RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 39 minutes ago

Serum and urine IEP/IF and serum kappa:lambda light chain level results before stem-cell transplant and at present? Bone marrow findings prior to ...

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RE: Elective Initiation of Hemodialysis in Pregnancy with Advanced CKD 43 minutes ago

I agree with Dr. Rodby. In my opinion, she should initiate dialysis to optimize fetal outcomes and targeting mid week BUN [More]

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RE: Hypercalcemia in ESRD 2 hours ago

I agree with most of the comments and it is most likely immobilization. Will be nice to see the 1,25 D level when it is available. I would also pre...

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RE: Salmonella Sepsis and C3 GN???? 2 hours ago

Salmonella infection has been associated with glomerulonephritis with C3 deposition, to be rare. The association manifests as post-infectious glome...

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RE: Salmonella Sepsis and C3 GN???? 2 hours ago

Apologies I meant to say there was no evidence of TMa in the initial post ... No schistocytes, normal haptoglobin, mild rise in LDH only. Will aw...

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Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 hours ago

64-year-old female, has a history of AL amyloidosis diagnosed in November 2022 when presented with nephrotic range proteinuria, normal renal functi...

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Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 3 hours ago

39 year old male healhtcare worker, BMI 36, history of stone in father, on routine labs was found to have a PTH of 142 pg/ml, Ca at that time 2.5 m...

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RE: Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 3 hours ago

Great recommendation Dr. @Richard Glassock, Prof. LeCun certainly brings interesting perspectives and serves as a much-needed, nuanced voice in the...

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RE: Elective Initiation of Hemodialysis in Pregnancy with Advanced CKD 4 hours ago

To be frank, a bit of this decision depends on just how badly the mother wants the baby to get through this. That is very personal, and may (or may...

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RE: Renal Dysfunction in a Diabetic Patient 4 hours ago

A 74 year old diabetic woman with a creatinine of 1.54 will never have a normal GFR despite what you call it, yes she has CKD. (I suppose this is A...

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RE: Salmonella Sepsis and C3 GN???? 4 hours ago

initially you said "His Blood film and tests showed evidence of a TMA process" then you said | "In regards to his hematological question, the...

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RE: Salmonella Sepsis and C3 GN???? 4 hours ago

His urinalysis shower RBC ++ urine PCR was 0.41 We do not have any previous labs I was expecting C4 , as IRGN is a disease if classic pathway ac...

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RE: Renal Dysfunction in a Diabetic Patient 5 hours ago

"This raises an important question: How can a patient with an eGFR of 46 mL/min/1.73 m² have no apparent signs or symptoms of CKD? " The answer i...

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RE: Salmonella Sepsis and C3 GN???? 5 hours ago

Dr. Dastoor, regarding the patient with Salmonella infection: Siince he arrived in the UAE just recently, I assume you don't have any past urinalys...

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RE: Salmonella Sepsis and C3 GN???? 5 hours ago

This posted case undoubtedly has IRGN (C3 GN due to Salmonella sepsis ) and should reciverc with anti-microbial therapy, what did the urinalysis sh...

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RE: Salmonella Sepsis and C3 GN???? 6 hours ago

That case , we had no detected clonal proliferation , including in bone marrow biopsy. Lamda staining was negative and IgG3 not done as lack of sta...

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RE: Salmonella Sepsis and C3 GN???? 6 hours ago

No comment on this case. But a couple of months ago you had an IgG predominant glomerulonephritis that may have been kappa light chain restricted. ...

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RE: Renal Dysfunction in a Diabetic Patient 7 hours ago

Assuming the urine is a representative sample of the whole day, U/P Cr 19.8/1.54 = ~13. (Big assumption) This is really dilute urine. If urine outp...

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RE: Elective Initiation of Hemodialysis in Pregnancy with Advanced CKD 7 hours ago

Dialysis in pregnancy doesn't follow your regular indications. Most studies have shown worse fetal outcomes with high Bun, even > 35 mg/dl ------...

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Salmonella Sepsis and C3 GN???? 8 hours ago

Just saw a young 24 year old labourer , who recently arrived from Pakistan. He was admitted with severe diarrhea and AKI - requiring 2 sessions ...

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RE: Hypercalcemia in ESRD 8 hours ago

The 1,25 OH Vitamin D is a send out test and will take a few days to get the result . If it is high , we could assume it is Aspergillosis ?? Just...

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RE: Hypercalcemia in ESRD 8 hours ago

Interesting. Not an uncommon event in transplant recipients but, aspergillus as a cause, is not common. See the included references: Ali MY, Gopa...

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RE: Hypercalcemia in ESRD 9 hours ago

I apologize but I did not see your earlier response (citrate associated hypocalcemia) and repeated the same thing. One of the drawbacks of using th...

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RE: Hypercalcemia in ESRD 9 hours ago

I was under the impression that the main reason for the hypocalcemia associated with PLEX was the concurrent use of citrate. --------------------...

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RE: Hypercalcemia in ESRD 9 hours ago

Interesting development. Do you have a result of the serum 1,25 Di - Hydroxy Vitamin D yet? ------------------------------ Richard Glassock MD, F...

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RE: Hypercalcemia in ESRD 9 hours ago

The BAL today tested positive for Aspergillus, which can cause granulomas and 1,25 Vitamin D excess. It may explain hypercalcemia in addition to im...

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RE: Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 10 hours ago

Please try to interview Yann Le Cun for one of the Podcastsx. Hearing his views on AI would provide a balanced examination of the good, the bad and...

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RE: Hypercalcemia in ESRD 10 hours ago

A formal study of the in vivo effects of infusion of 25% human serum albumin showed not effects at all of such infusuions on serum ionized calcium ...

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RE: Hypercalcemia in ESRD 11 hours ago

interesting thought Dr Dastoor But in regard to Patients who receive plasma exchange i was always taught that they develop hypocalcemia primarily ...

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RE: Hypercalcemia in ESRD 15 hours ago

In regards to the use of albumin , I was told , the following 1. Bottled albumin has no calcium bound to it , hence when infused , it will bing to...

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Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 18 hours ago

ASN has just launched a brand-new podcast series, Rewired: Navigating AI's Role in Kidney Health, hosted by Dr. @Navdeep Tangri and Dr. @Karandeep ...

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RE: Renal Dysfunction in a Diabetic Patient 23 hours ago

It looks like Mr. Franklin's quote is difficult to read. Let's try this version: " Tell me and I forget, teach me and I may remember, involve me ...

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RE: Renal Dysfunction in a Diabetic Patient 23 hours ago

Mr. Zada. Have you ever heard of Benjamin Franklin? One of his famous quotes is the following: Therefore, please read the article I shared wit...

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RE: Renal Dysfunction in a Diabetic Patient 23 hours ago

I agree with Dr. Rubin. Chronic kidney disease (CKD) in Diabetic (and other) patients can also be defined by a urine albumin excretion rate of 30mg...

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RE: Renal Dysfunction in a Diabetic Patient 23 hours ago

Thank you, dear Doctor, for your valuable answer and for sharing the reference. Yes, I reviewed and studied the definition, and according to estab...

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RE: Renal Dysfunction in a Diabetic Patient 23 hours ago

Mr. Zada. Have you had a chance to search the internet for the definition of CKD? This is what I found by performing a simple search: Chronic Kid...

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Renal Dysfunction in a Diabetic Patient 1 day ago

Dear Doctors and Colleagues, I'm a medical student, during my hospital shift, a 76-year-old female presented with a knee pain that was affecting ...

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RE: Hypercalcemia in ESRD 1 day ago

If the serum 1,25 dihydroxy Vitamin D level was 100pg/ml then the diagnosis would not be immobilization hypercalcemia ---------------------------...

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RE: Elective Initiation of Hemodialysis in Pregnancy with Advanced CKD 1 day ago

Initiation of dialysis decisions are made on basis of BUN level not eGFR . ------------------------------ Richard Glassock MD, FASN Laguna Woods ...

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RE: Hypercalcemia in ESRD 1 day ago

Thank you John for the extensive literature you have provided. Of note, the common denominator in all the reported cases you have included was rena...

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RE: Hypercalcemia in ESRD 1 day ago

Although there are lots of possibilities for 'unexplained hypercalcemia" (Olgaard NDT 1996), I suspect the explanation for this hypercalcemia is im...

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RE: Elective Initiation of Hemodialysis in Pregnancy with Advanced CKD 1 day ago

CKD -Epi creat + cystatin C but this has not been well validated against measured GFR in pregnancy. ------------------------------ Richard Glass...

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RE: Hypercalcemia in ESRD 1 day ago

Please see the attached article which underscores Dr. Rodby's statement. Also note the role of renal insufficiency. --------------------------...

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RE: Hypercalcemia in ESRD 1 day ago

I agree with Dr. Rubin, but when hypercalcemia and low iPTH emerge co-incident with hospitalization a medication induced cause (e.g Vitamin D analo...

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RE: Hypercalcemia in ESRD 1 day ago

The albumin use was suggested by my boss Dr. Steve Holt, who has extensive experience in Calcium disorders . I do not have a particular reference...

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RE: Fibrillary GN, unresponsive to rituximab 1 day ago

Yes. The four therapy strategies for FGN are : 1) High dose RTX 2) Obinutuzumab 3) ACTHAR gel 4) Combinations of RTX and CYC For FGN wi...

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RE: Hypercalcemia in ESRD 1 day ago

Yes, hypercalcemia can occur in immobilization in the absence of renal failure but is a rare event. Please see attached (including the original des...

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RE: Hypercalcemia in ESRD 1 day ago

Regarding denusomab in ESRD, prolonged hyPOcalcemia and been reported and has been discouraged inthis forum. I have no experience but I see a lot o...

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RE: Hypercalcemia in ESRD 1 day ago

Agree with Dr. Rubin that, for hospital-acquired hypercalcemia in a patient that has been hospitalized for 2 months, immobilization is the most lik...

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RE: Iptacopan in IgA - A very Impressive response 1 day ago

Dear Dr Dastoor, Thanks for your reply. ------------------------------ Syed Habib MD Edmonton AB (780) 492-3854 ------------------------------

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