RE: Avacopan 18 minutes ago

We have frank discussion with patient. Some have chosen to continue most of them stopped --------------------------------- Bajinder Reen MD Etobi...

View Discussion

RE: Avacopan 20 minutes ago

We are part of it. It is difficult to trial to enroll. Hopefully will be alternative in fyture --------------------------------- Bajinder Reen MD ...

View Discussion

RE: Avacopan 22 minutes ago

The real question I have is what will you do with a patient ON it that seems to be doing well. ------------------------------ Roger Rodby MD, FA...

View Discussion

RE: Avacopan 25 minutes ago

Thanks - the Alexion Phase 2 trial (TRANSCEND ) is currently in progress. ------------------------------ Richard Glassock MD, FASN Emeritus Prof...

View Discussion

RE: Avacopan 36 minutes ago

May be patient who responded to Avacopan needed low dose anyway without Avacopan. Just curious --------------------------------- Bajinder Reen MD...

View Discussion

RE: Avacopan 43 minutes ago

Sadly, I fear it will lead again to more use of steroids. ------------------------------ Jordan Rosenstock MD, FASN New York NY (212) 434-6800 -...

View Discussion

RE: Avacopan 58 minutes ago

When Data integrity is breached , it is big issue for me There is phase trial Trascend , may be an option in future -----------------------------...

View Discussion

Avacopan 1 hour ago

Today the European Medicine Agency (EMA) removed Avacopan from the market for therapy of ANCA Vasculitis Japan had done the same lat month. The FDA...

View Discussion

RE: AI in Kidney Care 23 hours ago

Dr. Wynn- Great question. It is importantly that you , and others , understand that Open Evidence, Claude, OpenAI (LLM and Agentuc general purpos...

View Discussion

RE: AI in Kidney Care 1 day ago

Same. It is a highly effective tool physicians can use to fine tune individualized patient care. Our education & practices continue to evolve....

View Discussion

RE: AI in Kidney Care 1 day ago

We could probably begin an infinitely long thread on AI in medicine and undergrad and graduate medical educatio There's something new and fascina...

View Discussion

RE: Recurrent CaPhos stones with low urinary citrate 1 day ago

Thanks for all the detailed clinical information. But I will always ask for more. As noted by Drs Glassock and Lerman, the simplest explanation f...

View Discussion

RE: AI in Kidney Care 1 day ago

Increasingly, I am using Claude (Anthropic) as well as Expert AI (UpToDate) to make informed responses to Posts on the ASN Open Forum. I find both ...

View Discussion

RE: Recurrent CaPhos stones with low urinary citrate 2 days ago

Yes it would be best for her to stop the topirimate especially if you can educate her on the relationship between the drug and her acidosis and sto...

View Discussion

RE: Recurrent CaPhos stones with low urinary citrate 2 days ago

Dr. Sawyers- thanks for the additional information, the low citrate excretion might be attributed to Topiramate.. It should be stopped, permanently...

View Discussion

RE: Recurrent CaPhos stones with low urinary citrate 2 days ago

Sir, Thank you for taking the time to reply. -Serial creatinines have been 0.89, 1.06, 0.93, 0.97 with concurrent eGFRs of 77, 63, >60, >60,...

View Discussion

RE: sibeprenlimab 2 days ago

Good point about complement inhibitors and viral infections. This is a problem will reveal itself when B-cell targeted therapy expands outside SL...

View Discussion

RE: Recurrent CaPhos stones with low urinary citrate 3 days ago

Have you considered r/o Sjögren's as the cause of dRTA particularly given the patients systemic symptoms. Unfortunately, even if she does have Sjog...

View Discussion

RE: Recurrent CaPhos stones with low urinary citrate 3 days ago

Dr Sawyers, Thanks for the thorough patient history, obviously a challenging case. I do have a few more questions for you: What is her current ...

View Discussion

AI in Kidney Care 3 days ago

Nice article in the June Kidney News focused on a study that benchmarks LLMs against human performance. Thank you @Karin Bergling and @Hanjie Zhang...

View Discussion

RE: Recurrent CaPhos stones with low urinary citrate 3 days ago

I am sure that Drs. Asplin or Goldfarb will give a much better answer to your question than mine . I think a real issue exists in the lack ever ach...

View Discussion

RE: sibeprenlimab 3 days ago

We would need to have a detailed description of the patient with IgAN to determine if Iptacopan was indicated in the first place. It seems unlikely...

View Discussion

Seeking Input for an NSF I-Corps Dialysis Initiative Monday, June 22 @ 2:13 PM

Hello everyone, My name is Ruimin Pan, and I am a Research Scientist at NYU Langone Health. My team and I are participating in the National Scien...

View Discussion

RE: sibeprenlimab Monday, June 22 @ 11:28 AM

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...

View Discussion

RE: sibeprenlimab Monday, June 22 @ 11:11 AM

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

View Discussion

RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation Monday, June 22 @ 9:34 AM

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

View Discussion

RE: Persistant metabolic acidosis after cystectomy Monday, June 22 @ 8:40 AM

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

View Discussion

RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation Monday, June 22 @ 8:37 AM

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

View Discussion

RE: Persistent metabolic acidosis after cystectoy Monday, June 22 @ 6:46 AM

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

View Discussion

RE: sibeprenlimab Monday, June 22 @ 2:14 AM

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

View Discussion

RE: Persistent metabolic acidosis after cystectoy Sunday, June 21 @ 9:32 PM

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...

View Discussion

RE: sibeprenlimab Sunday, June 21 @ 9:09 PM

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 ----------...

View Discussion

RE: Persistent metabolic acidosis after cystectoy Sunday, June 21 @ 9:08 PM

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...

View Discussion

sibeprenlimab Sunday, June 21 @ 8:46 PM

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...

View Discussion

RE: Persistent metabolic acidosis after cystectoy Sunday, June 21 @ 7:21 PM

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

View Discussion

RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation Sunday, June 21 @ 5:44 PM

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

View Discussion

RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation Sunday, June 21 @ 5:36 PM

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

View Discussion

RE: Persistent metabolic acidosis after cystectoy Sunday, June 21 @ 3:46 PM

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...

View Discussion

RE: Persistent metabolic acidosis after cystectoy Sunday, June 21 @ 3:02 PM

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

View Discussion

Recurrent CaPhos stones with low urinary citrate Sunday, June 21 @ 12:45 PM

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...

View Discussion

RE: Persistent metabolic acidosis after cystectoy Sunday, June 21 @ 12:41 PM

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

View Discussion

Persistent metabolic acidosis after cystectoy Sunday, June 21 @ 12:10 PM

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

View Discussion

RE: Rapidly progressive glomerulonephritis Sunday, June 21 @ 10:08 AM

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

View Discussion

RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation Sunday, June 21 @ 9:22 AM

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...

View Discussion

RE: Transplantation case Sunday, June 21 @ 9:03 AM

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 ...

View Discussion

RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation Sunday, June 21 @ 6:32 AM

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...

View Discussion

RE: + MPO ANCA RLV case Saturday, June 20 @ 5:46 PM

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 ...

View Discussion

RE: Membranous Nephropathy with PLA2R positive & crescents in 8/37 glomeruli with negative ANCA,ANA & ANTI GBM. Saturday, June 20 @ 5:39 PM

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

View Discussion

RE: Membranous Nephropathy with PLA2R positive & crescents in 8/37 glomeruli with negative ANCA,ANA & ANTI GBM. Saturday, June 20 @ 5:26 PM

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

View Discussion

RE: Persistent Indeterminate B-cell Crossmatch Before Living Donor Kidney Transplantation Saturday, June 20 @ 4:49 PM

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...

View Discussion