RE: Recurrence of IgA - post transplant 6 hours ago

Thanks for your response 1. I agree , we do a tapering dose of steroids , but he is currently taking instructions from his transplant nephrologist...

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RE: Membranous Nephropathy 7 hours ago

A measurement of anti-PLA2R antibody by the IFA method would be very helpful. the IFA is more sensitive than the ELISA so a negative result would c...

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RE: Osteoporosis In Stage 5 Ckd 7 hours ago

I just responded that I do feel a biopsy is the gold standard, the HR CT scan may be helpfu. I would avoid bisphosphonates in this patient with the...

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RE: Osteoporosis In Stage 5 Ckd 7 hours ago

In CKD one cannot use DEXA scans to differentiate osteopenia from Osteoprosus vex CKD-MB. A bone biopsy is the gold standard, A high resolution CT ...

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RE: Osteoporosis In Stage 5 Ckd 7 hours ago

Her decreased bone density may not have been the direct result of adynamic bone disease. I do think she would benefit from a biopsy, however, as me...

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RE: Membranous Nephropathy 7 hours ago

I no longer use the modified Ponticelli (too much steroids , in my opinion)I rely on Obinutuzumab monotherapy primarily and occasionally use a shor...

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RE: Membranous Nephropathy 12 hours ago

Thanks for update . I guess kidney biopsy will tell you . Tissue plar2 , EDD nature features of inflammation on LM or just chronic damage What p...

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RE: Hd Patient Running Out Of Access 12 hours ago

I suspect yes, the risk of perforation must be rare but I might as a radiation oncologist. anal cancer is pretty low and I would guess that the PD ...

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RE: GFR measurement in AKI with stable serum creatinine 12 hours ago

Congratulations to you and your son(?) Dr. Mellas. Your paper underscores what Dr. Pickering published 14 years ago (see attached) and that most of...

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RE: Osteoporosis In Stage 5 Ckd 12 hours ago

Thank you very much for your inputs. Is that reduced bone thickness is solely resultant of adynamic bone disease , the patient refused bone biopsy....

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RE: GFR measurement in AKI with stable serum creatinine 13 hours ago

As a follow-up to an old post; Attached is a recently published article describing a modeled mathematical proof of concept that a four hour urine c...

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Hd Patient Running Out Of Access 13 hours ago

Can we try pd in patient who has complex vascular and running of vascular access who had radiotherapy for anal squamous cell cancer Thanks

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RE: Dual Vascultis / Sle 14 hours ago

And why is crithidia not helpful in this setting? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle 14 hours ago

Do you biopsy then? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle 14 hours ago

Anca mpo --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle 14 hours ago

Blood culture negative , echo normal , complement Normal Not on hydralazine . Was dialysis dependent now eGFR 12 ----------------------------...

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RE: Membranous Nephropathy 14 hours ago

INR 1/7/2026 2.4 2/18/2026 3.0 3/11/2026 1.6 3/25/2026 2.7 Follows with coumadin clinic and they check every 4 - 6 weeks if INR is stable...

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RE: Dual Vascultis / Sle 14 hours ago

Complement (C3, C4) levels, rheumatoid factor, blood cultures, echocardiogram findings? ------------------------------ K.K. Venkat MD Troy MI (24...

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RE: Dual Vascultis / Sle 14 hours ago

Was the ANCA an anti-MPO or anti-PR3 or both? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------...

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RE: Dual Vascultis / Sle 14 hours ago

I don't think a Crithidia based antidsDNA will make much difference in therapy, regardless if the result.. Avacopan not indicated in dialysis depen...

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Dual Vascultis / Sle 15 hours ago

82 female , good functional status , hx of weight loss and unresolving chest infection/cough and haemoptysis needing filter and High flow 02 in Cal...

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RE: Recurrence of IgA - post transplant 15 hours ago

Dr. Dastoor/ as you know the optimal therapy for recurrent IgAN in a kidney transplant is highly uncertain due to the absence of any trials- a cour...

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RE: complex case of nephrotic syndrome in liver transplant patients 15 hours ago

Thanks prof glassock really helpful Kind regards --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Recurrence of IgA - post transplant 17 hours ago

Have a 60 year old gentleman , who underwent a living unrelated kidney transplant in the Phillipines approximately 8 years ago. Etiology of his r...

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RE: FSGS vs C3G and Canavan Disease 17 hours ago

She has been steroid on pulse steroids and MMF for now Awaiting EM results Creatinine slightly elevated last 24 hours ( ??Trimethoprim contri...

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RE: Polyuria 19 hours ago

Thanks Jaison. Better to do a cystoscopy then to rule out a chronic cystitis. In which case she will need further evaluation of the bladder with ur...

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RE: Dialyzer reaction 20 hours ago

Good morning Dr. Shah. Thank you for sharing your experience. Nipro Cellentia sounds like a strong backup option for patients with dialyzer reactio...

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RE: Dialyzer reaction 20 hours ago

Before dialysis, BUN was 79, serum sodium was 137. Thank you so much for your input! ------------------------------ Jinwook Park MD Assistant Pro...

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RE: Polyuria 20 hours ago

I think, as Dr Rodby has noted, the lack of nocturia makes this more a 'habit' issue than a pathology. If there were a concentration defect, she wo...

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RE: Osteoporosis In Stage 5 Ckd 21 hours ago

Thanks Dr. Sprague - after a deeper read and consultation with Open Evidence i agree with you concerning the lack of evidence demonstrating a clear...

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RE: Polyuria 23 hours ago

Update: I had asked for an early morning urine sample testing the reports of which came today. The early morning first urine osmolality is 319 mosm...

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RE: Postural hypotension 23 hours ago

Thanks Dr. Campese. I stopped fludrocortisone but did not stop midodrine. Serum Magnesium is normal. ------------------------------ Jaison George...

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RE: Postural hypotension 1 day ago

Did you stop midodrine? Did you measure serum Mg or, even better, erythrocyte Mg content? The patient is diabetic and has glycosuria. This leads fr...

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RE: Osteoporosis In Stage 5 Ckd 1 day ago

I again agree with Prof Glassock as I do not think there would be decreased chance of hypocalcemia, though not sure if it would be worse. The botto...

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RE: Postural hypotension 1 day ago

He feels better after stopping fludrocortisone and adding oral potassium supplements. His serum free light chain assay is normal (kappa 53.42, lamb...

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RE: Polyuria 1 day ago

Thank you Dr. Mellas. ------------------------------ Jaison George MD, MBBS Kollam, India ------------------------------

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RE: Canine amyloidosis treatment options 1 day ago

this is amazing! Can you post a picture of the 🐕? Mostly for fun since he responded to therapy? Does HIPPA apply to your veterinary patients...

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RE: Polyuria 1 day ago

The data is most consistent with mild, daily, and possibly excessive intake of water as evidenced by the pNa of 136 and U osm 146 suggesting an app...

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RE: Canine amyloidosis treatment options 1 day ago

Hi everyone, I just wanted to give an update on this dog for anyone who was interested. The dog has been receiving 4mg/m^2 of chlorambucil onc...

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RE: complex case of nephrotic syndrome in liver transplant patients 2 days ago

Hard question , because I can't factor in patient values or know whether UACR was trending downward ,But maybe 6 months. Your hypothesis of "l...

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RE: complex case of nephrotic syndrome in liver transplant patients 2 days ago

Thanks prof glassock how long would you wait for ? @ prof glassock if you have time for my not very cleve question question is in her case if she...

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RE: complex case of nephrotic syndrome in liver transplant patients 2 days ago

I do not think that we will ever know for sure, but the data available strongly suggests that this is Sirolimus induced diffuse Podocytopathy not a...

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RE: complex case of nephrotic syndrome in liver transplant patients 2 days ago

@ prof glassock and prof venkat you make a very important and good point . i did post a picture of acr on graph above but will display a clearer...

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RE: Membranous Nephropathy 2 days ago

“Later modified ponticelli regime failure” meaning it did not work Thanks for case and opportunity to learn / discuss --------------------------...

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RE: FSGS vs C3G and Canavan Disease 2 days ago

Normocomplementemic iC-MPGN makes IRGN less likely. Why not start steroids and MMF awaiting further studies ? Time in nephrons. -----------------...

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RE: Membranous Nephropathy 2 days ago

Sorry I missed that he was on coumadin prof glassock Was his level therapeutic over time ?And if so no need to exclude RVT Just curious what modi...

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RE: Osteoporosis In Stage 5 Ckd 2 days ago

No- I think just ithe opposite. Greater risk of hypocalcemia from Denosumab in presence of adynamic bone disease. Concomitant Hyperparathyroidism...

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RE: Membranous Nephropathy 2 days ago

Why? He is already in Warfarin. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------------------...

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RE: Membranous Nephropathy 2 days ago

And what about excluding renal vein thrombosis before a kidney biopsy ? Kind regards --------------------------------- Muhammad Soobadar MBChB ...

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RE: Pauci-Immune GN, Chronic, Minimally Active 2 days ago

Dr Glassock no hematuria now, eGFR is same. ------------------------------ Awais Nauman HMC Doha ------------------------------

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