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

@Roger Rodby Thanks for the appreciation. But please note that tatooing itself has been associated with the spread of HBV. ----------------------...

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RE: Tablo HD machine 11 minutes ago

thank you so muchchris frankel

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RE: is it SIADH 1 hour ago

Agree fits SIADH clinically and meds the only question here is out whether treat or not. ------------------------------ Roger Rodby MD, FASN P...

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RE: maintenance for PR3 ab AAV? 1 hour ago

14 years with no PR3 AAV relapse on prednisone alone, only 5 mg. considerations to stop prednisone altogether and watch or stop prednisone and us...

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RE: Tablo HD machine 1 hour ago

Thank you Dr Balan..helps very much....Prem Chandran

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 1 hour ago

@Satish Balan thanks for the info sheet. I wil distributie it to our faculty and fellows And wil have it tattooed on my arm ----------...

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RE: Tablo HD machine 1 hour ago

The older discussion is here https://community.asn-online.org/discussion/tablo-dialysis-machine?hlmlt=VT ------------------------------ Sati...

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maintenance for PR3 ab AAV? 1 hour ago

I have a 79 yo patient who has PR3 ab AAV with pulm/renal involvement during initial presentation back in 2009 which was treated with cytoxan/stero...

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RE: is it SIADH 2 hours ago

"question is this SIADH" current data meets requirements, serum uric acid and or FEurate would be helpful. sertraline is common cause and if patien...

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RE: is it SIADH 2 hours ago

With hyponatremia of this duration and a U [Na + K] of 133, while serum Na is < 130 and an elevated U osm this is likely SIADH. -----------------...

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RE: treatment of PLA2R positive Membranous in Hepatitis B carrier 4 hours ago

Thank you Dr Rodby. Unfortunately here we are not sure what exactly is the situation here. Help B carrier status means HbSAg positivity with or wit...

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RE: pr3 +ve is it endocarditis ? 4 hours ago

What is serum creatinine , urine sediment, UPC and UAC ? CRP? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [P...

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is it SIADH 17 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 ? 17 hours ago

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

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RE: pr3 +ve is it endocarditis ? 17 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 18 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 19 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 21 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 21 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 21 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 22 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 22 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 22 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 22 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 23 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 1 day 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 1 day 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 1 day 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 1 day 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 2 days 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 2 days 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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