RE: Case of intermittent Hyokalaemia with preserved kidney function 2 hours ago

I was implying that the HTN was obesity related, and that the K may not be part of a syndrome since it is often normal or so I interpreted the orig...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 hours ago

I do not have personal experience but I attach an article using infliximab. This reminds me of steroid unresponsive sarcoidosis where infliximab ca...

View Discussion

Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 4 hours ago

I would appreciate input from colleagues regarding a challenging case. A patient with advanced right RCC and suspected left supraclavicular nodal...

View Discussion

RE: treatment of C3GN after developing meningococcal infection with iptacopan 6 hours ago

Addendum- according to the ACIP- only Penucillin V , Ciprofloxacin, Rifampin are recommended for meningococcalprophylaxis. Amoxicillin is not recom...

View Discussion

RE: treatment of C3GN after developing meningococcal infection with iptacopan 7 hours ago

Extremely complex case and a classic "between a rock and a hard place " situationist.. evidence based advice is impossible. . I know of no data on ...

View Discussion

RE: nocturnal polyuria 14 hours ago

@Prem Chandran: I agree with you that the initial non-albumin dominant tubular proteinuria in a primary TI disorder can become albumin-dominant eve...

View Discussion

RE: nocturnal polyuria 16 hours ago

Thank you Dr Venkat: I follow you well. In tubulopathies, there is often glomerular sclerosis & altered glomerular permeability, especially in the ...

View Discussion

RE: nocturnal polyuria 16 hours ago

I fully agree. For completeness sake, let's add the diagnostic role of urinary retinol binding protein (molecular weight = 21.2 kDa) which has been...

View Discussion

RE: nocturnal polyuria 16 hours ago

@Prem Chandran, the following two statements are from Google AI: 1. "In a healthy kidney, the glomerular filtration barrier is highly restrictive t...

View Discussion

RE: nocturnal polyuria 17 hours ago

TOO cumbersome. I would stick to the UPCR where a normal ratio in a recumbent position (less than 0.2mg/mg creatinine) with a high ratio in samples...

View Discussion

RE: nocturnal polyuria 17 hours ago

Never mind. I found it. Selectivity as a clue to diagnosis of postural proteinuria F J Frey et al. Lancet. 1979. Now I need to read it and e...

View Discussion

RE: nocturnal polyuria 17 hours ago

Thank you for the clarification. Dr. Rodby's post was quite clear and it is followed by many seeking a quick and simple method of differentiating g...

View Discussion

RE: nocturnal polyuria 17 hours ago

Dr Venkat: Respectfully, with regard to your sentence:'In contrast, in UAlb/Cr vs UPr/Cr ratio on same sample of urine, one is looking at relative ...

View Discussion

RE: nocturnal polyuria 18 hours ago

Mario: With respect, thank you for the history lesson!. I never interacted with Dr Stuart Cameron. I did not do my fellowship in the sixties. Mine ...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 18 hours ago

Thanks prof Glassock . How do interprets above ? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 18 hours ago

Same time urine collected and analysed Potassium creatinine ratio o calculate is 7.36 implies k wasting with low serum k But this case k normal -...

View Discussion

RE: nocturnal polyuria 18 hours ago

@Prem Chandran, my understanding is as follows: In the now largely abandoned Cameron or Selectivity Index, concentration of a large molecular weigh...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 19 hours ago

It is not clear to me that the urine electrolytes were measured on the same sample as the urine creatinine. If the urine creatinine was measured in...

View Discussion

RE: nocturnal polyuria 19 hours ago

@Prem Chandran Dr. Chandran, talking about clarification, what are you referring to when you mentioned selective vs. non-selective proteinuria? A...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 20 hours ago

@ prof rodby thanks why does obesity cause low k? Would you scan renal artery for normal home bp? Appreciate your help -------------------------...

View Discussion

RE: nocturnal polyuria 20 hours ago

Roger: I appreciate the discussion; I follow & agree with you. The qstn I was asking was slightly different (as I still see it). The 'gap' between ...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 20 hours ago

Thanks Blood pressure at home normal Bicarbonate normal ECG not done Aldosterone normal Spot urine : Urine na and urine k very high in urine a...

View Discussion

RE: nocturnal polyuria 21 hours ago

With an eGFR of 57ml/min/1.73m2 and CKD 3A, a3 I would not be surprised if her response to exogenous AVP would be impaired. My guess is that when f...

View Discussion

RE: nocturnal polyuria 22 hours ago

"urine microalbumin/cr" ratio is the same as an urine ACR "albumin creatinine ratio" you just need to make sure you understand the units, typically...

View Discussion

RE: nocturnal polyuria 22 hours ago

Dr Venkat: A clarification (if I may): U.microalb/Cr ratio or U.alb/Cr ratio v. U.protein/Cr ratio as I understood is a helpful tool to differentia...

View Discussion

RE: nocturnal polyuria 1 day ago

2 Liters of urine a day doenst really qualifies her for polyuria, unless she is small, but I do not deny she has a concentration defect based on sy...

View Discussion

RE: nocturnal polyuria 1 day ago

Thank you very much for your reply. The patient's current serum sodium concentration is 145 mmol/L ------------------------------ Zineb Taaam MD ...

View Discussion

RE: nocturnal polyuria 1 day ago

I assume that her SNa is normal and it is reassuring that her fluid intake is not high. Intranasal or oral desmopressin has been used in both men a...

View Discussion

treatment of C3GN after developing meningococcal infection with iptacopan 1 day ago

Greetings, I was hoping to get your expert opinion on a patient of mine: 22 year old female with C3 GN diagnosed on biopsy in 2019. Her complemen...

View Discussion

RE: nocturnal polyuria 1 day ago

Thank you very much for your response. The proteinuria is predominantly composed of albumin. Initially, she only had microalbuminuria, but it has ...

View Discussion

RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 1 day ago

Dr Saja pt only on MMF not in CNI --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH (513) 841-0222 ...

View Discussion

RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 1 day ago

I can see she had Chronic allograft dysfunction since 2023, with almost the same GFR trend, which I don't think is related to the recurrence of IgA...

View Discussion

RE: SLE and HUS 1 day ago

There is no TMA and no reason to consider Complement inhibition. I have no experience treating monogenic LN- until now, I have never seen a case. I...

View Discussion

RE: SLE and HUS 1 day ago

Thank you for your emailYes prof i would agree with you may be too late to decide about trying very costly therapy with this recent biopsy But woul...

View Discussion

RE: SLE and HUS 1 day ago

Thank all for your active and informative contribution Actullay i put this case for discussion based on few things dose not fit classical lupus ...

View Discussion

RE: SLE and HUS 1 day ago

This recent kidney biopsy (June 8, 2026) shows no evidence at all of a Chronic TMA - so the suggestion for Eculizumab therapy can no longer be just...

View Discussion

RE: SLE and HUS 1 day ago

------------------------------ Saja Mohammed MD, MBChB, MS Doctor SQUH Muscat ------------------------------ Files Attached DocumentRE: SLE a...

View Discussion

RE: SLE and HUS 1 day ago

She needs Eculizumab (or Iptacopan) now. I agree with Dr. Rodby. . I think it is reasonable to assume that the renal limited TMA is C-dependent. An...

View Discussion

RE: SLE and HUS 1 day ago

Dear prof RichardThank you for your emailI need to know from your experience such mutation in CFHR which is related to CFH and sometimes associated...

View Discussion

RE: SLE and HUS 1 day ago

The simplest explanation is that she may have had LN in the past but not now. The problem now is renal limited TMA -----------------------------...

View Discussion

RE: SLE and HUS 1 day ago

"The initial C3 level was 0.3, then 0.8, and 0.89 until 2021, then normal." Drs. Glassock and Rodby: How do you interpret the gradual normalizati...

View Discussion

RE: nocturnal polyuria 1 day ago

Since 24hr urine volume is only around 2.0 L with nocturnal polyuria, it may be informative to check urine specific gravity/Uosm of separate daytim...

View Discussion

RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

" if uncertainty exists, then do a transplant kidney biopsy"- AGREE! !!!!!!!! assuming no significant contraindication i.e. anticoagulants or bleed...

View Discussion

RE: nocturnal polyuria 1 day ago

The eGFR of 57ml/min/1.73m2 confirms substantial loss of kidney function. What is the patients Blood Pressure, Hemoglobin and serum uric acid, and ...

View Discussion

RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

Bottom line- if uncertainty exists, then do a transplant kidney biopsy . This case is a good example of the truths in this adage. --------------...

View Discussion

RE: nocturnal polyuria 1 day ago

Is the protenuria glomerular or tubular? Have you done UAlb/Cr and UPr/Cr on same sample of urine? Serum albumin level? -------------------------...

View Discussion

RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

Alemtuzumab was initially thought to be such a powerfull induction agent that tacrolimus monotherapy may suffice. However, subsequent experience ha...

View Discussion

nocturnal polyuria 1 day ago

Hello everyone, Thank you for the opportunity to present this case for discussion. a 22-year-old patient born to a non-consanguineous marriage, w...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 1 day ago

The "intermittent " hypokalemia appears real. I assume that the serum Mg is in mMol/L -is this correct. ? Did you ever measure a serum aldosterone ...

View Discussion

RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

The iBox is available as an online calculator (www.paristransplantgroup.org) and can be computed at any time post-transplant, typically at protocol...

View Discussion