RE: Approach to flank pain ( my case series) 3 hours ago

Gross hematuria/clots have been described in association with IgA . See attached. ------------------------------ Mario Rubin, M.D. Houston TX (...

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RE: Pd Question 4 hours ago

Dr. Soobadar: How old is your patient? If she is a candidate for kidney transplantation, given the severity of her cyst infection, nephrectomy (as ...

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RE: uTi In Anuric Hd Patients 17 hours ago

I can think of several situations wherein UTI may occur in an anuric ESKD/dialysis patient: 1. As already pointed out by Dr. Rodby, some "anuric" p...

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RE: uTi In Anuric Hd Patients 20 hours ago

UTIs are often related to stasis and that is certainly something you will see in an ESRD patient, Yes I have seen what I thought to be cystitis in ...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 20 hours ago

"Pan diuresis" (polypharmacy of all diuretics known to mankind given all at once) is in my experience a good segway to severe azotemia and ESRD." ...

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RE: Approach to flank pain ( my case series) 20 hours ago

I have 'Never" seen gross hematuria with "clots" in IgAN. If the history is reliable In doubt that the hematuria is due to igAN without any LM abno...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 20 hours ago

Her BP is starting to rise! I have switched her to UF only for the past 24 hours and will continue for the next day or so as electrolytes are the s...

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RE: Approach to flank pain ( my case series) 20 hours ago

@ prof glassock how do explain case 3 biopsy ? Do you think its ig a ? Kr --------------------------------- Muhammad Soobadar MBChB UK ----------...

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RE: Approach to flank pain ( my case series) 21 hours ago

Thanks really helpful. Will mention it to urologist Kind regards and thanks for help --------------------------------- Muhammad Soobadar MBChB ...

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RE: Approach to flank pain ( my case series) 22 hours ago

See my edits to correct spelling errors . Deitl's crises are flank /abdominal pain episodes associated with UPJ obstruction. --------------------...

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RE: Pd Question 22 hours ago

Thanks prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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uTi In Anuric Hd Patients 22 hours ago

I was just wondering if colleagues have ever diagnosed UTI in anuric dialysis patients and if so how as no urine to test ? Kind regards

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RE: Pd Question 23 hours ago

Understood. Boots on the ground are better than arm chair philosophy when dealing with a life-threatening condition.I hope things go well with your...

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RE: Approach to flank pain ( my case series) 23 hours ago

Thanks prof glassock What do you mean “Probsbly Deitl's cresisex. Needs a retrograde pyelonephritis. “ by? Thanks so much for prompt reply KR ...

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RE: Approach to flank pain ( my case series) 23 hours ago

Just a few opinions. Case #1- bilateral UPJ obstruction of onkniwn cause, does alcohol make flank pair appear. Probably no Deitl's crises . Needs...

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RE: Pd Question 1 day ago

Appreciate and grateful for such promptly advise by experts to give care to patient in different continent 🙏🏼🙏🏼🙏🏼 -------------------------...

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RE: Pd Question 1 day ago

They have advise IR drain --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Pd Question 1 day ago

Thanks prof glassock my humble reading is this is a cyst infection and that has led to pyelonephritis . Source control should be drain . But I thin...

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RE: Pd Question 1 day ago

Dr. Soobadar. Thanks. I only raised the question about nephrectomy as I was taught (many years ago by a first class urologist ) that gas in the kid...

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Approach to flank pain ( my case series) 1 day ago

case 1( RPF and Nutcracker syndrome rule out on imaging) is it loin pain haematuria syndrome with complex urological history Gyane do not feel it...

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RE: Pd Question 1 day ago

Yes it’s amazing that I get answer so promptly helping in managing complex case with best evidence Very grateful @ prof glassock if she improves...

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RE: Pd Question 1 day ago

Thanks Dr. Bargman for the prompt and very helpful response. With emphysematous pyelonephritis in an AKPD patient on dialysis who is very ill, woul...

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RE: Pd Question 1 day ago

thanks prof glassock and prof bargman i have told iTU colleagues to give her a break from PD and do temporary HD via jugular line till this sepsi...

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RE: Pd Question 1 day ago

You don't specify where in the kidney the infected cyst is located. We published a case report of a PD patient who developed Serratia pyelonephriti...

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RE: Pd Question 1 day ago

I will defer to the PD and CRRT experts (Drs. Bargman and Rodby) for a opinion/response to this question, but I can't see any real advantage to int...

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Pd Question 1 day ago

Dear colleagues , Would appreciate input APKD patient who has cyst infection requiring drainage with IR Now in intensive care unit with ionotropic ...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

Sorry UPEP is negative now. Was positive for monoclonal kappa light chains 1/31/25 Sent from my iPhone

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RE: CMT with nephrotic syndrome 1 day ago

By my estimates, using the information available this patients kidneys are severely atrophic and fibrotic , inducating very chronic disease.. --...

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RE: Functional Classification of Dialysis-Dependent ESRD in Disability Frameworks 1 day ago

The Functional Impairment screening Tool (FIST) seem to be a very valid and reliable way of classifying disability in older dialysis patients. See ...

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RE: Functional Classification of Dialysis-Dependent ESRD in Disability Frameworks 1 day ago

Very difficult, complex and largely neglected areas of ESKD and its treatment by dialysis . Many books and book chapters available in the literatur...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

"I find it interesting all the past random you were positive. It is now negative." what was positive that is now negative? ------------------...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

Cryoglobulins are negative ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein MD Englewood NJ 201-567-0446 ------...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

Over the past years, she has had 3 BMbs. another one is now planned in coordination with Hematology understanding renal issues. I find it interesti...

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RE: Monosodium Urate Stone (MSU) 2 days ago

Thanks so much for such a thorough reply! He will be following up with urology soon and the plan is to repeat 24 hour urine collections in steady s...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

Hematology is closely following. In the past platelet transfusions, actually result in more antibodies and lowering of platelets so he is trying to...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

Yes they are negative ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein MD Englewood NJ 201-567-0446 -----------...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

Sorry to go backward, but did the cryoglobulins ever come back? certainly the neg RF agues against a cryoglobulin as most are IgM related, but ...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

I would seek help from experts in the blood bank and consider platelet transfusion indication and potential contraindications and risks in this cas...

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Functional Classification of Dialysis-Dependent ESRD in Disability Frameworks 2 days ago

I am a clinician managing End-Stage Renal Disease and have a specific question regarding the functional classification of dialysis-dependent patien...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

Final crops are negative only Sjogrens AB A positive with ACR 12 and UPCR 1.2 gms and random UPEP negative I suspect TIN from Sjogrens. better...

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RE: CMT with nephrotic syndrome 2 days ago

------------------------------ Mohamed Gharib MBBS Ain shams university Cairo 01000322177 ------------------------------

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

The elevated CO is a consequence of systemic vasodilatation and would represent a compensatory elevation in order to attempt to enhance kidney perf...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Overdosing on Thiamine? why not. You don't injure a patient with a big dose of that. "Pan diuresis" (polypharmacy of all diuretics known to manki...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

No AV shunt, nor old wound that woudl cause an avf type bypass situation to my knowledge. Interesting re adding tolvaptan to the heavy hitter di...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

Hgb level low at 10.9, alkphos is ok, no liver disease (LFT's ok, US liver ok) labs suggestive of subclinical hyperthyroidism (TSH high at 10.9 mcI...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 2 days ago

I shall ignore the wet beri beri consideration, how great would that be if it were that simple? If not and the CO is accurate, is there any other...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 3 days ago

Interesting suggestion. How do you factor the increased cardiac output into this formulation? ------------------------------ Richard Glassock MD,...

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RE: Monosodium Urate Stone (MSU) 3 days ago

Hi Dr Sarfaraz, Less than 0.5% of stones are composed primarily of NaUrate, so fairly uncommon. As you might guess, there are no trials of treat...

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RE: CMT with nephrotic syndrome 3 days ago

Thanks- i missed the fact that she is very tiny. What is her height (in cm) so her kidney size can be better understood. With a body weight of 40kg...

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RE: pulmonary hypetension, nephrotic syndrome refractory to diuresis, SCUF? HD with UF Only? 3 days ago

I would take a slightly different approach as to pathophysiology. The history of hypertension, DM, with proteinuria suggests diabetic kidney diseas...

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