RE: Pd Question 40 minutes ago

No did not remove it. Is it something that needs to be done ? --------------------------------- Muhammad Soobadar MBChB UK ---------------------...

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RE: anti gbm serology postive with fever and raised inflammatory markers 6 hours ago

I want to share this update on the management of Anti-GBM; still, we are limited by evidence, and all depends on how early the diagnosis and interv...

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RE: Pd Question 7 hours ago

Did you remove the external catheter cuff? ------------------------------ Giovanni Cancarini Nephrologist Brescia, Italy gcancarini@alice.it ----...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 8 hours ago

Professor Richard, I agree that we should repeat the biopsy and then decide on the further plan accordingly, especially given the absence of c...

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Pd Question. 9 hours ago

https://journals.sagepub.com/doi/10.1177/08968608221125714?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-bibr44-...

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RE: Pd Question 10 hours ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC4655795/ --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Pd Question 10 hours ago

Dear colleagues , How long to treat pseudomonas exit site infection in pd patient on APD ? I have a patient who pseudomonas ESI resistant to Cipr...

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RE: Pd Question. 11 hours ago

Very helpful Paper prof bargman Any colleagues have info/ resource on mesh repair and pd dialysis whether needs holding or not ? Thanks --------...

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RE: Pd Question. 11 hours ago

Many thanks prof bargman and prof rodby Case 1 Patient was given 48 hr break post pancreatic biopsy . Drain was bloody but settled down day aft...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 19 hours ago

I have a few questions. This patient has had only one kidney biopsy 8 +years ago showing Class III LN. The Anti-DNA has been negative for oast 8 mo...

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RE: anti gbm serology postive with fever and raised inflammatory markers 23 hours ago

I agree with the hypothetical scenario, except I would use CYC for another 4-week, plus steroids. Not much evidence for RTX in antiGBM with DAH . ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 23 hours ago

Thanks prof glassock the mdt met this afternoon and decided to stop ( personally I would have tried with Atleast 4 weeks of cyclo before calling ...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 1 day ago

Thank you for sharing this challenging case. From my perspective, I would consider this SLE-associated secondary TMA with complement amplificatio...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 1 day ago

With the strong evidence of serological activity of LN , I am not very confident that a repeat biopsy will contribute much to treatment decision ma...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Almost 4 weeks dialysis dependent and still not anti-GBM negative. The prognosis for recovery of renal function is very poor, but only the treating...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

22nd July dialysis dependent Post plex ( 3rd or 4th anti gbm level >8) --------------------------------- Muhammad Soobadar MBChB UK -----------...

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RE: PR-3 ANCA with lung involvement 1 day ago

The reason i brought up the Rituxvas trial was that they used in the Rituximab arm, IV Cyc day 1 and day 15 .. i thought this was the only rct evid...

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RE: PR-3 ANCA with lung involvement 1 day ago

the CYCLOPS trial compared IV to oral CYC in vasculitis in a RCT. The only differences were a lower cumulative dosage in IV and an increae in relap...

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RE: PR-3 ANCA with lung involvement 1 day ago

Daily oral CYC was the standard for lupus until the NIH started IV CYC monthly infusions for SLE which gained popularity bc of adherence and ease. ...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 1 day ago

Dear Dr. Mohammed, Thank you for your helpful advice. I have also been considering a repeat kidney biopsy and will likely proceed. We will also i...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 1 day ago

Dear Professor Glassock, Thank you so much for your feedback on my case. The patient has not received standard triple therapy because treatment...

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RE: Obstructing Urinary Stone 1 day ago

Glad she has done well! Would have loved to know what creatinine was prior to stone removal. Just regarding our discussion 😁 -------------------...

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RE: PR-3 ANCA with lung involvement 1 day ago

Thank you Prof. Glassock! --------------------------------- Mark Nader MD Germantown TN (201) 805-2000 ---------------------------------

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RE: Obstructing Urinary Stone 1 day ago

Both the patient and myself were concerned about the ill effects of untreated presumed complete unilateral urinary tract obstruction by a stone at ...

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RE: PR-3 ANCA with lung involvement 1 day ago

Oral was the way CYC was delivered in the trial. There pr is no proven advantages of IV over oral CYC in outcome studies of Vasculitis. In a compli...

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RE: Obstructing Urinary Stone 1 day ago

Exactly why an elevated creatinine above baseline in your patient with stone producing unilateral hydronephrosis ( mild to moderate ) on US was con...

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RE: PR-3 ANCA with lung involvement 1 day ago

@Richard Glassock , is there a reason you prefer oral cyclophosphamide in this case as opposed to IV cyc x 2 doses such as in the rituxvas trial? A...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

How long has he been oliguric and requiring dialysis?. Is his antiGBM antibody negative pre-PLEX? ------------------------------ Richard Glassock...

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RE: is it lead poisoning? 1 day ago

This is glomerular proteinuria and a near normal plasmal lead. I do not think that further testing is needed. ------------------------------ Ric...

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RE: is it lead poisoning? 1 day ago

0.11 umol/L <0.1 ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

@prog glassock do you agree for continuing cyclo and plex for now? ------------------------------ Muhammad Soobadar MBChB UK -------------------...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Timeline 4/08 first dose methlypred and on weaning pred He has finished 9 session of plex on Monday 19/08 first one 5/08 Cyclophosphamide 150 mg ...

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RE: Pd Question. 2 days ago

"I can't really comment about when a mesh is used, but we routinely continue with PD after a hernia repair. We will keep the patient dry for a few ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

May discuss with Pulom team if can go for bronchoscopy and BAL screen for any co-existing infection ------------------------------ Saja Mohammed...

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RE: Obstructing Urinary Stone 2 days ago

Reflex vasospssm in the contralateral kidney in acute urinary tract obstruction is stil a hypothesis, in my opinion. The serum creatinine level doe...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 2 days ago

If the platelet count is now above 100, I suggest repeating the kidney biopsy. Based on the initial presentation and biopsy findings, the patient l...

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RE: Pd Question. 2 days ago

I would hold PD for at least 24 hours after a pancreatic biopsy, and maybe more if it was a difficult procedure. Roger is right that PD patients ca...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 2 days ago

Is it correct that this X patient has not received standard "triple therapy " (MMF + Steroids + Obinutuzumab or Voclosporin or Belimumab) ) for sev...

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Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 2 days ago

Dear colleagues, I'd like to share a diagnostically challenging case from our nephrology unit, on which I would value the community's input. Case p...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

What is your question? Is the serum anti-GbM still positive. How long has the patient been oliguric and on HD. How many PLaeX sessions has he recei...

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RE: anti gbm serology postive with fever and raised inflammatory markers 2 days ago

@ prof glassock any thoughts on this issue please 🙏🏼 --------------------------------- Muhammad Soobadar MBChB UK -----------------------------...

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RE: Intersting case-Need your opinion 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days ago

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

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RE: Obstructing Urinary Stone 2 days 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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