RE: Pd Question 6 minutes ago

Appreciate and grateful for such promptly advise by experts to give care to patient in different continent 🙏🏼🙏🏼🙏🏼 -------------------------...

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RE: Pd Question 11 minutes ago

They have advise IR drain --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Pd Question 11 minutes ago

Thanks prof glassock my humble reading is this is a cyst infection and that has led to pyelonephritis . Source control should be drain . But I thin...

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RE: Pd Question 28 minutes ago

Dr. Soobadar. Thanks. I only raised the question about nephrectomy as I was taught (many years ago by a first class urologist ) that gas in the kid...

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Approach to flank pain ( my case series) 1 hour ago

case 1( RPF and Nutcracker syndrome rule out on imaging) is it loin pain haematuria syndrome with complex urological history Gyane do not feel it...

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RE: Pd Question 2 hours ago

Yes it’s amazing that I get answer so promptly helping in managing complex case with best evidence Very grateful @ prof glassock if she improves...

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RE: Pd Question 3 hours ago

Thanks Dr. Bargman for the prompt and very helpful response. With emphysematous pyelonephritis in an AKPD patient on dialysis who is very ill, woul...

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RE: Pd Question 4 hours ago

thanks prof glassock and prof bargman i have told iTU colleagues to give her a break from PD and do temporary HD via jugular line till this sepsi...

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RE: Pd Question 4 hours ago

You don't specify where in the kidney the infected cyst is located. We published a case report of a PD patient who developed Serratia pyelonephriti...

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RE: Pd Question 5 hours ago

I will defer to the PD and CRRT experts (Drs. Bargman and Rodby) for a opinion/response to this question, but I can't see any real advantage to int...

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Pd Question 8 hours ago

Dear colleagues , Would appreciate input APKD patient who has cyst infection requiring drainage with IR Now in intensive care unit with ionotropic ...

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RE: Biopsy dilemma in setting of severe refractory ITP 15 hours ago

Sorry UPEP is negative now. Was positive for monoclonal kappa light chains 1/31/25 Sent from my iPhone

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RE: CMT with nephrotic syndrome 16 hours ago

By my estimates, using the information available this patients kidneys are severely atrophic and fibrotic , inducating very chronic disease.. --...

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RE: Functional Classification of Dialysis-Dependent ESRD in Disability Frameworks 17 hours ago

The Functional Impairment screening Tool (FIST) seem to be a very valid and reliable way of classifying disability in older dialysis patients. See ...

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RE: Functional Classification of Dialysis-Dependent ESRD in Disability Frameworks 20 hours ago

Very difficult, complex and largely neglected areas of ESKD and its treatment by dialysis . Many books and book chapters available in the literatur...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

"I find it interesting all the past random you were positive. It is now negative." what was positive that is now negative? ------------------...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

Cryoglobulins are negative ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein MD Englewood NJ 201-567-0446 ------...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

Over the past years, she has had 3 BMbs. another one is now planned in coordination with Hematology understanding renal issues. I find it interesti...

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RE: Monosodium Urate Stone (MSU) 1 day ago

Thanks so much for such a thorough reply! He will be following up with urology soon and the plan is to repeat 24 hour urine collections in steady s...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

Hematology is closely following. In the past platelet transfusions, actually result in more antibodies and lowering of platelets so he is trying to...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

Yes they are negative ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein MD Englewood NJ 201-567-0446 -----------...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

Sorry to go backward, but did the cryoglobulins ever come back? certainly the neg RF agues against a cryoglobulin as most are IgM related, but ...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

I would seek help from experts in the blood bank and consider platelet transfusion indication and potential contraindications and risks in this cas...

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Functional Classification of Dialysis-Dependent ESRD in Disability Frameworks 1 day ago

I am a clinician managing End-Stage Renal Disease and have a specific question regarding the functional classification of dialysis-dependent patien...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

Final crops are negative only Sjogrens AB A positive with ACR 12 and UPCR 1.2 gms and random UPEP negative I suspect TIN from Sjogrens. better...

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RE: CMT with nephrotic syndrome 1 day ago

------------------------------ Mohamed Gharib MBBS Ain shams university Cairo 01000322177 ------------------------------

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 1 day ago

The elevated CO is a consequence of systemic vasodilatation and would represent a compensatory elevation in order to attempt to enhance kidney perf...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 1 day ago

Overdosing on Thiamine? why not. You don't injure a patient with a big dose of that. "Pan diuresis" (polypharmacy of all diuretics known to manki...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 1 day ago

No AV shunt, nor old wound that woudl cause an avf type bypass situation to my knowledge. Interesting re adding tolvaptan to the heavy hitter di...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 1 day ago

Hgb level low at 10.9, alkphos is ok, no liver disease (LFT's ok, US liver ok) labs suggestive of subclinical hyperthyroidism (TSH high at 10.9 mcI...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 1 day ago

I shall ignore the wet beri beri consideration, how great would that be if it were that simple? If not and the CO is accurate, is there any other...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Interesting suggestion. How do you factor the increased cardiac output into this formulation? ------------------------------ Richard Glassock MD,...

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RE: Monosodium Urate Stone (MSU) 2 days ago

Hi Dr Sarfaraz, Less than 0.5% of stones are composed primarily of NaUrate, so fairly uncommon. As you might guess, there are no trials of treat...

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RE: CMT with nephrotic syndrome 2 days ago

Thanks- i missed the fact that she is very tiny. What is her height (in cm) so her kidney size can be better understood. With a body weight of 40kg...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

I would take a slightly different approach as to pathophysiology. The history of hypertension, DM, with proteinuria suggests diabetic kidney diseas...

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RE: CMT with nephrotic syndrome 2 days ago

Thank you Dr Glassock. Indeed very challenging situation. She only weighs 30 kg so her small kidneys are probably proportionate to her size, e...

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RE: CMT with nephrotic syndrome 2 days ago

With bilateral small shrunken kidneys I would not do kidney biopsy but I would do genetic studies to better define the type of Charcot Marie Tooth ...

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RE: CMT with nephrotic syndrome 2 days ago

Thank you Dr Glassock for your valuable opinion. Yes I came accross INF-1 FSGS which has poor prognosis here unfortunately. My worry is tha...

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RE: CMT with nephrotic syndrome 2 days ago

I would manage without a kidney without a kidney biopsy in this case. But I would perform genetic testing to confrim CNT with FSGS due tovan autoso...

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CMT with nephrotic syndrome 2 days ago

Hi everyone, I would appreciate your opinion on this case 41-year-old lady with Charcot-Marie-Tooth syndrome, T2Dm since 2010 well controlled no c...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Thanks Dr. Glassock. AI says: "In wet beriberi, the typical mean pulmonary artery pressure (mPAP) iselevated, frequently presenting in the range of...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Answer- marked pulmonary arterial hypertension is a typical finding in "wet " Beri-Beri heart disease, I would give her megadoses of Thiamine now. ...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Dr. Venkat- are you considering "wet" Beri-Beri here?. Is pulmonary hypertension compatible with this. Why is this not " just" severe edema with Ne...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

High output heart failure: Hemoglobin level? Hyperthyroidism? Vitamin B1 deficiency? Liver disease? Pagets? In addition to obesity, the above are...

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RE: Monosodium Urate Stone (MSU) 2 days ago

@John Asplin I'm assuming thats the right doc to tag 😅 ------------------------------ Nimra Sarfaraz, DO (516) 637-3820 nimras@gmail.com --...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

I had her on diuril, acetazolamide, farrxiga, midodrine. On lasix drip had about 3 L of UOP and then when transitioned to oral meds between 500-150...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

She's on no BP meds and even with midodrine SBP remained in 120s Her RHC findings finalized as below CI > 5 CO 14 Wedge 20 Mean PAP 29 ...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Nephrotic edema to diabetic glomerulosclerosis (presumed by not proven ) can be a real challlenge. I had success with high dose Furosemude (IV), me...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Ultrafiltration is an excellent option for a case like this. Remove a couple of liters a day until euvolemia and decongestion is acchieved. Ultra...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 3 days ago

What other medications.? In patients such as these i typically stop calcium channel blockers/ vasodilators and find they often duress with a higher...

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