RE: STEC-HUS in pregnancy 17 minutes ago

@Richard Glassock That article could not be located with that reference. However I did manage to locate it and it seems very interesting that th...

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RE: low phosphate and smoldering myeloma 3 hours ago

Glycisurua is a major clue in this case, pointing to Fanconi syndrome.. ------------------------------ Richard Glassock MD, FASN Emeritus Profess...

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RE: low phosphate and smoldering myeloma 5 hours ago

Even though the assumption is renal losses of Phosphate due to Fanconi's , I would still like to confirm it by doing a Fractional Excretion of Po4,...

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RE: Post Renal Tx Chronic Steroid use and Anastomosis Leak 5 hours ago

Thanking you very much indeed for all of you for your very helpful feed back ------------------------------ Dr Mohamed Buhary MBBS, CCT, FRCP Con...

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RE: Post Partum AKI 6 hours ago

Thank you for your reply. The whole story started during rhe last month of pregnancy. Blood pressure was normal , yesterday was 146/94. Liver funct...

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RE: low phosphate and smoldering myeloma 7 hours ago

glycosuria (with I assume normal serum glucose or you wold have told us that) and hypophoshatemia with high Urine Phosphorus (Po4 wasting) thi...

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RE: Post Partum AKI 10 hours ago

I agree with Dr. Rodby - I doubt post-partum toxemia. I think this is unrecognized Primary glomerular Disease - she needs a kidney biopsy asap . An...

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RE: low phosphate and smoldering myeloma 10 hours ago

What are the absolute Free Light Chain seum values ? Does the patient have Fanconi Syndrome? What is serum uric acid , glucose and HCO3 level? What...

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RE: low phosphate and smoldering myeloma 11 hours ago

376.0 mOsm/kg urine osmolality ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: low phosphate and smoldering myeloma 11 hours ago

po42- chronically low since diagnosis of smoldering myeloma serum free light chain stable- never had treatment. urine acr 21.79 mg/mmol urin...

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low phosphate and smoldering myeloma 11 hours ago

DIAGNOSES: Asymptomatic kappa light chain myeloma (around 2023) Secondary polycythaemia Complex regional pain syndrome with left foot and ankle ...

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RE: Ckd 5 And Calciphylaxis 11 hours ago

This patient should be given 4-5 X per week HD, in my opinion. Not evidence based ------------------------------ Richard Glassock MD, FASN Emeri...

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RE: Ckd 5 And Calciphylaxis 11 hours ago

Vitamin K1 is phytonadione. Vitamin K2 is menaquinone. Both are forms of Vitamin K. Vitamin K2 seems to be more potent for therapy of calciphylaxis...

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RE: STEC-HUS in pregnancy 11 hours ago

Interestingly, genetic linkage for susceptibility/severity of STEC-related (typical ) HUS is more concerned with variation in non-complement genes ...

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RE: Ckd 5 And Calciphylaxis 12 hours ago

Thanks prof rodby Point noted. But If wife is suitable and he might also be on deceased donor list ( if wife not suitable ) Also highlights the ...

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RE: Post Partum AKI 12 hours ago

13 grams would be unusual for preeclampsia, and seems high for post-partum HUS too was she or is she HTNive? Does she have hematuria? I would...

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RE: Ckd 5 And Calciphylaxis 12 hours ago

Ideally 5X/week but that may be a bit much for starters, I would see how he does for a few months on 3X/week "In my experience the NOAC is sto...

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RE: Ckd 5 And Calciphylaxis 12 hours ago

Can i ask as he would start hd so we start three times a week or 5 times ? Any thoughts ? --------------------------------- Muhammad Soobadar MBC...

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RE: Ckd 5 And Calciphylaxis 12 hours ago

About Apixaban and listed for tx( reversal not licensed for this context in my centre switched to enoxparin or warfarin this reason -------------...

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RE: Ckd 5 And Calciphylaxis 12 hours ago

Thanks prof rodby , prof mellas , prof glassock and everyone In summary start HD and give thio Warfarin stopped @ Prof glassock You mean vitamin...

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RE: Hypertension With Impaired Natriuresis 12 hours ago

You can achieve 15 mmol/l of urine either with sodium restriction (if the daily ingestion of sodium is 20 mmol/day and the patient is in steady sta...

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Post Partum AKI 12 hours ago

I wanted to share this case with community looking for advice and suggestions for management. 25 year old female 7 days post partum. Delivered at 3...

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RE: STEC-HUS in pregnancy 14 hours ago

I think time is of the essence with TMAs (HUS), this is thrombosis and necrosis (limited recovery), not ATN (expected majority recovery) and I don'...

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RE: C3GN in the setting of melanoma 15 hours ago

Thank you very much Dr. Dastoor for your valuable insights. I will continue follow up this case. ------------------------------ Rui Song MD Willo...

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RE: C3GN in the setting of melanoma 15 hours ago

Thank you so much Dr Glassock for your valuable insights! The oncology team is planning for a bone marrow biopsy and considering daratumumab. Inter...

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RE: STEC-HUS in pregnancy 17 hours ago

In STEC- HUS , Shiga toxin can activate the AP of the complement system , especially in persons with underlying genetic vulnerability . They woul...

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RE: STEC-HUS in pregnancy 17 hours ago

Dr. Balan -Thanks for your useful (as usual ) commentary . STEC-related HUS seem to be a Complement dependent from of a TMA, not dependent on ADAMT...

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RE: Ckd 5 And Calciphylaxis 18 hours ago

Some pearls of wisdom about calciphylaxis in this thread. Many thanks. ------------------------------ Richard Glassock MD, FASN Emeritus Profess...

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RE: Encapsulating peritonitis 19 hours ago

We had a strikingly similar patient - a 17-year-old boy with bilateral nephrectomy for Wilms' tumor at age 2, then 15 years on PD. He developed EPS...

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RE: Ckd 5 And Calciphylaxis 20 hours ago

In my experience the NOAC is stopped by the transplant team due to delayed reversal, unlike coumadin, in the event an allograft becomes available. ...

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RE: Hypertension With Impaired Natriuresis 20 hours ago

Dr Jebur, If I may add to the discussion; Urine Na excretion is determined by pressure (pressure natriuresis) but also volume. In order to lower ...

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RE: STEC-HUS in pregnancy 20 hours ago

1.How can this be distinguished from complement mediated TMA for which pregnancy can be a trigger, except by the clinical course and timeline? ...

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RE: Hypertension With Impaired Natriuresis 20 hours ago

Suggest dietary history and 24 hr urine collection for sodium. Creatinine, and k to clarify what has already been expressed. ------------------...

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RE: Post Renal Tx Chronic Steroid use and Anastomosis Leak 20 hours ago

"should thus patient receive adjuvant chemotherapy? Should he be receiving Belatacept?" I am not a oncologist, however given the fact that we hav...

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RE: Post Renal Tx Chronic Steroid use and Anastomosis Leak 21 hours ago

Agree with Drs. Rodby and Rubin that in regard to his low-dose immunosuppression reversal of his clostomy is not contraindicated. Equally important...

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RE: Ckd 5 And Calciphylaxis 21 hours ago

Calciphylaxis would be unusual on a shin, not enough fatty tissue. I agree biopsy not the best way bc of healing , we tend to indirectly diagnose w...

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Applications for Travel Support to ASN Kidney Week 2026 Now Open 22 hours ago

Hi all, Travel support applications for the world's premier nephrology meeting, ASN Kidney Week, are now open and will close on Wednesday, June 10...

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RE: Iptacopan in IgA 1 day ago

As long as their eGFr's are improving , I would prefer to hold off on the biopsies ... if worsening will consider a biopsy, but I think it's too ea...

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RE: Iptacopan in IgA 1 day ago

wonder if doing another biopsy would help here. ------------------------------ M.N. Alhosaini ------------------------------

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RE: Hypertension With Impaired Natriuresis 1 day ago

Thank you Dr. Campese, How may we explain this randome urinary sodium excretion of 15 meq/l in the phase of uncontrolled to accelerated hypertensio...

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RE: STEC-HUS in pregnancy 1 day ago

Yes , if the patient is not improving I would consider a short trial of Complement blockers . The fact that C3NEF , c5nef , factor h may be negati...

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RE: Ckd 5 And Calciphylaxis 1 day ago

Did you stop warfarin and give Vitamin K? I believe that HD would be preferred for this patient. ------------------------------ Richard Glassock ...

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RE: STEC-HUS in pregnancy 1 day ago

Low seum C3 levels and elevated serum C5b-C9 (MAC) levels are commonly found in severe STEC-HUS implicating terminal and alternate pathway activati...

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RE: STEC-HUS in pregnancy 1 day ago

What if serum and urine C5b-C9 were greatly elevated -o would you use antiC5 MoAB then. Or only if anti-Factor H antibodies , C3NEF or C5NEF were p...

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RE: Hypertension With Impaired Natriuresis 1 day ago

I agree with Dr. Glassock that" he use of raw urine sodium concentration in spot urine to predict 24-hour urine sodium excretion/intake is full of ...

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RE: STEC-HUS in pregnancy 1 day ago

I agree about complement test but if no complement antibodies / result I would be reluctant to use c5 i in pregnant patient ( humble opinion) Not...

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Ckd 5 And Calciphylaxis 1 day ago

67 M Huddersfield LCC patient- ADPKD, HT, Crohn’s, PAF- Previously on DOAC but switched to warfarin to enable tx listing. Initially admitted to xxx...

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RE: Membranous Nephropathy 1 day ago

Appreciate the replies. ANCA is negative. PLA2R 172 (2/2025) --> Received Obi x 2 doses in 5/2025 --> 18 (6/2025) --> 6 (8/2025) PLA2R started...

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RE: STEC-HUS in pregnancy 1 day ago

Dr. Dastoor- All very reasonable conclusions. Can we have some follow up on what was done and what happened to the patient and the pregnancy? -...

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DEADLINE TOMORROW: Case Report Reviewer Volunteer Application Closes May 11! 1 day ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

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