RE: sibeprenlimab 1 hour ago

My specific question was prompted by a pt with high titer core and sAb and negative sAg-ie no active infection but definitely with hx of past infec...

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RE: sibeprenlimab 1 hour ago

In The Phase 2 ENVISION trial, "known chronic infectious disease" was listed among the key exclusion criteria. This included patients with Hepatiti...

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RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation 3 hours ago

With a negative SAB I don't have anything else to offer except to follow the excellent advice of @Mark Lerman ------------------------------ Sati...

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RE: Persistant metabolic acidosis after cystectomy 4 hours ago

Thank you very much for your expertise and suggestions. Lactate has been measured repeatedly on blood gas analysis and fluctuates between 1.5 and ...

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RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation 4 hours ago

Thank you very much for your invaluable comments and expert guidance. As an update, the repeat Single Antigen Bead (SAB) assay remains negative, w...

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RE: Persistent metabolic acidosis after cystectoy 6 hours ago

The progression of kidney disease can be hastened by metabolic acidosis. Researchers at Tulane University, led by Sixto G. Giusti, MD, conducted a ...

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RE: sibeprenlimab 10 hours ago

Great question. The FDA approved level for Sibeprenlinab clearly states that patients prescribed this agent should be evaluated for active infectio...

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RE: Persistent metabolic acidosis after cystectoy 15 hours ago

Thanks Dr. Lerman for finding this case report I doubt the findings in this case have any clear relevance to the posted case under discussion. If P...

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RE: sibeprenlimab 15 hours ago

In order to assess reactivation risk we will need to know the following tests results: LFTs, HBVs Ag and Ab, HBV DNA, HBVc IgG and IGM ----------...

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RE: Persistent metabolic acidosis after cystectoy 15 hours ago

found a single case report on-a case suggesting a PPI contributed to metabolic acidosis in a patient with dRTA secondary to autoimmune hepatitis wi...

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sibeprenlimab 16 hours ago

Wondering if anyone has any data or experience with Sibeprenlimab or other APRIL -BAFF agents on background of hep B core positivity should we tre...

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RE: Persistent metabolic acidosis after cystectoy 17 hours ago

What is the evidence that a PPI causes metabolic acidosis? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen Sch...

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RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation 19 hours ago

"we would greatly appreciate your opinion on whether you would still proceed with basiliximab or consider ATG induction instead. given age of pot...

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RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation 19 hours ago

A Flow cytometric crossmatch can detect DSA that may be missed by SAB, particularly antibodies against alleles not represented on the bead panel. A...

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RE: Persistent metabolic acidosis after cystectoy 21 hours ago

The use of PPI's was proposed (a decade ago +) to ameliorate the metabolic alkalosis which associates with NG suction via a decrease in gastric aci...

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RE: Persistent metabolic acidosis after cystectoy 21 hours ago

Proton pomp inhibitor ------------------------------ Daniel Van Caesbroeck MD Turnhout 3214658919 ------------------------------

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Recurrent CaPhos stones with low urinary citrate 1 day ago

I was hoping for the group's input on management strategies for a 54 yo female with a history of recurrent calcium phosphate stones (100% hydroxyap...

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RE: Persistent metabolic acidosis after cystectoy 1 day ago

This is a novel suggestion. I can't find any literature that supports it. What mechanism for such effect do you propose? -----------------------...

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Persistent metabolic acidosis after cystectoy 1 day ago

Pantoprazole could also be a driver of metabolic acidosis ------------------------------ Daniel Van Caesbroeck MD Turnhout 3214658919 ----------...

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RE: Rapidly progressive glomerulonephritis 1 day ago

Thank you all for the contribution. EM was difficult to interpret since it contained few glomeruli with predominantly ischaemic changes. However, ...

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RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation 1 day ago

From the post, I see that his antibody screen is negative but a HLA DSA has not been done. In this case, I would definitely need a HLA DSA. If that...

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RE: Transplantation case 1 day ago

Yes it is worth screening if vigourous excercise is related to AKI especially if serum uric acid is low or low normal during episode -@Zineb Taaam ...

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RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation 1 day ago

Thank you very much for your invaluable comments and expert advice. We are truly grateful for your time and guidance. To answer Dr. Soobadar's que...

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RE: + MPO ANCA RLV case 1 day ago

We will have to agree to disagree on this point. My AI consultant and colleague (Claude ) agrees with me that the urinary albumin-creatinine ratio ...

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RE: Membranous Nephropathy with PLA2R positive & crescents in 8/37 glomeruli with negative ANCA,ANA & ANTI GBM. 1 day ago

Epitope spreading as a prognostic indicator in Primary MN, independent of the total anti-PLzA2R antibody , is controversial and predominantly a res...

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RE: Membranous Nephropathy with PLA2R positive & crescents in 8/37 glomeruli with negative ANCA,ANA & ANTI GBM. 1 day ago

In mn relapsers there is concept of epitope spreaders vs non spreaders and impact as result can you explain ? --------------------------------- M...

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RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation 1 day ago

Many thanks for case and input from Prof lerman Haploidentical means 50% genetic match. Therefore as alluded doing flow on top sab with cdc for com...

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RE: Persistant metabolic acidosis after cystectomy 1 day ago

the anion gap can fool you. If the baseline is low a normal anion gap may be lelvated. I like the above idea of checking lactate and B-oH butyrat...

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RE: + MPO ANCA RLV case 1 day ago

@Richard Glassock says "I think that Dr. Rodby's more conservative suggestions are very reasonable (as expected) but proteinuria is likely to be ...

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RE: Transplantation case 1 day ago

I know that it is a rare cause of recurrent AKI, but exercise induced AKI , with spontaneous reversibility has been observed in patients with genet...

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RE: + MPO ANCA RLV case 1 day ago

I will admit that the persistence of + anti-MPO serology has influenced my opinions in this case. I fully recognize, the possibility that the persi...

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RE: + MPO ANCA RLV case 2 days ago

I will have those results back early next week. Thank you. Sent from my iPhone

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RE: Transplantation case 2 days ago

it would be interesting especially if serum uric acid levels were unusually high or low but since each episode recovered with IV 0.9 NS not sure ho...

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RE: Transplantation case 2 days ago

Got it thanks. Would it be worthwhile to study fractional excretion of uric acid after the patient has recovered from AKI. What about genetic studi...

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RE: Transplantation case 2 days ago

Dr. Lerman -what is the date of the post and the topic title so I can find the discussion of this case in es in the Transplantation Community posts...

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RE: + MPO ANCA RLV case 2 days ago

What are the values for ESR and CRPas Biomarkers for "active inflammation"? ------------------------------ Richard Glassock MD, FASN Emeritus Pro...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

HI John, I also wondered about SGLT2 and Metformin contributing but AG 6 ( though HCO3 was taken from BG ) would seem to exclude euglycemic DKA and...

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RE: Transplantation case 2 days ago

this same case has been discussed in more detail under KIDNEY TRANSPLANTATION community ------------------------------ [Mark] [Lerman] [MD,FASN,F...

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RE: Transplantation case 2 days ago

Do the episodes of have any relationship to vigorous exercise or gross hematurua/hemoglbinuria ? .. is the donor perfectly healthy? How firm is the...

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RE: Transplantation case 2 days ago

Denovo Iga diagnosis was confirmed by IF staining ? any hematuria along with protienuria What's his HB AIC < his sugar under control Th...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

I also wondered about SGLT2i euglycemic ketoacidosis and Metformin lactic acidosis playing a role, but the normal anion gap discouraged those two t...

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RE: + MPO ANCA RLV case 2 days ago

I suppose this is one of the issues that has bothered me… With the presence of an active urine sediment, and no evidence of increased albuminuria,...

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RE: + MPO ANCA RLV case 2 days ago

I think that Dr. Rodby's more conservative suggestions are very reasonable (as expected) but proteinuria is likely to be a poorly reliable biomarke...

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RE: + MPO ANCA RLV case 2 days ago

Thank you Dr. Rodby. Sent from my iPhone

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

Thank you Dr. Emmett for your customary thoughtful comments and therapeutic suggestions. ------------------------------ Mario Rubin, M.D. Housto...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

Very interesting discussion. Couple of things to point out. First re mechanism – there is one abstract describing 2 patients with One thing I h...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

@Joseph Crivelli Excellent points. Thank you ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 -----------------------...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

Agree with trying to replace at least some of the sodium bicarbonate with potassium citrate, with caution because of lisinopril. His serum K looks ...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

Dr. Rubin you are correct to question the sensitivity of ultrasound in measuring residual urinary volume in an orthotopic ileal Bladder as Trans...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

@Michael Emmett @Biff Palmer Stasis of urine within the pouch (as already mentioned) leads to enhanced activity of the Cl-/HC03- intestin...

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