AKI - D 4 minutes ago

I saw the patient in the hospital who had sepsis syndrome after abdominal surgery and subsequently AKI requiring dialysis She recovered her sepsis...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 33 minutes ago

Thanks dr Mohiuddin There is important consideration here.This this relapse of disease in stem cell transplant patient Does it also mean rejecti...

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RE: anti gbm/mpo +ve in young female 39 minutes ago

Thanks dr Asha really helpful And for boys ? @ prof glassock - thanks for your clear statement . In summary its case based approach . If someone...

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RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 2 hours ago

Thanks Dr Glassock and Dr Sprague. Phosphate has been normal throughout. ------------------------------ Awais Nauman HMC Doha ----------------...

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Indolent crescentic GN 2 hours ago

Hi everyone. I need your support with this case. 49-year-old female. Since 2021, she has had progressive proteinuria, reaching up to 3.5 g/24 ...

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RE: anti gbm/mpo +ve in young female 4 hours ago

It is more of a concern in post-pubertal girls. We routinely refer our SLE children to fertility preservation clinics and they do multiple things (...

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RE: anti gbm/mpo +ve in young female 7 hours ago

Dr. Soobadar - you are asking guidance for declaration of futility in cases of severe anti-GBM disease with oligio-anuria, dialysis dependent kidne...

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RE: anti gbm/mpo +ve in young female 7 hours ago

Thanks dr Asha. Is fertility a consideration at this age? And can anything be done ? --------------------------------- Muhammad Soobadar MBChB U...

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RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 18 hours ago

I agree with Prof Glassock, this does appear to be primary HPTH. I am curious as to what his serial serum phosphates are. Since he is not overtly h...

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RE: Gap Acidosis 20 hours ago

Yes, there have been many cases of 5-OP acidosis associated with flucloxacillin, fewer with Dicloxacillin or Nafcillin – almost always in associati...

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RE: Gap Acidosis 21 hours ago

Here is a reference for PGMA coincident with flucloxacillin and paracetamol. Irani, AZ, et al . BMJ Case Rep 2021; 14: e237536. -----------------...

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RE: Gap Acidosis 22 hours ago

I was unable to find any evidence that the second generation cephalosopin has been associated with metabolic acidosis in the absence of sepsisIf yo...

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RE: anti gbm/mpo +ve in young female 1 day 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...

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RE: anti gbm/mpo +ve in young female 1 day 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 ...

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RE: Gap Acidosis 1 day 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...

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

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

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

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RE: Normocalcemic Hyperparathyroidism or Idiopathic Hypercalciuria 1 day ago

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

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

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

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

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

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

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days 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 2 days 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 days 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 days 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 days 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 days 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 2 days 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 2 days 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 2 days 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 2 days 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???? 2 days 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???? 2 days 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 2 days 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???? 2 days 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???? 2 days 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???? 2 days 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???? 2 days 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 2 days 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 2 days 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???? 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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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