RE: anti gbm/mpo +ve in young female 57 minutes ago

Combined anti-GBM and ANCA driven crescentic GN with RPGN features is quite rare in the Pediatric age population less than 8 years old, but I agree...

View Discussion

RE: anti gbm/mpo +ve in young female 3 hours ago

I am a pediatric nephrologist and had a 4-year-old presenting with crescentic GN (100% crescents, mostly fibro cellular) and was double + for ANCA ...

View Discussion

RE: Gap Acidosis 10 hours ago

Dont forget that the ABx Cefuroxime this patient was on also is associated with pyroglutamic acid metabolic acidosis. I guess this is perhaps combi...

View Discussion

RE: Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 19 hours ago

Dr. @Richard Glassock Thank you for the recommendation. I will follow up with the team about extending the invitation. We welcome suggestions on th...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 22 hours ago

Thanks for the additional information. I feel that decision regarding need for additional plasma cell-directed therapy will have to be made by the ...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 22 hours ago

Mr Zada First congratulations for looking into what ails this lady. Indeed looking into available resources is first but do not see anything wrong ...

View Discussion

RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 22 hours ago

According to the available literature , an iPTH of this magnitude woukd be seldom found in idiopathic renal hypercalciuria . The Bone Density data ...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 23 hours ago

From the data available, I don't see any need to re-institute chemotherapy. Observation only and a deeper evaluation of the extent of the hematolog...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 23 hours ago

Proteinuria, even in the Nephrotic Range, can persist for long periods (? Years) following a complete hematological remission of AL Amyloid due to ...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 23 hours ago

Kidney Biopsy on 8/26/22 was positive for renal amyloidosis. - 8/16/22 SPEP with M protein: IgA Kappa ([More]

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 day 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 ...

View Discussion

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

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

View Discussion

RE: Hypercalcemia in ESRD 1 day 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...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day ago

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

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day 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...

View Discussion

Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 day ago

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

View Discussion

Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 1 day 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...

View Discussion

RE: Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 1 day ago

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

View Discussion

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

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day 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...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day 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...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day 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...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day 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...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day 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...

View Discussion

RE: Salmonella Sepsis and C3 GN???? 1 day 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. ...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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...

View Discussion

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

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

View Discussion

Salmonella Sepsis and C3 GN???? 1 day 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 ...

View Discussion

RE: Hypercalcemia in ESRD 1 day 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...

View Discussion

RE: Hypercalcemia in ESRD 1 day ago

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

View Discussion

RE: Hypercalcemia in ESRD 1 day 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...

View Discussion

RE: Hypercalcemia in ESRD 1 day ago

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

View Discussion

RE: Hypercalcemia in ESRD 1 day ago

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

View Discussion

RE: Hypercalcemia in ESRD 1 day 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...

View Discussion

RE: Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 1 day 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...

View Discussion

RE: Hypercalcemia in ESRD 1 day 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 ...

View Discussion

RE: Hypercalcemia in ESRD 1 day ago

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

View Discussion

RE: Hypercalcemia in ESRD 1 day 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...

View Discussion

Introducing Rewired: Navigating AI's Role in Kidney Health - New ASN Podcast 1 day 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 ...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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 ...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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...

View Discussion

RE: Renal Dysfunction in a Diabetic Patient 1 day 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...

View Discussion

Renal Dysfunction in a Diabetic Patient 2 days 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 ...

View Discussion

RE: Hypercalcemia in ESRD 2 days ago

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

View Discussion

RE: Elective Initiation of Hemodialysis in Pregnancy with Advanced CKD 2 days ago

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

View Discussion

RE: Hypercalcemia in ESRD 2 days 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...

View Discussion