RE: Postural hypotension 37 minutes ago

Does patient have any neurological symptoms or signs Could it be Shy Drager Syndrome Severe autonomic neuropathy if not from Diabetes mellitus ...

View Discussion

RE: VIH persistence of serology showing low-level HIV antibodies (2.64) by ELISA and a negative viral load in an old patient 2 hours ago

Most 4th generation Anti-HIV antibody tests are claimed to have 99.5% specificity ( 0.5% false positive rate. ) if a 4th generation assay was utili...

View Discussion

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

Thanks prof glassock . Sorry late reply March 24 sirolimus started August 24 normal urine pcr August 25 urine pcr 4g with low albumin and sirolimu...

View Discussion

Membranous Nephropathy 2 hours ago

44 year old Hispanic male with gout, HTN diagnosed with membranous nephropathy 8/2023 – KIDNEY, BIOPSY: - MEMBRANOUS NEPHROPATHY, PLA2R ASSOCIA...

View Discussion

RE: VIH persistence of serology showing low-level HIV antibodies (2.64) by ELISA and a negative viral load in an old patient 11 hours ago

I would do another antibody test for HIV to see that this is not a false positive. If that is negative, and the HIV RNA is also negative, that woul...

View Discussion

VIH persistence of serology showing low-level HIV antibodies (2.64) by ELISA and a negative viral load in an old patient 15 hours ago

Dear colleagues, could you please give me your opinion on this patient? This 94-year-old patient was started on dialysis in December 2022 following...

View Discussion

RE: Postural hypotension 20 hours ago

Long standing Diabetes mellitus seems poorly controlled Any information on any complications such as retinopathy peripheral neuropathy gastropares...

View Discussion

RE: Dialyzer reaction 20 hours ago

Interesting case. What were the serum sodium and urea levels prior to starting the hemodialysis session? If you are confident that the early in...

View Discussion

Treatment uncertainty with Secondary TMA in Advanced HIV 21 hours ago

A middle aged male with PMH HIV (not on HAART), seizure disorder, hypertension, and neurosyphilis treated years prior presented after two witnessed...

View Discussion

RE: Postural hypotension 23 hours ago

You might want to stop the medication with the Mitaconozolole as it might be aggravating the symptoms ot orthostatic hypotension. ---------------...

View Discussion

RE: Postural hypotension 1 day ago

How do we know that the orthostatic hypotension is not a result of dehydration since he has nocturia 10 times a night? Was the supine blood pres...

View Discussion

RE: Dialyzer reaction 1 day ago

Dear Dr, Chandran. Thank you for your input! Since our acute and chronic units do not typically stock AN69, it is not easy to obtain. I am planning...

View Discussion

RE: Postural hypotension 1 day ago

The lack of postural tachycardia makes volune depletion unlikely. Unless the patient is on a BB ------------------------------ Richard Glassock M...

View Discussion

RE: Postural hypotension 1 day ago

With a SPEP not showing a M spike and a UPCR of about 0.7gm/gm AL amyloid is likely. If the sFLC is normal I doubt that further evaluation for Amyl...

View Discussion

RE: Postural hypotension 1 day ago

Thanks Dr. Glassock. Serum protein electrophoresis was negative. I shall do a free light assay as advised. Could these be amyloidosis? ----------...

View Discussion

RE: Postural hypotension 1 day ago

Thanks Dr. Glassock. Didn't do a valsalva, shall do it. ------------------------------ Jaison George MD, MBBS Kollam, India ---------------------...

View Discussion

RE: Dialyzer reaction 1 day ago

Dr Park: Your patient is exhibiting a strange reaction: Optiflex dialyzers are polysulfone & gamma ray sterilized. ST 150 is AN 69 sterilized with ...

View Discussion

Dialyzer reaction 1 day ago

Good evening I am Jinwook Park, a nephrologist at Louisville KY. I'd really appreciate any thoughts or similar experiences on this case. Than...

View Discussion

RE: Postural hypotension 2 days ago

Why is he so anemiic ? Have you done a bone survey And a serum Free light chain ? ------------------------------ Richard Glassock MD, FASN Lagun...

View Discussion

RE: Gross Hematuria 2 days ago

Besides sickle cell trait (as already mentioned by Dr. Lerman), hypercalciuria (without overt nephrolithiasis) may cause recurrent gross hematuria ...

View Discussion

RE: Gross Hematuria 2 days ago

The patient is Caucasian Jewish. CT Angiogram was negative for "Nutcracker". Urine cytology was negative. She has stopped running and will see what...

View Discussion

RE: Postural hypotension 2 days ago

Looks like Diabetic autonomic neuropathy to me. Have you done Valsalva's maneuver? ------------------------------ Richard Glassock MD, FASN Lagun...

View Discussion

Postural hypotension 2 days ago

Requesting opinion on this case: A 68 year old male presented with history of hypotensive episodes for the past 7–8 years, which are worse in the ...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

Thanks for posting the report. While there is 1 glom with segmental hypercellularity, it seems mild at best, so while this could qualify as a cla...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

Thanks Dr Glassock and Dr Venkat I have a attached a copy of kidney biopsy report as well as UA ANA neg c3,c4 neg anemia...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

"negative serologies for anti-dsDNA, ANCA, and anti-PLA2R antibodies" Was ANA also negative? Coomb's test? ------------------------------ K.K. ...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

Also- what is the nature of the anemia in this case? What is the result of the hematological indices snd blood smear.? --------------------------...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

It would help if you can post a deidentified copy of thr kidney biopsy report (LM, IF, EM). Was the biopsy stained for DNA JB9 and IgG subclasses? ...

View Discussion

Nephrotic range proteinuria, kidney biopsy showing lupus 2 days ago

Greetings to all the members, I would appreciate your input in this case. A 40-year-old woman was evaluated for incidentally detected nephrotic-ran...

View Discussion

RE: Gross Hematuria 3 days ago

Thanks for all the good ideas. I have passed them on to the patient's internist and if he comes with a dx will let you know. Mike E -----------...

View Discussion

RE: Pd Question 3 days ago

One more point; a patient intubated usually very sick and catabolic. Still need to maintain nutrition. Probably hemo better than PD in handling cat...

View Discussion

RE: Pd Question 3 days ago

Thanks prof bargman very helpful and dr Jose Last question what antibiotics do colleagues use for cyst penetrance ? Kr ----------------------...

View Discussion

Reminder: Encourage fellows to volunteer as case report reviewers for Kidney Week 2026! 3 days 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...

View Discussion

Reminder: Volunteer by April 29 to serve as a case report reviewer for Kidney Week 2026! 3 days 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...

View Discussion

RE: Pd Question 3 days ago

HAve seen a couple; Pulmonary folks did not want anything lifting diaphracm, plus fear of peritoneo-pleural leaks so catheter and hemo plus drain a...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 3 days ago

How long did you observe the patient without therapy after stopping Sirolimus? This is crucial information lacking in your presentation ---------...

View Discussion

RE: Pd Question 3 days ago

There are a lot of theories as to why intensivists are so opposed to PD, especially because there is no evidence for this. Probably much of this is...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 3 days ago

Rituxan seemed to have done the trick . --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 3 days ago

Hi prof glassock thanks for reply Sirolimus was stopped and despite that nephrotic syndrome did not resolve. Steroids was tried and did not impro...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 3 days ago

This case seems to be an example of Sirolimus induced podocytopathy with spontaneous resolution upon stopping the agent. I know of no evidence for ...

View Discussion

RE: Gross Hematuria 3 days ago

Sorry for my late entry into the dialogue generated by this case. The fact that she is a habitual distance runner raises the possibility of exercis...

View Discussion

RE: Pd Question Wednesday, April 15 @ 5:20 PM

@ prof bargman Would appreciate your thoughts on this. For PD patient who get acutely unwell and needing intubation ventilation not for pd peritoni...

View Discussion

RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. Wednesday, April 15 @ 4:10 PM

thanks everyone. family had sought IMCA but they said they don't have anything to offer. patient admitted with general deterioration and all ...

View Discussion

complex case of nephrotic syndrome in liver transplant patients Wednesday, April 15 @ 4:05 PM

22 female complex patient with liver transplant due to Auto immune hepatitis developed nephrotic syndrome while on Sirolimus. Liver transplant team...

View Discussion

RE: Gross Hematuria Wednesday, April 15 @ 1:15 PM

I think I would ask her to stop running for a few weeks! Also are the urine RBCs acanthcytic If that is a word) at all? Does she have albumin...

View Discussion

RE: Gross Hematuria Wednesday, April 15 @ 9:08 AM

Hi Michael, this is a longshot, but if the patient is African-American would get a hemoglobin electrophoresis to rule out sickle cell trait, which ...

View Discussion

RE: Membranous nephropathy Tuesday, April 14 @ 6:50 PM

Thank you for the clarification. For those interested, these are the references which support Dr. Glassock's statement: Sethi et al., Kidne...

View Discussion

RE: Membranous nephropathy Tuesday, April 14 @ 6:36 PM

That is mostly due to NELL1 which was negative in this case. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8...

View Discussion

RE: Membranous nephropathy Tuesday, April 14 @ 6:30 PM

I was under the impression that, although not a single IgG subclass is reliably specific, IgG1 and IgG2 are the most common isotypes identified in ...

View Discussion

RE: Membranous nephropathy Tuesday, April 14 @ 5:57 PM

Thanks Vito

View Discussion