RE: complex case of nephrotic syndrome in liver transplant patients 29 minutes ago

Dr. Soobadar -in regards to the use of campath -I am not a liver transplant specialist but review current guidelines campath is not recommended for...

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

Dr. Soobadar: Our center doesn't use alemtuzumab (Campath) for kidney transplantation. I have no personal experience with this drug. What I posted ...

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RE: Help me make sense of this 24 hr urine study for stones. 2 hours ago

I assume the Magnesium is being given as the citrate salt. Is this the case. This might explain the urine findings.even though K Citrstr is being g...

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Help me make sense of this 24 hr urine study for stones. 2 hours ago

70 year old man with Hypertension , Diabetes Mellitus Type II, CKD 2/3, , Hyperlipidemia , Depression , atrial fibrillation, Peripheral Vascular Di...

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RE: Total Hip Replacement in ESRD 2 hours ago

I would keep looking, she is 30. https://www.sciencedirect.com/science/article/pii/S0972978X23000685 ------------------------------ R...

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

The recurrence rate of ANCA vasculitus in kidney transplants is already so low that it might be difficult to ascertain if the induction regimen mak...

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RE: Applications for Travel Support to ASN Kidney Week 2026 Now Open 3 hours ago

Dear all, As a reminder, applications for the ASN Kidney Week 2026 travel support grants will close on Wednesday, June 10, 2026. Please spre...

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Applications for Travel Support to ASN Kidney Week 2026 Now Open 4 hours ago

Hi all, Travel support applications for the world's premier nephrology meeting, ASN Kidney Week, are now open and will close on Wednesday, June 10...

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Applications for Travel Support to ASN Kidney Week 2026 Now Open 4 hours ago

Hi all, Travel support applications for the world's premier nephrology meeting, ASN Kidney Week, are now open and will close on Wednesday, June 10...

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RE: Total Hip Replacement in ESRD 4 hours ago

I can understand the surgeon's reluctance if it is an elective cosmetic procedure. This patient is in considerable pain with greatly restricted mob...

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RE: Total Hip Replacement in ESRD 5 hours ago

Dr Glassock, I agree, the avascular necrosis and the pain and limitations she has are surely from previous steroid use and not renal osteodystrophy...

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RE: complex case of nephrotic syndrome in liver transplant patients 5 hours ago

Thanks prof venkat . Really helpful points In your practice then do you give Campath in patients who have Anca vasculitis and get transplant ? My...

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RE: Post Partum TMA 5 hours ago

Sachin: What were the complement studies that were sent? Was there a C5b-9. My understanding is that systemic TMA & Renal limited TMA can co-exit, ...

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RE: Post Partum TMA 14 hours ago

With a kidneys showing cortical necrosis and no active hemolysis, I think it would be safe to stop complement inhibition and observe. She may still...

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Post Partum TMA 14 hours ago

Wondering if you would continue with complement blockade in this situation. 25 year old female no past medical history, with NO prenatal care, pr...

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RE: Total Hip Replacement in ESRD 14 hours ago

I would imagine that the bilateral osteonecrosis is related to steroid therapy of SLE and not CKD-MBD. Her problem can likely be cured by hip repla...

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RE: Total Hip Replacement in ESRD 17 hours ago

The following reference is relevant to the question raised by Dr. Hirsch: https://pubmed.ncbi.nlm.nih.gov/35389908/ Wonder if bone densitometry...

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RE: Total Hip Replacement in ESRD 18 hours ago

Great Question Dr. Hirsch- i don't understand the rationale behind refusal of Orthopefic Surgeons to offer this young woman with a life altering di...

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

I have no idea about the clinical relevance of the "equivocal " IF findings for C3, C1q and Lambda. Please discuss this with your renal pathologist...

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RE: IgA nephropathy with crescents 1 day ago

Dear Colleagues, I appreciated your discussion regarding therapy in patients with IgA nephropathy (IgAN) presenting with crescents on kidney biops...

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RE: SIADH conundrum 1 day ago

This is SIADH. I would use low dose tolvaptan and adjust accordingly. You cannot continue with HTS indefinitely. ------------------------------ J...

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

Please see the following from AI: "Campath is a monoclonal antibody designed to target the CD52 protein. Because CD52 is found on the surface of ...

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RE: SIADH conundrum 1 day ago

Personally I don't believe there is a renal salt wasting syndrome (see attached). The literature on the subject is very weak. Most likely this case...

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

@ prof glassock what is the relevance of c3 granular glomerular staining . And c1q ig k lambda? If this is diffuse podocytopathy due to sirolimus ...

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Total Hip Replacement in ESRD 1 day ago

I have a 30 yo SLE ESRD with severe avascular necrosis of the hip; she's mostly in a wheelchair, hardly walks ("I hop") and requires daily narcotic...

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RE: Dual Vascultis / Sle 1 day ago

If Elisa +ve and crithidea negative and symptoms not In keeping with lupus /ctd? Then maybe can rule it out as false positive ds dna? What are yo...

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RE: SIADH conundrum 1 day ago

Thank you for the feedback.. would be interesting to see what happens to her volume status, once the IV acyclovir is stopped ---------------------...

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RE: SIADH conundrum 1 day ago

Her initial urine studies were, in fact, done prior to fluids and prior to acyclovir initiation. As stated above, no evidence clinically of a salt ...

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RE: SIADH conundrum 1 day ago

Thanks for the response. I have used all of these options before though in this particular case was unsure about the potential increase in risk of ...

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RE: SIADH conundrum 1 day ago

Baseline renal function is normal and remains normal now. She is receiving IV acyclovir 650 mg (13 mL volume) in 100 mL NS run at 100 mL/hr. The on...

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RE: SIADH conundrum 1 day ago

Thanks for the response. She clinically appears euvolemic. BP has actually been high. There is nothing to suggest presence of salt wasting. Her uri...

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RE: IgA nephropathy with crescents 1 day ago

Thank you all. Thank you Dr. Glassock. Looking at all data, I will start him MMF, switch to moderate dose steroids and over next few weeks come dow...

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RE: Dual Vascultis / Sle 1 day ago

If the ELISA anti-dsDNA is positive, what additional information will be provided by an Crithida anti -ds DNA assay. ----------------------------...

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RE: SIADH conundrum 1 day ago

Assuming this patient has the folllowing : Pna 120 , weight 70kg, then TBW = 35 l and TBna = 35x120=4200 meq. If shes getting 3 liters of fluid and...

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RE: AKI - 3 weeks post normal vaginal delivery 1 day ago

Thanks dr kaur What does cva pain mean ? What range was her tacrolimus levels? Are there any features of PRES? Eye changes because of HTN? Any p...

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

The liver team feels patient would need new liver transplant and asking us whether they can use campath ? Any thought? @ prof mark lerman apprecia...

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RE: Dual Vascultis / Sle 1 day ago

This case was discussed with rheumatologists/ mdt and they advised that they felt it was Anca and sle was less likely ( clinical +age) so no biopsy...

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RE: SIADH conundrum 1 day ago

With the high U osm I would consider this an ADH-mediated problem and with the high U Na (and no mention of low BP or high bun to cr ratio) I would...

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RE: IgA nephropathy with crescents 1 day ago

Cyclophosphamide is great for severe LN and ANCA vasculitis but this may not translate to crescentic IgAN (C1) without RPGN. The only RCT of CYC th...

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RE: Pd Patient And Lipid Lowering Agent 1 day ago

@prof bargman what is your approach to lipid management in your cohort ? Many thanks --------------------------------- Muhammad Soobadar MBChB ...

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RE: IgA nephropathy with crescents 1 day ago

Thanks I would agree with prof glassock and dr dastoor . The conundrum in this case is if use Sparsentan first and proteinuria drops after 4 weeks...

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RE: yeast peritonitis and return to PD. 1 day ago

Thanks really helpful Bw Belal --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: yeast peritonitis and return to PD. 1 day ago

All except the patient with the pessary and repeat yeast peritonitis. You can look up the absolute numbers in our paper that I attached. Get Outl...

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RE: low phosphate and smoldering myeloma 1 day ago

Hi dr dastoor, Interested to know how you get the figure of 40 mmol of phosphate in urine daily? And what is the expected range for potasssium and...

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RE: yeast peritonitis and return to PD. 1 day ago

Thanks dr Mariam @ prof bargman. What number of patients restarted pd after yeast peritonitis and what number managed to maintain on it ( expect 2 ...

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RE: Pd Patient And Lipid Lowering Agent 1 day ago

Thanks prof glassock I was not aware of lipid oil but from the trial Seems promising . I will discuss with colleagues in my unit and consider imp...

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RE: SIADH conundrum 1 day ago

Vasopressin Storm - Vasopressin Surge - Vasopressin Spray Here I propose a name change to SIADH. "Vasopressin Storm!" We no longer call this wa...

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RE: SIADH conundrum 2 days ago

in regard to potential nephrotoxicity of iv acyclovir, i assume baseline renal function was normal? how fast is acyclovir being infused and at what...

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RE: SIADH conundrum 2 days ago

The Uosm is high , which can mean 2 things 1. The patient is volume depleted , or 2. The patient has an inappropriate ADH excretion in the face o...

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RE: C3 or MGRS 2 days ago

No , this is another case . The previous case had a bone marrow and no evidence of a monoclonal disorder . This case also has a gamma spike on SPEP...

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