RE: Potential donor with compound heterozygous mutations in CFHR1/3 and CFHR1/4 4 hours ago

Average GFR in age 40-49 is 80-100 ml/min-1.73-so 80 is lower limit for normal but many LKD programs prefer > 90 in donors with potential longer li...

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RE: Potential donor with compound heterozygous mutations in CFHR1/3 and CFHR1/4 5 hours ago

I have to find out what was her birth weight. However, my understanding from reviewing literature evaluating normal GFR in general population, is t...

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RE: Potential donor with compound heterozygous mutations in CFHR1/3 and CFHR1/4 6 hours ago

In addition to the genetic concerns mentioned above, a 44 year-old donor with a GFR is 81 ml/min/1.73. Would cause me to recommend against acceptan...

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RE: AKI, urinary K Wasting and uncontrolled HTN 11 hours ago

He was started on spironolactone 25 mg daily on 26 March and since then, creatinine has rose from 3.5 to 4.1, a 17% rise, BUN has rose from 41 to 5...

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RE: AKI, urinary K Wasting and uncontrolled HTN 14 hours ago

13,6grams /d of total urine protein excretion , yet only 3.5milligrams/ d of albumin. Something is wrong here. What is the urinary Immunofixation o...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 17 hours ago

This is highly suggestive of LCCN based on high sFLC > 500 mg/l and predominantly non-albumin proteinuria plus kappa light chains predominance. I w...

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RE: AKI, urinary K Wasting and uncontrolled HTN 17 hours ago

Thanks for additional informations. Blood gas with knowing of blood PH is important in interpretation of acid-base disorders. Because if we have on...

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RE: Potential donor with compound heterozygous mutations in CFHR1/3 and CFHR1/4 22 hours ago

A compound heterozygous (deletion) mutation in CFHR1/3 and CFHR1/ 4 is associated with C3G and anti-Factor H autoantibodies I am eager to learn tge...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

Pet, scan mentioned above. August, 2024. MRI did not find any bone lesions . April, 2024 and May, 2023 chest x-rays and 2/2023 knee Cray did not fi...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

Although he has Chronic kidney Disease G3 with recent rise of Creatinine as explained above and Anemia also but for more than 10 years, he has not ...

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RE: Potential donor with compound heterozygous mutations in CFHR1/3 and CFHR1/4 1 day ago

Personally, I suggest you contact any of the following individuals for their expert advise: Dr. Richard Smith and/or Dr. Carla Nester at the Univ...

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Potential donor with compound heterozygous mutations in CFHR1/3 and CFHR1/4 1 day ago

I would love the community's input on the following case: A 44-year-old AA female who is being evaluated as potential donor for her father, who ha...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

Dr Ali BPH plus UTI with unusual organism. Does he have prostatitis? Incomplete bladder emptying? Tough case. Thank you, Jorge Roman-Latorre MD For...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

Does this patient have Overt MM (satisfying CRAB criteria) or does he have "Smoldering" MM. I can't tell from the data provided. The very low alb...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

CRAB - calcium (hypercalcemia, renal (kidney dysfunction), anemia, bone (usually radiographically apparent bone lesions). -----------------------...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

There was no Vomiting . 1-2 days of nausea and stomach discomfort resolved after admission . The only Diuretic that he may be using as outpatient w...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

How would a biopsy change the therapy? ------------------------------ John Mellas MD Nephrology and Hypertension Specialists St Louis MO 31453723...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

Any history of repeated vomiting or high dose diuretics use? What doses of NaHCO3 he was on per day? Agree to look for RAS or PA in this setting. ...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 2 days ago

I suppose that Diabetic Nephropathy is also in the differential diagnosis , but he stilll needs therapy for MM ------------------------------ Ric...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 2 days ago

He has Multiple myeloma which largely excludes a "diagnosis " of MGRS. He likely has a renal complication of MM, either AL Amyloid or LC Cast Nephr...

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RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

Time of flight MRA of renal arteries found today. Limited exam demonstrates normal caliber and appearance of proximal and mid portions of both...

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RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

Empagliflozin and Sodium Bicarbonate were discontinued on admission. 24HR 24 HOURS WC LB #218979 Collection time: Mar 28, 2025@15:59 Test ...

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RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

Today the Creatinine is 3.7 but he also had Spironolactone started 25 mg daily on 26th of March. ------------------------------ Sadeem Ali MD Bri...

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whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 2 days ago

White gentleman age 77 with history of BPH, type 2 diabetes(last A1c 8.0 in January, 2025 compared to prior 9.6 in August, 2024), hypertension, COP...

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RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 2 days ago

Due to the age of the patient and expected life expectancy, effort to preserve renal tissue is needed. I agree with Dr. Rodby that this is LN with ...

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RE: management of ESRD patient post-parathyroidectomy 2 days ago

I agree with Prof Glassock, not sure it will do much, but may be worth a try if Mg is low, which is unusual in ESRD pts -------------------------...

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RE: " Super" Severe Resistant HTN in CKD 4 patient 2 days ago

If he shows up for follow-up, how much and how many anti-hypertensive medications he needs to control BP will be interesting to document. If his BP...

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RE: " Super" Severe Resistant HTN in CKD 4 patient 2 days ago

Thanks for your response. Does he have LVH and HR? Severity? ------------------------------ Ella Koifman-Zeltzer MD Tel-Aviv ------------------...

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RE: management of ESRD patient post-parathyroidectomy 2 days ago

Interesting suggestion. This patient has very little or no functioning parathyroid tissue, so magnesium repletion will not have much effect on hypo...

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RE: management of ESRD patient post-parathyroidectomy 2 days ago

@Stuart Sprague if serum Mg was found to be low and treated, does this will help increase serum PTH? --------------------------------- Hayder Aled...

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RE: management of ESRD patient post-parathyroidectomy 3 days ago

I agree 100% with Dr. Sprague . Patients with hypoparathyroidism secondary to total parathyroidectmyv And ESKD are very difficult to manage. ---...

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RE: " Super" Severe Resistant HTN in CKD 4 patient 3 days ago

Our PT most definitely has severe HTN that appears to be controlled on meds but when he stops meds his BP it becomes severely elevated. It seems th...

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RE: management of ESRD patient post-parathyroidectomy 3 days ago

My default is partial PTX, I would want to totally avoid total PTX. ------------------------------ Stuart Sprague DO, FASN Director of Research,...

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RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 3 days ago

I truly thank you all, for your valuable time. Our thought is for the patient to receive treatment for lupus, and we will monitor the response. In ...

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RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? 3 days ago

Dear colleague, yes she is Greek but not from Cyprus ------------------------------ Dimitrios Xydakis MD PEANIA +302810368443 -----------------...

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RE: Renally limited MPO-vasculitis 3 days ago

Thank you, good to know that not all MPO-Ab are pathogenic. For my education: what would be principle difference between low dose Rituximab (I cons...

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RE: Renally limited MPO-vasculitis 3 days ago

It is clear that not all anti-MPO antibodies are pathogenic ( largely dependent on the nature of the epitopes that react with the autoantibody) ...

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RE: Renally limited MPO-vasculitis 3 days ago

Kidney Biopsy 9/2020 Kidney, right, biopsy: Focal ANCA-associated crescentic glomerulonephritis, see comment. Acute tubular epithelial i...

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RE: Renally limited MPO-vasculitis 3 days ago

Kidney biopsy findings please (if done)? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: " Super" Severe Resistant HTN in CKD 4 patient 3 days ago

"Monday morning off all his meds SBP 140s" @Jonathan Slater: How did this patient markedly increase his BP and sustain severely elevated BP long ...

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RE: " Super" Severe Resistant HTN in CKD 4 patient 3 days ago

" do you think hypertension likely to reoccur after transplant?" Based on my own experience of managing renal transplant, patients for almost 40 ...

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Renally limited MPO-vasculitis 3 days ago

Looking for advice please: 76 yo male diagnosed with MPO-renally limited vasculitis when presented with AKD on 9/10/20 and was dialysis dependent a...

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RE: management of ESRD patient post-parathyroidectomy 3 days ago

@Stuart Sprague Since your default is not reimplantation, is it subtotal PTH-ectomy, or total PTH-ectoimy and only if pt becomes hypoCa you ini...

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RE: " Super" Severe Resistant HTN in CKD 4 patient 3 days ago

well done persistence ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicag...

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RE: AKI, urinary K Wasting and uncontrolled HTN 3 days ago

The combination of sodium bicarbonate and glucoretic (SGLTI) could certainly explain the hypokalemia and hyperbicarbonatemia. Anything that reduces...

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RE: AKI, urinary K Wasting and uncontrolled HTN 3 days ago

Is a rise in SCr from 2,2 to 3.3 /dL over 4 months rally AKI in a patient with CKD? Just curious. ------------------------------ Richard Glassoc...

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RE: AKI, urinary K Wasting and uncontrolled HTN 3 days ago

I think you should consider bilateral renal arteries stenosis which can lead to uncontrolled HTN, hypokalemia and worsening renal function (he alre...

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RE: " Super" Severe Resistant HTN in CKD 4 patient Wednesday, March 26 @ 9:14 PM

This is truly a once in a lifetime( i hope) management decision. I was discussing this case report with colleagues, and a couple of questions poppe...

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RE: management of ESRD patient post-parathyroidectomy Wednesday, March 26 @ 6:03 PM

I agree with Dr Rodby's comments, it is unlikely that the PTH will recover. I am personally very opposed to reimplantation procedures. Frequently t...

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RE: C3 Glomerulonephritis is an Overlap Lupus Syndrome ? Wednesday, March 26 @ 5:35 PM

Do you have UAlb/Cr and UPr/Cr ratios on sample of urine (or urine protein electrophoresis)? Puzzled by absence of proteinuria (and only few segmen...

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