RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 hour ago

This case is certainly one that brings to mind Hickams Dictum- "the patient can have as many diseases as they damn well please " ----------------...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 hour ago

The EM findings do not fit with MN and look more like MPGN. Can we have another opinion on the renal pathology in this . case. Dr. Brodsky, Dr. Fog...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 hours ago

Yes, we tested for cryoglobulinemia more than once, with proper collection and processing. Unfortunately, although it was also our main suspicion, ...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 hours ago

It may be a long shot but I would still test for VEGF ( and my Ai consultant agrees).. the renal cell carcinoma just does not fit into this picture...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 hours ago

We have all serologies negative, including viral loads and HCV DNA. Flow cytometry did not identify any abnormalities. ANA is also negative. We con...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 6 hours ago

The overall picture is more compatible with Type II (mixed ) cryoglobulinemia with neuropathic Vasculitis than POEMs Syndrome, but I would do a ser...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 6 hours ago

Before excluding POEMS Syndrone in this case you should do special flow cytometry for monoclonal cell and do serum VEGF.levels . Up to 20% of POEMS...

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Renal-restricted antiGBM 9 hours ago

Dear doctors, I would like to share a patient who, per renal pathology, luckily, has the "mildest form of antiGBM dz" they have seen. 53 y/o la...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 9 hours ago

Please find the attached files. ------------------------------ Joao E Lima Souza MS UNIVERSIDADE FEDERAL DE PERNAMBUCO Universidade federal de pe...

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Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 9 hours ago

Requesting guidance regarding a case of a 51-year-old male with a two-year history of recurrent edematous syndrome and hypertensive emergencies, wi...

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RE: Hd Patient Running Out Of Access 15 hours ago

It is worth a try. The rectum, sigmoid colon ascending and descending colon are retroperitoneal structures. I suspect the risk of perforation is mo...

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RE: Hd Patient Running Out Of Access 15 hours ago

I agree with Dr . Rodby. The peritoneal membrane in pretty resistant to radiation injury . I have never seen any significant peritoneal membrane ir...

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RE: Hd Patient Running Out Of Access 17 hours ago

"I was thinking along radiation to peritoneum and damage and therefore high risk of pd not working" Good thought , but radiation is very targeted...

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RE: Osteoporosis In Stage 5 Ckd 19 hours ago

Again I agree and it is similar to the article I mentioned earlier J Clin Pharmacol 2022 Apr 2;62(9):1132–1141. doi: 10.1002/jcph.2050 --------...

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RE: Membranous nephropathy 22 hours ago

Hi. Thanks very much! Very Interesting case. If you have a chance please let us know how your pt is doing with treatment Thanks for sharing this ...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

The rationale , efficacy and safety issues concerning the use of Rososuzunab or Teriparatide in Adynamic Bone Disease in CJD is very well summarize...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

May I ask you what is Rational of using Romosozumib in this patient? How teriparatide modefied dose may help? --------------------------------- Wa...

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RE: Membranous nephropathy 1 day ago

Hi Dr. Garrick. The duodenal biopsy report came two days ago and it's benign and no dysplastic features. So I hope I can take this as a PLA2R negat...

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RE: Canine amyloidosis treatment options 1 day ago

Yes! These are my colleagues at the International Veterinary Renal (and Urinary) Pathology Service. It is physically within Texas A&M. Those are th...

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RE: Canine amyloidosis treatment options 1 day ago

A friend of mine just sent me this poster. It looks like mass spectrometry proteomics is being explored in veterinary medicine. The technique here ...

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RE: Hd Patient Running Out Of Access 1 day ago

Worth a try considering complexity of the patient certainly as an advanced laparoscopic insertion- to have a nice look around and do adjunctive pro...

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RE: Hd Patient Running Out Of Access 1 day ago

Thanks prof rodby I had not make That link to perforation and was inquisitive to learn about your thought process.( as in I had not thought about ...

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RE: Canine amyloidosis treatment options 1 day ago

awwwwwww! ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicago IL (773) 505-3...

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RE: Hd Patient Running Out Of Access 1 day ago

well I suppose the anus is attached to the rectum and the rectum to the peritoneal cavity ... Clearly there was a concern of something or you wou...

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RE: Membranous nephropathy 2 days ago

Hi Did results of duodenal return? Perhaps I missed them. Thanks! ------------------------------ Renee Garrick,MD,FACP, FASN Professor of Cl...

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RE: Recurrence of IgA - post transplant 3 days ago

In regards to cost help may be on the way. Recently I did a survey, on a C5 blocker given every 8 weekly ( assuming Ravulizumab). The phase 3 data ...

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RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 3 days ago

Update - patient admitted to hospital with general deterioration. All Family members agreed to stop and for conservative care Best regards ------...

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RE: Hd Patient Running Out Of Access 3 days ago

What would perforate ? Bw --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Recurrence of IgA - post transplant 3 days ago

I'm curious to see how the felzartamab data stacks up. Also, my understanding is that atacicept has an ongoing trial which specifically includes re...

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RE: Recurrence of IgA - post transplant 3 days ago

With all due respect for the Iptacopan advocates, I think that anti/CD38 MoAB is a better choice for recurrent IgAN in a kidney transplant. Just an...

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RE: Recurrence of IgA - post transplant 3 days ago

Dr. Dastoor This is personal experience since data are lacking A patient with recurrent IgA + MVI (peritubular capillaritis C4d1) that failed ...

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RE: Recurrence of IgA - post transplant 3 days ago

While the clinical trials for iptacopan approval in IgAN did not include any recIgAN post-transplant, there are certainly scattered case reports of...

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RE: Canine amyloidosis treatment options 3 days ago

We don't have HIPAA in veterinary medicine, but the client did give me permission to share photos of PJ! We do see nephrotic edema in dogs and ca...

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RE: Dual Vascultis / Sle 3 days ago

@ prof glassock appreciate your thought on question ? Kind regards --------------------------------- Muhammad Soobadar MBChB UK ----------------...

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RE: GFR measurement in AKI with stable serum creatinine 3 days ago

Thank you Mario. Big Al is offspring 7 of 7 with degrees in engineering, He assisted with confirming the mathematics and graphs. John Pickering i...

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RE: Recurrence of IgA - post transplant Friday, April 24 @ 12:05 AM

Thanks for your response 1. I agree , we do a tapering dose of steroids , but he is currently taking instructions from his transplant nephrologist...

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RE: Membranous Nephropathy Thursday, April 23 @ 11:31 PM

A measurement of anti-PLA2R antibody by the IFA method would be very helpful. the IFA is more sensitive than the ELISA so a negative result would c...

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RE: Osteoporosis In Stage 5 Ckd Thursday, April 23 @ 11:28 PM

I just responded that I do feel a biopsy is the gold standard, the HR CT scan may be helpfu. I would avoid bisphosphonates in this patient with the...

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RE: Osteoporosis In Stage 5 Ckd Thursday, April 23 @ 11:21 PM

In CKD one cannot use DEXA scans to differentiate osteopenia from Osteoprosus vex CKD-MB. A bone biopsy is the gold standard, A high resolution CT ...

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RE: Osteoporosis In Stage 5 Ckd Thursday, April 23 @ 11:21 PM

Her decreased bone density may not have been the direct result of adynamic bone disease. I do think she would benefit from a biopsy, however, as me...

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RE: Membranous Nephropathy Thursday, April 23 @ 11:07 PM

I no longer use the modified Ponticelli (too much steroids , in my opinion)I rely on Obinutuzumab monotherapy primarily and occasionally use a shor...

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RE: Membranous Nephropathy Thursday, April 23 @ 6:27 PM

Thanks for update . I guess kidney biopsy will tell you . Tissue plar2 , EDD nature features of inflammation on LM or just chronic damage What p...

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RE: Hd Patient Running Out Of Access Thursday, April 23 @ 6:20 PM

I suspect yes, the risk of perforation must be rare but I might as a radiation oncologist. anal cancer is pretty low and I would guess that the PD ...

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RE: GFR measurement in AKI with stable serum creatinine Thursday, April 23 @ 6:00 PM

Congratulations to you and your son(?) Dr. Mellas. Your paper underscores what Dr. Pickering published 14 years ago (see attached) and that most of...

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RE: Osteoporosis In Stage 5 Ckd Thursday, April 23 @ 5:41 PM

Thank you very much for your inputs. Is that reduced bone thickness is solely resultant of adynamic bone disease , the patient refused bone biopsy....

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RE: GFR measurement in AKI with stable serum creatinine Thursday, April 23 @ 5:26 PM

As a follow-up to an old post; Attached is a recently published article describing a modeled mathematical proof of concept that a four hour urine c...

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Hd Patient Running Out Of Access Thursday, April 23 @ 5:07 PM

Can we try pd in patient who has complex vascular and running of vascular access who had radiotherapy for anal squamous cell cancer Thanks

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RE: Dual Vascultis / Sle Thursday, April 23 @ 4:30 PM

And why is crithidia not helpful in this setting? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle Thursday, April 23 @ 4:26 PM

Do you biopsy then? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle Thursday, April 23 @ 4:25 PM

Anca mpo --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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