RE: IVIG with Rituximab treatment 4 hours ago

I agree that the general felling (not evidence based) is that IVIgG is "helpful" in some cases of ANCA Vasculitis.- unfortunately we do not know wh...

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RE: IVIG with Rituximab treatment 9 hours ago

Just one thought: while I agree that IVIG administration based on IgG level may be unwarranted, IVIG has been regarded as therapeutically helpful i...

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RE: Electrolyte Issue 9 hours ago

Many thanks for the clarification. My understanding of the "alkaline tide" has just improved. I assume that patients with atrophic gastritis (and h...

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RE: Electrolyte Issue 11 hours ago

Just a small point, but the term alkaline tide refers to the normalphysiologic response after any meal, due to the stimulation of parietal cell pro...

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RE: PIGN with only proteinuria? 11 hours ago

Setting all STI biases aside, have you ruled out secondary syphilis? --------------------------------- Oded Friedman -----------------------------...

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RE: PIGN with only proteinuria? 12 hours ago

Thanks for posting the EM. This does not seem to be APSGN or Infection related GN, so C3GN in the differential diagnosis. The pattern of C3 and C4 ...

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RE: PIGN with only proteinuria? 12 hours ago

EM deposits certainly look "humpy". Very strange case. Clinical presentation certainly suggests MCD/FSGS/podocytopathy. Will be interesting to see ...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 13 hours ago

Hello! If you are interested serving as a fellow case report reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 13 hours ago

Hello! If you are interested serving as a reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ----------------...

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RE: PIGN with only proteinuria? 13 hours ago

attached is the EM. very curious. ------------------------------ Kenneth Brand MD West Hartford CT (860) 819-9001 ---------------------------...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 13 hours ago

Hello, i would like to volunteer as a reviewer for case reports. Please let me know further steps. Best regards, Arjun -------------...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 14 hours ago

I have done several case reports and here is my Google scholar page. I could be valuable resource for moderating case reports. https://schola...

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RE: Case discussion 19 hours ago

Thanks alot for ur valuable comments Yahoo Mail: Search, Organize, Conquer

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RE: Case discussion 19 hours ago

The main differential diagnoses are malaria (falciparum and/or vivax), G6PD deficiency and paroxysmal cold hemoglobinuria, in my Nephrological opin...

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RE: Case discussion 20 hours ago

Thanks . What are other down the list differentials ?? Yahoo Mail: Search, Organize, Conquer

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RE: Atypical case 20 hours ago

Linear monoclonal IgA deposits suggest anti-GBM Disease, but absence of crescents would be unusual. Serum anti-GBM antibodies by ELISA are often ne...

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RE: Case discussion 21 hours ago

Based on this classic presentation , this patient should be strongly suspected as having PNH. The diagnosis can be quickly affirmed by appropriate ...

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Case discussion 21 hours ago

17 years old male , hx of renal stones 8 years back, passed spontaneously in urine, no intervention required and no labs done at that timeNo other ...

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RE: Atypical case 1 day ago

Updated the case as requested. ------------------------------ Hasan Ozpolat MD University of Arizona College of Medicine Tucson AZ (206) 393-785...

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RE: PIGN with only proteinuria? 1 day ago

Infection related GN presenting as proteinuria only is uncommon. Could you post the de identified EM photos, so we can verify the nature of the "Hu...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 1 day ago

For reasons that remain poorly understood , DAH us strongly related to anti.Phospholipid antibody . I would agree with adding RTX (or OBI , if avai...

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PIGN with only proteinuria? 1 day ago

could turn out to be nothing special, but what i have here, folks is a 78-year-old white gentleman with sudden onset 8-10 grams of proteinuria an...

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RE: Atypical case 1 day ago

IgA with lambda restriction is not usual and does not mean a MGRS, but that is lambda not kappa. Linear IgG is not unusual with Diabetes and is f...

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RE: Atypical case 1 day ago

Didn’t see that coming. When will EM be available? What did pathologist conclude? LHCDD on background of DM/HTN changes? Did TBM also stain simi...

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RE: decline in kidney function linked with Graves disease 1 day ago

Hi thanks fascinating . If the hypothesis of gfr drop causing hypothyroid would be interesting to know kidney function in hyperthyroid pre and post...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 1 day ago

Thanks for the thoughtful feedback. Haptoglobin is very low, with C4 at 0.035 and C3 at 0.5 Regarding Ravulizumab, my thinking is that complement...

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Atypical case 1 day ago

A 58-year-old female with a history of diabetes mellitus type 2 with retinopathy, uncontrolled hypertension, chronic lymphedema, and systemic lupus...

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RE: Complex SLE Case with Diffuse Alveolar Hemorrhage 1 day ago

We had a somewhat similar patient last year, did not have alveolar hemorrhage but had a MAHA with thrombocytopenia, AKI, seizures We plexed h...

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Complex SLE Case with Diffuse Alveolar Hemorrhage 1 day ago

I'd really love to hear your thoughts regarding this complex case. A 30‐year‐old female with a recent diagnosis of SLE (diagnosed 2 weeks prior t...

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RE: decline in kidney function linked with Graves disease 1 day ago

"It has been my understanding that topiramate inhibits carbonic anhydrase and commonly causes a hyperchloremic acidosis and as a consequence a mode...

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Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 1 day ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2025. The reviewing/gradin...

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Encourage fellows to volunteer as case report reviewers for Kidney Week 2025! 1 day ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2025. The reviewing/gradin...

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RE: decline in kidney function linked with Graves disease 1 day ago

It has been my understanding that topiramate inhibits carbonic anhydrase and commonly causes a hyperchloremic acidosis and as a consequence a modes...

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RE: decline in kidney function linked with Graves disease 1 day ago

Yes Hypothyroid state can cause acute drop in the GFR-this is not reported enough and should be. I learnt this through my patient-see below. Would ...

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RE: FSGS 1 day ago

"RASI/SGLT2i are symptomatic and do not address the pathological mechanism." That is the usual thinking, that RASIs and SGLT2is are all about remn...

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RE: lupus nephropathy ? 1 day ago

The devil is in the details and I usually miss the devil, but for once this time no! I cannot tell you how many times I see a urea reported in mg...

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RE: Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 1 day ago

1) A baseline PNa of 131 is at essentially no risk for ODS from any increase of any kind 2) SGLT2i is a mild diuretic, and it is not an aquareti...

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RE: Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 1 day ago

I agree with Dr Glassock, no real indication. Re: the specific question, in the link/study cited, Na increased from 131 to 134, a very mild effect,...

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RE: lupus nephropathy ? 1 day ago

Sorry- i misinterpreted the initial Scr because if the atypical units used. This is not RPGN and is a very unusual course for Pauci Immune Crescent...

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RE: lupus nephropathy ? 1 day ago

Thank you for your response. The patient is currently receiving prednisone at 5 mg/day and mycophenolate mofetil (MMF) at 2 g/day. Renal function h...

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RE: Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 2 days ago

I don't think that this will make much difference, so either strategy is acceptable. My thought is that SGLT2i are not indicated in the first place...

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RE: Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 2 days ago

my question is, is it okay to check electrolyte package including sodium 2 to four weeks after starting Empagliflozin or sodium should be checked e...

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RE: Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 2 days ago

I do not think he is a good candidate for SGLT2i. Non-obese., UACR < 200mg/gm. Control BP with RASi +- Aldactone.. -----------------------------...

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RE: Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 2 days ago

BMI 24. Urine album to Creatinine ratio 118 today compared to 196 in February compared to 245 in December compared to 348 in October . He is alread...

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RE: Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 2 days ago

What is his UACR? Is he obese? I would not be in a big hurry to treat this miild hyponatremia, but RASi+ SGLT2i might be indicated fir his CKD. -...

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RE: decline in kidney function linked with Graves disease 2 days ago

What is the TSH value now? What is the serum bicarbonate level? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 38...

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RE: decline in kidney function linked with Graves disease 2 days ago

Calcium 2.40 (2.20-2.60 mmol/l) Phosphate 1.07( 0.8-1.50 mmol/l) Uric acid not tested but can check next time she is in clinic as well as bicarbona...

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RE: FSGS 2 days ago

I second genetic testing. RASI/SGLT2i are symptomatic and do not address the pathological mechanism. To drop from 5g to 0.3, could indicate that ...

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RE: lupus nephropathy ? 2 days ago

Dr. Taaam, please clarify: SCr: 9 mg/L -> SCr: 9.6 mg/L (after 6 months treatment) -> Serum creatinine: 150 µmol/L now, 10m after initial present...

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Serum sodium monitoring for starting Empagliflozin for SIADH related Hyponatremia 2 days ago

White gentleman age 75 with untreated sleep apnea and continued smoking, COPD, hypertension, chronic kidney disease G3 A, A2, peripheral arterial d...

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