RE: another ANCA case 1 hour ago

If b cell deplete then either 2 cyclo with obi or just obi --------------------------------- Muhammad Soobadar MBChB UK -----------------------...

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RE: another ANCA case 1 hour ago

I would combine 2 pulses in cyclo with ritux with weaning ateroids Check cd19 counts Ensure crp coming down with steroids ( if not concurrent se...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 hours ago

The absence of EM is unfortunate. But unless you feel very strongly about having EM confirmation of a diffuse Podocytopathy, I would treate empiric...

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RE: Puzzling Case of Post-Transplant Proteinuria 5 hours ago

No, she is not on ARB, ACE-I, SGLT2-I or other anti-proteinuric measures. ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 --...

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unexplained rhabdomyolysis 6 hours ago

I saw a 42 year old gentleman , who is an ex- army vet . He had been on several rotations in Yemen in 2014/2015 ( exposure to metals/ chemicals /...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 7 hours ago

How sudden/abrupt/explosive was the onset of nephrotic edema? How much weight gain over what period of time? The more abrupt the onset, a podocytop...

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RE: Puzzling Case of Post-Transplant Proteinuria 8 hours ago

given stable serum creatinine and normal albumin- forgive me if I missed this but is treatment with ARB,SGLT2 being used and if so any decrease in ...

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CLOSING TODAY! - Nephrology Quiz and Questionnaire 8 hours ago

Calling all nephrology fellows and program directors-we need your help with the Nephrology Quiz and Questionnaire. Take the quiz today! Each year...

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CLOSING TODAY! - Nephrology Quiz and Questionnaire 8 hours ago

Reminder: The Nephrology Quiz and Questionnaire closes TODAY! Calling all nephrology fellows and program directors-we need your help with the Neph...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 9 hours ago

As per prior post CNI dose not related to post- Tx TMA - can increase TAC to appropriate trough levels IMO ------------------------------ [Mark...

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Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 15 hours ago

Dear seniors, I want to discuss a case of 64 years old male, treated case of HCV(SVR achieved, currently PCR negative), no other known co-morbs pr...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 22 hours ago

Happy to note your patient's recovery. We have had experience restarting CNI after recovery from post-transplant TMA. without problem. Admittedly, ...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 23 hours ago

Dear Colleagues, A brief two-week update, with latest results from September 17: creatinine improved to 0.58 mg/dL, platelets recovered to 300,00...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 23 hours ago

Dear Colleagues, A brief two-week update, with latest results from September 17: creatinine improved to 0.58 mg/dL, platelets recovered to 300,00...

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RE: proteinuria ? cause 1 day ago

Thanks for the prompt replyFirst kidney biopsy from right was inadequate sampleSecond biopsy from left and is hydronephrotic .stent was removed few...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

There are multiple urine tests over the past several months consistently showing very high UAlb/Cr and UPr/Cr ratios. Urine protein electrophoresis...

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RE: proteinuria ? cause 1 day ago

Was the biopsy of the left or right kidney.? Any hematuria or acanthocyturia by urinalysis (red cell casts in tubules) ? Any family history of kidn...

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proteinuria ? cause 1 day ago

77 years old female with history of chronic hydronephrosis on the left. Cystoscopy and stents ×3. Noted to have scarring of the ureter in May 2025....

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

Renin is not suppressed in Obesity related hyperaldosteronism 10.1093/ckj/sfaf218 Regardless treatment is medical IMO -----------------------...

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RE: Resistant Rejection 1 day ago

Good morning Interesting case. Given the lack of response to steroids and thymoglobulin, I would question whether the persistent inflammation re...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

if urine is non-milky and confident patient provided urine with normal TG level then Chyluria very unlikely. would get urine electrophoresis again ...

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RE: Resistant Rejection 1 day ago

DSA?- positive or negative is necessary to classify this mixed rejection t-cell + ABMR -which has important implications for prognosis and addition...

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Resistant Rejection 1 day ago

Clinical History A 37-year-old woman with a history of systemic lupus erythematosus (SLE), diagnosed in 2009, has a significant obstetric history ...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

According to Claude, a normal TG level in a single urine specimen does not rule out Chyluria. He recommends an oral fat challenge test, similar to ...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

Could this be a lab error? Unlikely, I admit. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medic...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

What is serum creatinine? were 24 hr urine albumin and protein and creatinine done? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

My AI search was from Claude and it gave different results than yours, this ocurrs fairly commonly, in my experience. It matters how you ask the qu...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

Dr. Glassock: My AI search was done using Google Gemini. Unfortunately, the outside pathology lab which reported on the 2 kidney biopsies, did not ...

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RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 1 day ago

Just spironolactone at discharge to try to counteract the mineralocorticoid effects. The confirmatory tests (urine cortisol) resulted only recently...

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RE: PGNMID case -Request help 1 day ago

If this is IgG 3 kappa + IC-MPGN then there is a 70% chance that this is a monotypic PGN and a10% chance that this is a monoclonal PGN- withe 20% u...

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RE: PGNMID case -Request help 1 day ago

Hi Dr Glassock, thank you for the response and the article. IgG subtyping was sent out to UCLA or Cedars path and showed staining for IgG3 heavy ch...

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RE: PGNMID case -Request help 1 day ago

Do you have IgG3 subclass staining? IgG subclass staining is positive for IgG3 only, this is likely to be monotypic PGN,with no monoclonal IgG pres...

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PGNMID case -Request help 2 days ago

Hello I would like to request help from our experts with this case. 41-year-old Caucasian female who presented in June 2023 with AKI and severe nep...

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RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 2 days ago

Thanks for the FU. What therapy did you choose for presumed ectopic ACTH syndrome? ------------------------------ Richard Glassock MD, FASN Eme...

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RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 2 days ago

I wanted to give an update on her 24 hr urine cortisol (this pt with new lung cancer, metabolic alkalosis and hypokalemia) The 24 hr urine cortis...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

I agree with Dr. Rodby's suggestion to "call it a day" and treat this patient medically as a case of "presumed" PHA without any further testing.. ...

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RE: Puzzling Case of Post-Transplant Proteinuria 2 days ago

"Mild" GBM thickening in the second kidney biopsy, can we have some morphometric GBM thickness in the first and secondtransplant. biopsies. Also do...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

This is the problem with diagnosiy PHA, it always seems complicated by meds, overlapping non consistsnt renin Aldo levels. Adrenal vein sampling is...

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RE: Puzzling Case of Post-Transplant Proteinuria 2 days ago

Dr,. Venkat - Which AI did you use for your search? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

Dr. Anand- thanks for posting the PodCast - I guess I will have to disagree. In my opinion , the Use of RASI , Beta Blocker and MRA can make it ver...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

In patients with suspected primary aldosteronism it is difficult to withhold bp meds esp in cases like mine where the BP was very high. @Richard...

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RE: Puzzling Case of Post-Transplant Proteinuria 2 days ago

Was transplant RAS ruled out? --------------------------------- Oded Friedman ---------------------------------

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RE: Puzzling Case of Post-Transplant Proteinuria 2 days ago

Thanks Dr. Glassock Did an AI search: As you had mentioned, it said that heavy glomerular proteinuria without podocyte effacement can occur in the ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 3 days ago

not an expert on this, not sure, defer to others can say this: agree with Dr Glassock, not sure we can trust the renin and aldo levels here, give...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 3 days ago

wouldn't renin levels be normal or elevated? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Direct...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 3 days ago

In my practice I typically measure CrCl in an ICU patient with AKI where the urine output can be reasonably measured. I ask the ICU nurse to accura...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 3 days ago

"With dialysis the SCr falls as does the urine Cr excretion so that the ratio of U x V / S Cr remains rather constant and equal to actual ClCr." ...

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RE: Puzzling Case of Post-Transplant Proteinuria 3 days ago

Dr- Venkat- very unusual case. The lack of a correlation between albuminuria and podocyte FP effacement is well described in the literature. Serum ...

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Puzzling Case of Post-Transplant Proteinuria 3 days ago

I wish to obtain the impressions/recommendations of Forum participants regarding the following patient: Question: How to explain very heavy albumi...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 3 days ago

It is fortuitous that ClCr is rather accurate using the standard method of ClCr in AKI or to measure residual kidney function in a patient on dialy...

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