RE: Parvovirus B19 associated FSGS 2 minutes ago

I must admit tgat I have no personal experience with treating Parvovirus induced FSGS. And the literature consists mainly of case reports And limit...

View Discussion

Parvovirus B19 associated FSGS 8 hours ago

Hello all, I'm looking for advice on a case of parvovirus B19 associated FSGS. A 43-year-old Filipino gentleman presented last year with overt ...

View Discussion

RE: FSGS vs C3G and Canavan Disease 15 hours ago

Returning to this case , with a cresenteric and necrotizing GN , strong C3/IgM condominamce , weak IgA and IgG , should we be considering Bartonell...

View Discussion

RE: Bivalirudin for CRRT 19 hours ago

We considered it during COVID bc of so much filter clotting and was in a treatment algorithm, but I'm not sure we ever used it but I looked at th...

View Discussion

RE: PD question - Peritoneal dialysis in bile peritonitis with an indwelling PTGBD and exhausted hemodialysis vascular access 19 hours ago

Seems like you are between "A rock and a hard place" I suppose you could do PD with smaller more frequent exchanges you may get some leakage f...

View Discussion

PD question - Peritoneal dialysis in bile peritonitis with an indwelling PTGBD and exhausted hemodialysis vascular access 20 hours ago

Dear colleagues, I would like to share and seek your expert advice on a highly challenging clinical case below. Case summary A 57-year-old wo...

View Discussion

Bivalirudin for CRRT 20 hours ago

We are exploring use of bivalirudin for CRRT circuits (prefilter) that clot early or repeatedly. We do not currently use citrate and are reluctant ...

View Discussion

RE: Renal-restricted antiGBM 22 hours ago

Thanks for posting thus interesting case. Q1- i would stop PLEX and monitor anti-GBM leveks periodically Q2 I would taper and stop CYC Q3. I ...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

This case is certainly one that brings to mind Hickams Dictum- "the patient can have as many diseases as they damn well please " ----------------...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

The EM findings do not fit with MN and look more like MPGN. Can we have another opinion on the renal pathology in this . case. Dr. Brodsky, Dr. Fog...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

Yes, we tested for cryoglobulinemia more than once, with proper collection and processing. Unfortunately, although it was also our main suspicion, ...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

It may be a long shot but I would still test for VEGF ( and my Ai consultant agrees).. the renal cell carcinoma just does not fit into this picture...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

We have all serologies negative, including viral loads and HCV DNA. Flow cytometry did not identify any abnormalities. ANA is also negative. We con...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

The overall picture is more compatible with Type II (mixed ) cryoglobulinemia with neuropathic Vasculitis than POEMs Syndrome, but I would do a ser...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

Before excluding POEMS Syndrone in this case you should do special flow cytometry for monoclonal cell and do serum VEGF.levels . Up to 20% of POEMS...

View Discussion

Renal-restricted antiGBM 1 day ago

Dear doctors, I would like to share a patient who, per renal pathology, luckily, has the "mildest form of antiGBM dz" they have seen. 53 y/o la...

View Discussion

RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

Please find the attached files. ------------------------------ Joao E Lima Souza MS UNIVERSIDADE FEDERAL DE PERNAMBUCO Universidade federal de pe...

View Discussion

Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 1 day ago

Requesting guidance regarding a case of a 51-year-old male with a two-year history of recurrent edematous syndrome and hypertensive emergencies, wi...

View Discussion

RE: Hd Patient Running Out Of Access 1 day ago

It is worth a try. The rectum, sigmoid colon ascending and descending colon are retroperitoneal structures. I suspect the risk of perforation is mo...

View Discussion

RE: Hd Patient Running Out Of Access 1 day ago

I agree with Dr . Rodby. The peritoneal membrane in pretty resistant to radiation injury . I have never seen any significant peritoneal membrane ir...

View Discussion

RE: Hd Patient Running Out Of Access 1 day ago

"I was thinking along radiation to peritoneum and damage and therefore high risk of pd not working" Good thought , but radiation is very targeted...

View Discussion

RE: Osteoporosis In Stage 5 Ckd 1 day ago

Again I agree and it is similar to the article I mentioned earlier J Clin Pharmacol 2022 Apr 2;62(9):1132–1141. doi: 10.1002/jcph.2050 --------...

View Discussion

RE: Membranous nephropathy 1 day ago

Hi. Thanks very much! Very Interesting case. If you have a chance please let us know how your pt is doing with treatment Thanks for sharing this ...

View Discussion

RE: Osteoporosis In Stage 5 Ckd 2 days ago

The rationale , efficacy and safety issues concerning the use of Rososuzunab or Teriparatide in Adynamic Bone Disease in CJD is very well summarize...

View Discussion

RE: Osteoporosis In Stage 5 Ckd 2 days ago

May I ask you what is Rational of using Romosozumib in this patient? How teriparatide modefied dose may help? --------------------------------- Wa...

View Discussion

RE: Membranous nephropathy 2 days ago

Hi Dr. Garrick. The duodenal biopsy report came two days ago and it's benign and no dysplastic features. So I hope I can take this as a PLA2R negat...

View Discussion

RE: Canine amyloidosis treatment options 2 days ago

Yes! These are my colleagues at the International Veterinary Renal (and Urinary) Pathology Service. It is physically within Texas A&M. Those are th...

View Discussion

RE: Canine amyloidosis treatment options 2 days ago

A friend of mine just sent me this poster. It looks like mass spectrometry proteomics is being explored in veterinary medicine. The technique here ...

View Discussion

RE: Hd Patient Running Out Of Access 2 days ago

Worth a try considering complexity of the patient certainly as an advanced laparoscopic insertion- to have a nice look around and do adjunctive pro...

View Discussion

RE: Hd Patient Running Out Of Access 2 days ago

Thanks prof rodby I had not make That link to perforation and was inquisitive to learn about your thought process.( as in I had not thought about ...

View Discussion

RE: Canine amyloidosis treatment options 2 days ago

awwwwwww! ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicago IL (773) 505-3...

View Discussion

RE: Hd Patient Running Out Of Access 2 days ago

well I suppose the anus is attached to the rectum and the rectum to the peritoneal cavity ... Clearly there was a concern of something or you wou...

View Discussion

RE: Membranous nephropathy 3 days ago

Hi Did results of duodenal return? Perhaps I missed them. Thanks! ------------------------------ Renee Garrick,MD,FACP, FASN Professor of Cl...

View Discussion

RE: Recurrence of IgA - post transplant Saturday, April 25 @ 2:24 AM

In regards to cost help may be on the way. Recently I did a survey, on a C5 blocker given every 8 weekly ( assuming Ravulizumab). The phase 3 data ...

View Discussion

RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. Friday, April 24 @ 6:31 PM

Update - patient admitted to hospital with general deterioration. All Family members agreed to stop and for conservative care Best regards ------...

View Discussion

RE: Hd Patient Running Out Of Access Friday, April 24 @ 5:06 PM

What would perforate ? Bw --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Recurrence of IgA - post transplant Friday, April 24 @ 4:31 PM

I'm curious to see how the felzartamab data stacks up. Also, my understanding is that atacicept has an ongoing trial which specifically includes re...

View Discussion

RE: Recurrence of IgA - post transplant Friday, April 24 @ 4:22 PM

With all due respect for the Iptacopan advocates, I think that anti/CD38 MoAB is a better choice for recurrent IgAN in a kidney transplant. Just an...

View Discussion

RE: Recurrence of IgA - post transplant Friday, April 24 @ 2:17 PM

Dr. Dastoor This is personal experience since data are lacking A patient with recurrent IgA + MVI (peritubular capillaritis C4d1) that failed ...

View Discussion

RE: Recurrence of IgA - post transplant Friday, April 24 @ 12:01 PM

While the clinical trials for iptacopan approval in IgAN did not include any recIgAN post-transplant, there are certainly scattered case reports of...

View Discussion

RE: Canine amyloidosis treatment options Friday, April 24 @ 9:45 AM

We don't have HIPAA in veterinary medicine, but the client did give me permission to share photos of PJ! We do see nephrotic edema in dogs and ca...

View Discussion

RE: Dual Vascultis / Sle Friday, April 24 @ 8:46 AM

@ prof glassock appreciate your thought on question ? Kind regards --------------------------------- Muhammad Soobadar MBChB UK ----------------...

View Discussion

RE: GFR measurement in AKI with stable serum creatinine Friday, April 24 @ 7:42 AM

Thank you Mario. Big Al is offspring 7 of 7 with degrees in engineering, He assisted with confirming the mathematics and graphs. John Pickering i...

View Discussion

RE: Recurrence of IgA - post transplant Friday, April 24 @ 12:05 AM

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

View Discussion

RE: Membranous Nephropathy Thursday, April 23 @ 11:31 PM

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...

View Discussion

RE: Osteoporosis In Stage 5 Ckd Thursday, April 23 @ 11:28 PM

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...

View Discussion

RE: Osteoporosis In Stage 5 Ckd Thursday, April 23 @ 11:21 PM

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 ...

View Discussion

RE: Osteoporosis In Stage 5 Ckd Thursday, April 23 @ 11:21 PM

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...

View Discussion

RE: Membranous Nephropathy Thursday, April 23 @ 11:07 PM

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

View Discussion

RE: Membranous Nephropathy Thursday, April 23 @ 6:27 PM

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...

View Discussion