week-Long Research Course and Longitudinal Mentorship Program 1 day ago

Hi all, This is a reminder that applications for the 2025 Kidney TREKS program are due on Wednesday, January 22, 2025. Please visit the program w...

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RE: Central diabetes insipidus with a nephrogenic component? 1 day ago

The first examination of the patient without using the ddavp was urine osmolarity of 58 (urine volume of 19.6 liters), sodium 144, calcium 10.5, an...

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RE: Case For Thought 1 day ago

Very old kidneys, especially from donors with low birth weight, may have a markedly low total nephron number and therefore lead to nephron under-do...

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RE: Global glomerulosclerosis vs. FSGS 1 day ago

Great comment Dr. Balan. CKDu, Balkan Nephropathy and the Hyaline arteriopathic form of Tyoe 2 Disbetic Nephropathy are excellent examples of "non-...

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RE: Case For Thought 1 day ago

Thanks everyone. It’s not reported as variant of undetermined significance . Can someone help with questions about age and donation as asked pleas...

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RE: Central diabetes insipidus with a nephrogenic component? 1 day ago

Agree with Dr Rodby that this may be a solute diuresis. But, using the U osm to estimate free water clearance requires an intake exceeding 3 L if t...

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RE: Immune complex GN in patient with untreated RA 1 day ago

Cr starting increasing in August ua in july with 4+ pro that apparently was not further investigated prior to that most recent UA was nov 22 p...

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