RE: Intersting case-Need your opinion 3 hours ago

I totally agree Prof Glassock. This case has taught me a lot ------------------------------ Jagadeesh Kurtkoti MBBS, MD SOUTHPORT ---------------...

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RE: Intersting case-Need your opinion 4 hours ago

Dr. Kurtkoti- remarkable and highly instructive case. Thanks for the FU. It looks like we should retire the use of Eculizumab for C-mediated TMA an...

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RE: Intersting case-Need your opinion 5 hours ago

Dear all, Just an update on this lady. She improved soon after the swithc from Eculizumab to Ravulizumab. She came off dialysis and creatinine is...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 5 hours ago

This is the proverbial "64,000 Dollar " question!!a, So far as I know, the final 24 month data from the VISIONARY trial have not yet been published...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 7 hours ago

@Roger Rodby@Richard Glassock thanks for your responses. So , this woupd lead to my second question in that would you consider Sibeprelimab as th...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 10 hours ago

Without some sort of adjustment for severity of disease at randomization (e.g a prognostic score ) the eGFR slopes (in placebo arm ) between trials...

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RE: PR-3 ANCA with lung involvement 10 hours ago

With a presenting serum creatinine of 1.3mg/dL (maximum) can a multi-drug, PLEX based regimen really be justified? In my opinion, this patient will...

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RE: PR-3 ANCA with lung involvement 10 hours ago

I would consider attached ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associ...

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RE: Obstructing Urinary Stone 10 hours ago

Thanks. No NSAID. Only Opiods- I don't agree that acute total unilateral obstruction will not alter the serum creatinine concentration. The data fr...

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RE: ICI induced IgAV 10 hours ago

I suspect the AKI is as much from the RBC casts and ATN than the 17% crescents, I have no problem with ritux but might wait it out a bit longer -...

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RE: Pd Question. 10 hours ago

Do we need to hold pd for pancreatic biopsy using percutaneous US/CT technique ? I would, PD can be skipped for days typically without a problem ...

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RE: Obstructing Urinary Stone 10 hours ago

"One of the reasons for acute rise in creatinine following unilateral obstruction is reflex vasospasm in the contralateral kidney due to pain or ? ...

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RE: Obstructing Urinary Stone 11 hours ago

what did serum creat do? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas T...

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RE: Obstructing Urinary Stone 12 hours ago

Just an opinion. I would not wait a week. The patient is going to have ureteroscopy and stone removal tomorrow. ------------------------------ Ri...

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Pd Question. 12 hours ago

Dear colleagues , Do we need to hold pd for pancreatic biopsy using percutaneous US/CT technique ? Do we need to hold pd in APKD patient with haem...

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RE: ICI induced IgAV 12 hours ago

I would consider adding RTX at this point. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine...

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RE: Modality Of Imaging For Decline In Kidney Function 13 hours ago

Depends on the purpose of the imaging? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Professor of Medicine Director of Dia...

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ICI induced IgAV 13 hours ago

I would kindly appreciate your opinion on this patient 64M with history of NSCLC diagnosed last year s/p left upper lobectomy, has been on durval...

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RE: PR-3 ANCA with lung involvement 14 hours ago

This patient should receive RTX and Steroids according to the PEXIVAS protocol. In my opinion, PLEX is not indicated and the addition of CYC is not...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 14 hours ago

Your hypothesis may be incorrect, the placebo rate of eGFR decline will likely vary according to the risk profile of the randomized subjects, which...

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RE: is it lead poisoning? 14 hours ago

What are the units used by your lab? It this level further testing may not be needed. ------------------------------ Richard Glassock MD, FASN Em...

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RE: PR-3 ANCA with lung involvement 14 hours ago

Counsel patient for pregnancy as young and female and use ovarian protective medication --------------------------------- Muhammad Soobadar MBC...

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RE: PR-3 ANCA with lung involvement 14 hours ago

Ask about joint , sensory loss or legs arm and ent symptoms --------------------------------- Muhammad Soobadar MBChB UK -----------------------...

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RE: PR-3 ANCA with lung involvement 14 hours ago

Thanks for case I would use two pulse iv cyclo and rituximab due to pulmonary haemorrhage and crescent and would do plex ( tho this might be deba...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 14 hours ago

I guess what I am trying to get at , is the difference between placebo groups in Sibeprelimab and let's say phase 2 Ravulizumab , which could hypot...

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PR-3 ANCA with lung involvement 14 hours ago

I would like to ask for an expert opinion with regards to management of patient currently being seen in the hospital. F/28 years, referred to hos...

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RE: pr3 +ve is it endocarditis ? 14 hours ago

Thanks prof glassock we are following this route of action --------------------------------- Muhammad Soobadar MBChB UK -----------------------...

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RE: is it lead poisoning? 14 hours ago

Thanks prof glassock “plasma lead levels after administration of a chelating agent are much better for diagnosis if chronic lead poisoning.” Do I...

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RE: anti gbm serology postive with fever and raised inflammatory markers 14 hours ago

Question Is this pulmonary haemorrhage? tho pt has no has haemoptysis nor oxygen requirement Is it infection? No fever so i dont think If this...

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RE: anti gbm serology postive with fever and raised inflammatory markers 14 hours ago

@ prof venkat not cigarette smoker or vape user --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 14 hours ago

@ prof lerman HRCT done yesterday as hb keeps dropping and pt needing transfusion --------------------------------- Muhammad Soobadar MBChB UK -...

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RE: anti gbm serology postive with fever and raised inflammatory markers 14 hours ago

Anca negative thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Obstructing Urinary Stone 14 hours ago

One of the reasons for acute rise in creatinine following unilateral obstruction is reflex vasospasm in the contralateral kidney due to pain or ? R...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 15 hours ago

I am not sure what you are asking, are you overthinking it or am I underthinking it? but look at this figure GFR stable on sibeprenlimab , GFR...

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How to interpret VISIONARY Trial data on Sibeprenlimab 16 hours ago

Just wanted to get some thoughts on the Sibeprenlimab in the Visonary trial which was relesed at GlomCon Hawaii Looking at it : Placebo gro...

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RE: anti gbm serology postive with fever and raised inflammatory markers 17 hours ago

Dr. Muhammad, what about the ANCA serology? He might have an overlap syndrome, which supports the need for plasmapheresis and Cyclophosphamide (CYC...

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RE: anti gbm serology postive with fever and raised inflammatory markers 17 hours ago

@Muhammad Soobadar: is the patient a cigarette smoker? If not a smoker, risk pulmonary hemorrhage due to anti-GBM-ab is small. -----------------...

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RE: Obstructing Urinary Stone 18 hours ago

As mentioned by Dr. Lerman, SCr trend in the first 24-48 hours following living donor nephrectomy is relevant to this discussion. My experience is ...

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RE: Obstructing Urinary Stone 18 hours ago

Thank you, Professor, for sharing this case. I have a similar concern regarding the AKI that the patient experienced due to UUO. I would like to sh...

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RE: Modality Of Imaging For Decline In Kidney Function 18 hours ago

I assume that an abdominal CT is being done for reasons other than impaired kidney function. If this is the case, a separate US test is not require...

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RE: Modality Of Imaging For Decline In Kidney Function 19 hours ago

Prof. Glassock's case brought back an old teaching, do not know if true or old myth: "Reflex anuria" A long, long time ago heard old Urologists com...

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RE: Obstructing Urinary Stone 19 hours ago

Re: Lady with single kidney stone may be obstructed; Scr almost doubled. Is she taking OTC NSAIA's? Single kidney total obstruction should not chan...

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RE: anti gbm serology postive with fever and raised inflammatory markers 20 hours ago

ground -glass changes stable from when-? now that on IS( cyclophosphamide) must be very careful to diagnose infection follow this carefully! ----...

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RE: anti gbm serology postive with fever and raised inflammatory markers 20 hours ago

HRCT for anaemia requiring transfusion below and anti GBM >8 still today Respiratory Review sought Report Body CT Chest high resolution - 18-A...

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RE: Obstructing Urinary Stone 21 hours ago

One rationale for a 4–6 week trial of passage (if the patient can tolerate it) is to avoid the morbidity of stone procedures, particularly the issu...

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RE: Obstructing Urinary Stone 21 hours ago

Thanks Dr.Lerman for this comment. My Urology colleagues taught me to expect marked hydronephrosis in chronic partial obstruction and vesico-ureter...

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RE: is it lead poisoning? 21 hours ago

Probably of no consequence, plasma lead levels after administration of a chelating agent are much better for diagnosis if chronic lead poisoning. ...

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RE: Obstructing Urinary Stone 22 hours ago

"abdominal US shows mild to moderate hydronephrosis in the Right kidney." If completely obstructed the ultrasound should show severe hydronephrosis...

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RE: Obstructing Urinary Stone 22 hours ago

Thanks Dr. Glassock - great discussion regarding complete acute obstruction of one kidney with normal contralateral kidney. In living donors with n...

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RE: is it lead poisoning? 23 hours ago

Hi lead level are back . Blood lead 0.11 normal <0.1 Any thoughts ? Clinical lab scientist left comment saying repeat in 4 weeks if concerned Ma...

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