is it SIADH 11 hours ago

Right PUJ obstruction presenting with ruptured pelvic system June 2024 - managed with nephrostomy - waiting list for robotic pyeloplasty and admitt...

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RE: pr3 +ve is it endocarditis ? 11 hours ago

any thoughts about kidney biopsy? ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: pr3 +ve is it endocarditis ? 11 hours ago

PET Scan Persistent FDG activity posterior to the pacemaker/ICD box in the chest wall which has mildly increased since 2023. This can indicate a ch...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 11 hours ago

HBsAg + and HBV-DNA PCR negative usually occurs on anti-viral therapy and may be due to persistence of HBV in liver cells, without viremia but with...

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RE: Suspected COL4 related disease 13 hours ago

What is her BMI? If greatly elevated the eGFR might be normal after deindexing for BSA. She may need Semaglutide as well as RASi. What was the dips...

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RE: Tablo HD machine 15 hours ago

Do be aware if you also plan on ALSO using it for CRRT it has a limit of 24 hours before machine maintenance. No truly a CRRT machine ------...

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RE: Suspected COL4 related disease 15 hours ago

sure seems like an Alport disease COL4A3-5 but the lack of hematuria and proteinuria seems odd given elevated creatinine Perfect indication fo...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 15 hours ago

Hep b carrier states and just what they mean is very confusing to me but the person I know that clearly does know is @Satish Balan ---------...

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RE: anti gbm serology postive with fever and raised inflammatory markers 15 hours ago

He started to pass urine today a little bit --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 15 hours ago

Thanks for case prof athavale Was it hep core antibody +ve and hep b pcr negative from onset What was the reason to start hep b treatment ? Is t...

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RE: anti gbm serology postive with fever and raised inflammatory markers 16 hours ago

Anti gbm >8 and after 3 plex and methyl pred still anti gbm >8 --------------------------------- Muhammad Soobadar MBChB UK -------------------...

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RE: Tablo HD machine 16 hours ago

One of the small hospitals I worked at in Kentucky, only had Tablo machines and not the Fresenius workhorse or Baxter machines. My experience with ...

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treatment of PLA2R positive Membranous in Hepatitis B carrier 17 hours ago

66/M, diagnosed with PLA2R positive Membranous nephropathy. PLA2R titre is > 1: 160 (PLA2R was > 1: 320 6 months ago), serum creatinine is 1, prote...

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RE: Tablo HD machine 19 hours ago

Dr. Glassock is correct. There is relatively a small effect of dialysate flow rate on small molecule clearance with the lower blood flow of 300 mL/...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 20 hours ago

follow-u? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas Transplant Medic...

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RE: anti gbm serology postive with fever and raised inflammatory markers 21 hours ago

What happened to serum anti-GBM antibody levels with PLEX and steroids without CYC? ------------------------------ Richard Glassock MD, FASN Emer...

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RE: Suspected COL4 related disease 22 hours ago

Thus case has features that are likely due to Alport Spectrum disorder (inheritance pattern + thin GBM). Hopefully the genetic testing will establi...

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Suspected COL4 related disease 1 day ago

Ms. R.A. is a 29-year-old woman who was referred to our clinic for evaluation of an elevated serum creatinine level of 109 µmol/L. She has a backg...

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Tablo HD machine 1 day ago

Our hospital currently outsources bedside HD and, separately, CRRT is run by critical care hospital nurses. In an economic move the hospital is loo...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Affected --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

90% glomeruli --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Or treat with cyclo without if /IHC --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Continuing with plex What about cyclo? Without IF? Wait for ihc or treat with cyclo --------------------------------- Muhammad Soobadar MBChB UK...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

If Anti-GBM still > 8 this not false positive IMO -the question is any viable glomeruli on biopsy - if so continue Plex ------------------------...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

I have also asked plex team if blood test that day was after crp blood test As if after methyl pred and not plex then more reassurance not infecti...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Dear team IF is degraded , Crp came down after pulse methyl pred However it’s not clear if this blood test after first plex Histopathology team ha...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 1 day ago

"But "de novo" igAN has been associated with fairly 'benign" outcomes." Thanks Dr. Glassock but not much data on patients like this 27 years post t...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 1 day ago

Still need to see the unidentified biopsy to blame proteinuria in a 27 y/o allograft on IGAN. ------------------------------ [Mark] [Lerman] [MD,...

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RE: Management of Sjögren's syndrome with type II cryoglobulinemic MPGN in the absence of a confirmed lymphoproliferative disorder 2 days ago

Thank you Prof Glassock. ------------------------------ Payal Gaggar MD, DM Nephrology Asst prof Nephrology Nizams Institute of Medical Sciences ...

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RE: Management of Sjögren's syndrome with type II cryoglobulinemic MPGN in the absence of a confirmed lymphoproliferative disorder 2 days ago

I would treat with RTX (cautiously with careful observation ) now, rather than waiting so see deterioration of kidney function. I do not think that...

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RE: Management of Sjögren's syndrome with type II cryoglobulinemic MPGN in the absence of a confirmed lymphoproliferative disorder 2 days ago

Thanks Prof Glassock . In your opinion is "wait and watch " an option for this patient.? And if treated would she require prolonged therapy with ...

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RE: Management of Sjögren's syndrome with type II cryoglobulinemic MPGN in the absence of a confirmed lymphoproliferative disorder 2 days ago

Thanks Prof Rodby. "Pearls of wisdom" as usual !!! ------------------------------ Payal Gaggar MD, DM Nephrology Asst prof Nephrology Nizams Inst...

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RE: Management of Sjögren's syndrome with type II cryoglobulinemic MPGN in the absence of a confirmed lymphoproliferative disorder 2 days ago

If you choose to treat this patient with RTX be wary of passive serum sickness ,which can ocurr in this situation with devastating results. ----...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 2 days ago

Furthermore, the absence of a T0 biopsy in this case, makes it impossible to exclude a donor derived IgAN , although this seem unlikely on the surf...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 2 days ago

But "de novo" igAN has been associated with fairly 'benign" outcomes. I am not confident that this is de novo IgAN in an allograft.. ------------...

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RE: Management of Sjögren's syndrome with type II cryoglobulinemic MPGN in the absence of a confirmed lymphoproliferative disorder 2 days ago

Forgive me for repeating this that I started a couple years ago "When in question, pronase digestion" ------------------------------ Roger Rod...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 2 days ago

"no data on APRIlL/BAFF drugs as transplants were excluded in studies" I have seen some pretty bad outcomes in renal transplant with IgAN. We u...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 2 days ago

I had a different take on Wagner's review. It was an excellent review of previous data and the history, but it really didn't add much to today's di...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 2 days ago

Agree with the need to review unlabeled biopsy report. Allograft 27 yrs since transplant would be expected to have IFTA and possibly evidence of ch...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 2 days ago

It should read that repeat gado dosing should be avoided. ------------------------------ Mark Perazella MD, MS, FASN Boynton Beach FL (203) 464-...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 2 days ago

Any prior kidney transplant biopsies over the 27 years post-transplant? Were these free of findings suggestive of IgA nephropathy? Has SCr been sta...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 3 days ago

See Haas et al KI Reports 2025 for a recent study of recurrent vs de novo IgAN in Allografted kidneys. ------------------------------ Richard Gla...

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RE: Immunotherapy For De Novo IgA Nephropathy Post Transplant 3 days ago

No personal experience with April- or April-BAFF inhibitors in this situation. De novo IgAN in renal allografts is pretty rare so no literature..Ho...

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Immunotherapy For De Novo IgA Nephropathy Post Transplant 3 days ago

62 year old with reflux nephropathy and LRD kidney transplant in 1999. De novo IgAN on biopsy. Currently on Envarsus, prednisone, sparsentan and da...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

Thank you so much Dr.Lambeau for your valuable input, that was very useful! ------------------------------ Safa Nowrooz MD Dr. Governmental Hospi...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 3 days ago

Less gadolinium is better. But, you don't want to limit gado dose and not get adequate images. Also, avoiding repeat dosing within short time inter...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 3 days ago

Thanks for the input , agree for not only MRI but for all other tests to be done when only necessary One more question, is using a low dose gadoli...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 3 days ago

We were among the first to enlighten Gadolinium toxicity. Although small, the risk is never zero. I would organize to meet the radiologist and the ...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 3 days ago

Besides NSF, there is evidence of Gd deposition (mainly with linear, but with 2nd generation as well) in the brain. Not just in CKD but in patients...

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RE: 3rd Generation Gadolinium Use In Pt With CKD IV/V 3 days ago

My 2 cents. Are the new gado agents completely safe. Nope. However, their benefit when used to diagnose serious illnesses far outweighs their relat...

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