MPGN with negative IMF 1 hour ago

Dear all, My colleague has an 83-year-old female patient who presented to her clinic with progressive renal dysfunction (creatinine 90 umol/L in ...

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RE: Pd Patient And Lipid Lowering Agent 4 hours ago

For the PISCES trial. see Lok C et al NEJM, 2026. It currently applicable only to HD patients, but I do not see why it would not work in PD . Just ...

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RE: Membranous Nephropathy treatment 6 hours ago

Not sure about membranous but in Anca vasculitis , CD20 counts more predictive of relapse over Anca titers --------------------------------- Dr. H...

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RE: Pd Patient And Lipid Lowering Agent 8 hours ago

The entire concept of treating to prevent ASCVD in dialysis patients has been turned upside down with the findings of the PISCES trial that showed ...

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RE: Membranous Nephropathy treatment 9 hours ago

Thanks. The infusion is not hard to get in Atlanta

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RE: Membranous Nephropathy treatment 11 hours ago

Hi James , I understand you find infusion hard to get in your centre I would personally check ELiSA and then give rituximab 1g and then 14 days la...

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Pd Patient And Lipid Lowering Agent 13 hours ago

Dear colleagues , Primary care physician has queried use of lipid lowering agent in established pd patient Not tolerating statin question about us...

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RE: yeast peritonitis and return to PD. 13 hours ago

No previous peritonitis . You mean doing echocardiogram , Ct whole body ? Pet ? Blood cultures negative Never fungaemic and clinically well ( afte...

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RE: Post Partum AKI 14 hours ago

Yes, vaginal discharge mixing with urine can confound interpretation of proteinuria. However, this patient has edema, hypoalbuminemia and increasin...

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RE: FSGS vs C3G and Canavan Disease 16 hours ago

Just as a followup, after nearly 4 weeks the patient still has persistent protienuria of 14 grams per day Her LM showed MPGN and IF ( though inco...

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RE: High output HF from AVF? 20 hours ago

!! Alejandro C Alvarez St. Louis, MO alejoclaudio@gmail.com

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RE: AI in Epic? 20 hours ago

Thank you, Dr. Glassock, that's good to know. I was able to update my account on UpToDate to add on that option under my user settings. An extra fe...

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RE: High output HF from AVF? 20 hours ago

Above appreciated and more valuable than this, but I like the "eye test", for whatever it is worth, I have only seen high output heart failure in L...

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RE: AI in Epic? 20 hours ago

As far as know the decision is up the health system that purchases/ leases the EPiC Program with or without embedded UpToDate option ---------...

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RE: AI in Epic? 20 hours ago

that's good to know, but how do you elect for that option? ------------------------------ Mark Cook DO Pikes Peak Nephrology Associates Colorado ...

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RE: High output HF from AVF? 20 hours ago

Dr. Ekiz, Those Blood flow volume values are unreliable, as evidenced in the wide range of the measurements above (assuming it is a surgical AVF ...

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RE: AI in Epic? 20 hours ago

AI is already available in EPIC with the option of embedded UpToDate (Expert AI). Full disclosure- I am Editor in Chief of the glomerular disease s...

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RE: High output HF from AVF? 20 hours ago

Has the volume overload improved with CRRT, and what happened to blood pressure during that time? I don't think a shunt flow of 900 ml/min caused t...

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AI in Epic? 21 hours ago

Hi, does anyone know when artificial intelligence for epic will be available for providers? ------------------------------ Mark Cook DO Pikes Pea...

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RE: Post Partum AKI 21 hours ago

Postpartum and without curettage, lochia often persists for up to 4 weeks. During this time, proteinuria cannot be interpreted. If necessary, pleas...

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RE: yeast peritonitis and return to PD. 21 hours ago

Fungal peritonitis is rare in patients who are not immunocompromised. Was the same pathogen identified in the second episode of peritonitis as in 2...

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RE: low phosphate and smoldering myeloma 21 hours ago

In regards to the PO4 loss in the urine ,let's assuming with normal eGFR , his PO4 excretion per day is around 40 mmol/day. However with eGFR of 4...

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RE: Membranous Nephropathy 1 day ago

A CNI will not help ( much) for inducing a lasting immunological remission.- I do not recommend this option. ------------------------------ Richa...

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RE: Post Partum AKI 1 day ago

But was it looked for? Is this the first pregnancy or one of multiple. If multiple, , any toxemia events or proteinuria with prior pregnanies.? -...

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RE: Post Partum AKI 1 day ago

No proteinuria reported in the 1st trimester. --------------------------------- Wael Jebur MD drwaellatif@hotmail.com Dubai ---------------------...

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RE: Membranous Nephropathy 1 day ago

Consider combining a CNI with antiCD 20 inhibitors . The combination seems to work very well. Risk of recurrence is high when you with hold CNI tho...

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High output HF from AVF? 1 day ago

Dear community, Here is a 69 y/o gentleman w ESRD (presumed to be 2/2 FSGS + post nephrectomy for RCC) on HD via R BC AVF since 2022, w asx CAD, ...

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RE: Membranous Nephropathy 1 day ago

You could try a short 8 week course of CYC ( 1-1.5mg/kg po) to see if you can prolong the B-cell reducing effect of OBI and yield am more prolonged...

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RE: low phosphate and smoldering myeloma 1 day ago

Thank you for your prompt answer. Back in February his ratio was 17. So he is edging on the myeloma stage. ------------------------------ Mario ...

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RE: low phosphate and smoldering myeloma 1 day ago

Dr. Rubin: A FLC ratio > 8 is a risk factor for high risk MGUS. A ratio > 20 is a risk factor for smoldering myeloma for progression to multiple ...

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RE: Membranous Nephropathy 1 day ago

Update: ANCA Negative C3, C4 normal DS DNA Negative ------------------------------ Sachin ------------------------------

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RE: low phosphate and smoldering myeloma 1 day ago

@Nelson Leung Is a huge Kappa/Lambda ratio (as in this case) enough to label this patient as suffering from a high risk smoldering myeloma? As su...

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RE: low phosphate and smoldering myeloma 1 day ago

The data is compelling to treat the MM. The 24h urine phosphate is actually on the low end. If the patient intake is sufficient, intestinal wasting...

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RE: Membranous Nephropathy treatment 1 day ago

Elisa is also available. ------------------------------ James Wells MD Atlanta GA (770) 934-2585 ------------------------------

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

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

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RE: Membranous Nephropathy treatment 1 day ago

And I you have Elisa you can do repeated measurement and check treatment response . IFA is not used for monitoring ( under correction of prof gla...

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RE: Membranous Nephropathy treatment 1 day ago

Thank you ------------------------------ James Wells MD Atlanta GA (770) 934-2585 ------------------------------

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RE: Membranous Nephropathy treatment 1 day ago

1:100 means you are using the IFA rather than ELISA . The ELISA is preferred as it is quantitative (RU/ml). But this is a clearly positive result i...

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

One lady came back to PD and got another yeast peritonitis for which I felt terribly! She had the second catheter removed and stayed on hemo. Inter...

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RE: Membranous Nephropathy treatment 1 day ago

Is 1:100 considered a high or low titer? ------------------------------ James Wells MD Atlanta GA (770) 934-2585 ------------------------------

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RE: Membranous Nephropathy treatment 1 day ago

It is the only titer I have. Proteinuria responds to change in CSA dosage. Now 460 which seems very good. Just concerned about the rise in creatini...

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RE: AI Transparency in Kidney Week Abstract Submissions 1 day ago

Thank you for the clarification! ------------------------------ Karin Bergling MD, PhD Senior Clinical AI Scientist Renal Research Institute New ...

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RE: Membranous Nephropathy treatment 1 day ago

1:100 titer done last week Sent from my iPhone

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RE: Membranous Nephropathy treatment 1 day ago

If we were to treat based on plar2I agree kidney biopsy would not change management . There is no suggestion for additional renal disease apart fr...

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RE: Ig A case 1 day ago

No need to add SGLT2I , in my opinion Not Obese. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Me...

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RE: AI Transparency in Kidney Week Abstract Submissions 1 day ago

Thanks- disclosure of the use of AI to prepare visuals or posters at Renal Week is optional. ------------------------------ Richard Glassock MD,...

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RE: Membranous Nephropathy treatment 1 day ago

What would be the point of a repeat biopsy in the face of continued immunological activity of the disease , which needs treatment? What would be ga...

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RE: AI Transparency in Kidney Week Abstract Submissions 1 day ago

Hi Dr. Glassock. Thanks for clarifying. In abstract submissions, authors should report the use of artificial intelligence, language models, mach...

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RE: Membranous Nephropathy treatment 1 day ago

Thanks I would stop csa, mmf and give rituximab if serum plar2 is rising I wonder who would consider repeat kidney biopsy as longstanding mn (200...

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RE: Ig A case 1 day ago

Thanks prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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