RE: Recurrence of IgA - post transplant 5 hours ago

In regards to cost help may be on the way. Recently I did a survey, on a C5 blocker given every 8 weekly ( assuming Ravulizumab). The phase 3 data ...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 12 hours ago

Update - patient admitted to hospital with general deterioration. All Family members agreed to stop and for conservative care Best regards ------...

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RE: Hd Patient Running Out Of Access 14 hours ago

What would perforate ? Bw --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Recurrence of IgA - post transplant 14 hours ago

I'm curious to see how the felzartamab data stacks up. Also, my understanding is that atacicept has an ongoing trial which specifically includes re...

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RE: Recurrence of IgA - post transplant 15 hours ago

With all due respect for the Iptacopan advocates, I think that anti/CD38 MoAB is a better choice for recurrent IgAN in a kidney transplant. Just an...

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RE: Recurrence of IgA - post transplant 17 hours ago

Dr. Dastoor This is personal experience since data are lacking A patient with recurrent IgA + MVI (peritubular capillaritis C4d1) that failed ...

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RE: Recurrence of IgA - post transplant 19 hours ago

While the clinical trials for iptacopan approval in IgAN did not include any recIgAN post-transplant, there are certainly scattered case reports of...

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RE: Canine amyloidosis treatment options 21 hours ago

We don't have HIPAA in veterinary medicine, but the client did give me permission to share photos of PJ! We do see nephrotic edema in dogs and ca...

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RE: Dual Vascultis / Sle 22 hours ago

@ prof glassock appreciate your thought on question ? Kind regards --------------------------------- Muhammad Soobadar MBChB UK ----------------...

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RE: GFR measurement in AKI with stable serum creatinine 23 hours ago

Thank you Mario. Big Al is offspring 7 of 7 with degrees in engineering, He assisted with confirming the mathematics and graphs. John Pickering i...

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RE: Recurrence of IgA - post transplant 1 day ago

Thanks for your response 1. I agree , we do a tapering dose of steroids , but he is currently taking instructions from his transplant nephrologist...

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RE: Membranous Nephropathy 1 day ago

A measurement of anti-PLA2R antibody by the IFA method would be very helpful. the IFA is more sensitive than the ELISA so a negative result would c...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

I just responded that I do feel a biopsy is the gold standard, the HR CT scan may be helpfu. I would avoid bisphosphonates in this patient with the...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

In CKD one cannot use DEXA scans to differentiate osteopenia from Osteoprosus vex CKD-MB. A bone biopsy is the gold standard, A high resolution CT ...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

Her decreased bone density may not have been the direct result of adynamic bone disease. I do think she would benefit from a biopsy, however, as me...

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RE: Membranous Nephropathy 1 day ago

I no longer use the modified Ponticelli (too much steroids , in my opinion)I rely on Obinutuzumab monotherapy primarily and occasionally use a shor...

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RE: Membranous Nephropathy 1 day ago

Thanks for update . I guess kidney biopsy will tell you . Tissue plar2 , EDD nature features of inflammation on LM or just chronic damage What p...

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RE: Hd Patient Running Out Of Access 1 day ago

I suspect yes, the risk of perforation must be rare but I might as a radiation oncologist. anal cancer is pretty low and I would guess that the PD ...

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RE: GFR measurement in AKI with stable serum creatinine 1 day ago

Congratulations to you and your son(?) Dr. Mellas. Your paper underscores what Dr. Pickering published 14 years ago (see attached) and that most of...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

Thank you very much for your inputs. Is that reduced bone thickness is solely resultant of adynamic bone disease , the patient refused bone biopsy....

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RE: GFR measurement in AKI with stable serum creatinine 1 day ago

As a follow-up to an old post; Attached is a recently published article describing a modeled mathematical proof of concept that a four hour urine c...

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Hd Patient Running Out Of Access 1 day ago

Can we try pd in patient who has complex vascular and running of vascular access who had radiotherapy for anal squamous cell cancer Thanks

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RE: Dual Vascultis / Sle 1 day ago

And why is crithidia not helpful in this setting? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle 1 day ago

Do you biopsy then? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle 1 day ago

Anca mpo --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle 1 day ago

Blood culture negative , echo normal , complement Normal Not on hydralazine . Was dialysis dependent now eGFR 12 ----------------------------...

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RE: Membranous Nephropathy 1 day ago

INR 1/7/2026 2.4 2/18/2026 3.0 3/11/2026 1.6 3/25/2026 2.7 Follows with coumadin clinic and they check every 4 - 6 weeks if INR is stable...

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RE: Dual Vascultis / Sle 1 day ago

Complement (C3, C4) levels, rheumatoid factor, blood cultures, echocardiogram findings? ------------------------------ K.K. Venkat MD Troy MI (24...

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RE: Dual Vascultis / Sle 1 day ago

Was the ANCA an anti-MPO or anti-PR3 or both? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------...

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RE: Dual Vascultis / Sle 1 day ago

I don't think a Crithidia based antidsDNA will make much difference in therapy, regardless if the result.. Avacopan not indicated in dialysis depen...

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Dual Vascultis / Sle 1 day ago

82 female , good functional status , hx of weight loss and unresolving chest infection/cough and haemoptysis needing filter and High flow 02 in Cal...

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RE: Recurrence of IgA - post transplant 1 day ago

Dr. Dastoor/ as you know the optimal therapy for recurrent IgAN in a kidney transplant is highly uncertain due to the absence of any trials- a cour...

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RE: complex case of nephrotic syndrome in liver transplant patients 1 day ago

Thanks prof glassock really helpful Kind regards --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Recurrence of IgA - post transplant 1 day ago

Have a 60 year old gentleman , who underwent a living unrelated kidney transplant in the Phillipines approximately 8 years ago. Etiology of his r...

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RE: FSGS vs C3G and Canavan Disease 1 day ago

She has been steroid on pulse steroids and MMF for now Awaiting EM results Creatinine slightly elevated last 24 hours ( ??Trimethoprim contri...

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RE: Polyuria 1 day ago

Thanks Jaison. Better to do a cystoscopy then to rule out a chronic cystitis. In which case she will need further evaluation of the bladder with ur...

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RE: Dialyzer reaction 1 day ago

Good morning Dr. Shah. Thank you for sharing your experience. Nipro Cellentia sounds like a strong backup option for patients with dialyzer reactio...

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RE: Dialyzer reaction 1 day ago

Before dialysis, BUN was 79, serum sodium was 137. Thank you so much for your input! ------------------------------ Jinwook Park MD Assistant Pro...

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RE: Polyuria 1 day ago

I think, as Dr Rodby has noted, the lack of nocturia makes this more a 'habit' issue than a pathology. If there were a concentration defect, she wo...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

Thanks Dr. Sprague - after a deeper read and consultation with Open Evidence i agree with you concerning the lack of evidence demonstrating a clear...

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RE: Polyuria 2 days ago

Update: I had asked for an early morning urine sample testing the reports of which came today. The early morning first urine osmolality is 319 mosm...

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RE: Postural hypotension 2 days ago

Thanks Dr. Campese. I stopped fludrocortisone but did not stop midodrine. Serum Magnesium is normal. ------------------------------ Jaison George...

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RE: Postural hypotension 2 days ago

Did you stop midodrine? Did you measure serum Mg or, even better, erythrocyte Mg content? The patient is diabetic and has glycosuria. This leads fr...

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RE: Osteoporosis In Stage 5 Ckd 2 days ago

I again agree with Prof Glassock as I do not think there would be decreased chance of hypocalcemia, though not sure if it would be worse. The botto...

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RE: Postural hypotension 2 days ago

He feels better after stopping fludrocortisone and adding oral potassium supplements. His serum free light chain assay is normal (kappa 53.42, lamb...

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RE: Polyuria 2 days ago

Thank you Dr. Mellas. ------------------------------ Jaison George MD, MBBS Kollam, India ------------------------------

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RE: Canine amyloidosis treatment options 2 days ago

this is amazing! Can you post a picture of the 🐕? Mostly for fun since he responded to therapy? Does HIPPA apply to your veterinary patients...

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RE: Polyuria 2 days ago

The data is most consistent with mild, daily, and possibly excessive intake of water as evidenced by the pNa of 136 and U osm 146 suggesting an app...

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RE: Canine amyloidosis treatment options 2 days ago

Hi everyone, I just wanted to give an update on this dog for anyone who was interested. The dog has been receiving 4mg/m^2 of chlorambucil onc...

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RE: complex case of nephrotic syndrome in liver transplant patients 3 days ago

Hard question , because I can't factor in patient values or know whether UACR was trending downward ,But maybe 6 months. Your hypothesis of "l...

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