RE: Encapsulating peritoneal sclerosis 3 hours ago

I have no idea how to answer your questions. Is any data available that would help? This is an area of known unknowns. --------------------------...

View Discussion

RE: Curious about Anti Nephrin Antibody commercial availability 3 hours ago

Thank you for your email.It was helpful.RegardsKrishna

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 4 hours ago

Dr. Rodby- you may be right about the perceptions of regulators. The point is that HBV infections are very very difficult to cure- if this is even ...

View Discussion

RE: Curious about Anti Nephrin Antibody commercial availability 4 hours ago

Development of a (quantitative ) commercial assay for serum anti-Nephrin antibodies is going to be a lot more difficult than we experienced with an...

View Discussion

RE: Curious about Anti Nephrin Antibody commercial availability 5 hours ago

I assume you meant blood? I believe that Dr Glassock is speaking only for tissue IF. And anti-nephrin Abs for MCD is not close to the utility ...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 6 hours ago

"With absence of DNA and if antiHbs is positive there is a very low chance of infection spread and it may be safe to dialyze in the main unit with ...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 8 hours ago

Excellent discussion. Thank you for all your help. I am checking a DNA PCR and awaiting those results before deciding on Isolation. I did consult w...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 10 hours ago

This patient had a hepatitis B infection in the past and has now lost the HBsAg status. This could be due to, as already pointed out, a precore mut...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 14 hours ago

Is your patient on prophylactic anti-HBV therapy? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 14 hours ago

You may consider discussing the matter with the superb ID and hepatologists in the bay area. ------------------------------ Mario Rubin, M.D. Ho...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 15 hours ago

Thank you all for your comments. ------------------------------ David Pai MD, FASN Capital Nephrology Medical Group Sacramento CA (916) 647-7231...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 15 hours ago

suggest HbeAg, and HBeAb along with HBV DNA PCR. If he has high viral loads he should be on lifelong antivirals eg entecavir. The recommendations w...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 15 hours ago

IMO DNA and simultaneous serology should be performed ------------------------------ Arvind Madan MBBS, MD Partner Central Florida Kidney Spe...

View Discussion

RE: Curious about Anti Nephrin Antibody commercial availability 22 hours ago

Commercial availability of anti-nephrin antibody tests will likely vary by country and by regulatory authority. It is not an easy assay to develop ...

View Discussion

Curious about Anti Nephrin Antibody commercial availability 1 day ago

Hi, I am curious about what could be the time line for commercial availability of the Anti Nephrin antibody level detection by ELISA for use in C...

View Discussion

RE: Question about Hepatitis B Isolation s/p Liver Transplant 1 day ago

Mutant HBs ag may escape detection in conventional assays , despite positive HBV-DNA . While uncommon. i think that this patient should be tested f...

View Discussion

Question about Hepatitis B Isolation s/p Liver Transplant 1 day ago

General Question for the group. I have a patient that wants to come to my dialysis clinic. Patient is s/p Orthotopic Liver Transplant and developed...

View Discussion

RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 2 days ago

Very interesting thank you all for your valued input and fruitful discussion, will give you an update ------------------------------ Saja Mohammed...

View Discussion

RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 2 days ago

Good morning Kidney biopsy in our institute usually done by IR and the indication is justified in her case Thank you ---------------...

View Discussion

RE: Appreciate Input in this case ESP 2 days ago

She has permacath. Complete Metabolic Panel - TP 6.1 and albumin 2.9 Ascites fluid albumin 1.6 Ascites fluid protein 3.2 Ascites fluid gluc...

View Discussion

RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity 2 days ago

Thank you, Dr Glassock . ------------------------------ Rochak Varma MD Oro Valley AZ (917) 459-0750 ------------------------------

View Discussion

RE: Appreciate Input in this case ESP 2 days ago

Can you provide ascitic fluid albumin + protein & serum albumin values? Odd though that reports show EPS ascites to be either low SAAG which is w...

View Discussion

RE: Re: variation in GFR measurements 2 days ago

This is good to know, thank you Dr Glassock ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assistant Professor in Nephrolo...

View Discussion

RE: Re: variation in GFR measurements 2 days ago

yes, it is ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assistant Professor in Nephrology] [Virginia Commonwealth Unive...

View Discussion

RE: Re: variation in GFR measurements 2 days ago

The Gates method for estimating GFR by nuclear scan can be associated with major errors in patients low or high BMi - not recommended. I would rele...

View Discussion

RE: Re: variation in GFR measurements 2 days ago

Was the DTPA GFR based on plasma disappearance ? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 --------...

View Discussion

RE: Re: variation in GFR measurements 2 days ago

Thank you Dr Glassock Nuclear scan was done approximately 3 months after starting Jardiance. Since Flozins decrease GFR, is it possible that her ...

View Discussion

RE: Re: variation in GFR measurements 2 days ago

CKD-EPI creat is known to seriously overestimate GFR in adolescents and young adults. The low BMI (low muscle mass) may be another factor. The DTPA...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 2 days ago

Dr. Aledan- Great suggestion!!!. Do we have an serum FLC and bone survey in this patient? ------------------------------ Richard Glassock MD, ...

View Discussion

RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 2 days ago

Very good point. The transplacental transfer of IgG1 is negligible until about 13 weeks of gestation. Rituximab may be very safe in the first trime...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 2 days ago

Laboratory interference of monoclonal immunoglobulins with phosphomolybdate colorimteric measurements of serum phosphorus is another cause of pseud...

View Discussion

Re: variation in GFR measurements 2 days ago

Hi all, Good afternoon. I am sharing details about a patient that I have seen in clinic recently for CKD Female in high teens- transferred from...

View Discussion

RE: Appreciate Input in this case ESP 2 days ago

have the surgeon talked to pictures of the peritoneum my cases the peritoneum was NOT normal looking , very beefy, no sclerosis per se but we...

View Discussion

RE: Appreciate Input in this case ESP 2 days ago

Such a strange story. Just to clarify, the paracenteses were bloody taps, not necessarily that the PD fluid itself was bloody? (implied not by CT...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 2 days ago

I agree with Dr Rodby and am very curious about the 1,25 level. I do believe the low phosphate is from lack of absorption, though interesting to fi...

View Discussion

RE: Appreciate Input in this case ESP 2 days ago

Ovaries are unremarkable on CT Scan. I spoke with her surgeon who is willing to do peritonoscopy and peritoneal biopsy. PD fluid cultures are n...

View Discussion

Encapsulating peritoneal sclerosis 2 days ago

We have a young pt that has developed EPS. PD cath has been removed. On high dose steroids he is finally improving and able to stop TPN. We are swi...

View Discussion

RE: Appreciate Input in this case ESP 2 days ago

bloody PD fluid scares me. I have seen it a couple of times with early EPS. but EPS after only a year seems very unlikely. Culture for TB... ...

View Discussion

RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 2 days ago

We had a case years ago where a young woman with vasculitis and a prior history of alveolar hemorrhage, but was in remission, who relapsed late in ...

View Discussion

Appreciate Input in this case ESP 2 days ago

59 years old female started HHD in 2017 then changed to In Center HD in 2022. PD catheter placed in 11/2022 and pt transitioned to PD. PD catheter ...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 2 days ago

without urine this pth or FGF 23 cannot be involved in low PO4, I did not see the "elevated ACE" level , thanks Dr Sprague. How high is it? eit...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 2 days ago

Hi Is it possible that he has pica to chalk? Consuming large amount of chalk may cause mile alkali syndrome, hypercalcemia as well as hypophos...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 2 days ago

Please check if the patient has been taking niacin as a supplement. This can cause hypophosphatemia. ------------------------------ [Basant Pawa...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 2 days ago

Dear Siva, What are the values and trends? Low phosphate with little urine output is usually nutritional. Ideally easiest to see pattern with seria...

View Discussion

RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 2 days ago

Understand. Good luck. Let us know what happens with the pregnancy. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949...

View Discussion

RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 2 days ago

Thank you We chose induction with rituximab over azathioprine as induction providing rituximab has been used based on limited evidence with the ...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 3 days ago

Here is a "far out" - " off the wall " suggestion- spontaneous infarction of parathyroid glands in secondary hyperparathyroidism with hungry bone s...

View Discussion

RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 3 days ago

I agree with Dr. Aledan that AZA is " conventionally" regarded as a maintenance o( remission drug in ANCA Vasculitis - but its efficacy for inducti...

View Discussion

RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity 3 days ago

In my opinion, the density and frequency of deposits by EM can be used to asses "activity" of disease in non-anti-PLA2R induced MN. ------------...

View Discussion

RE: Haemodialysis patient with high calcium and low Po4 3 days ago

This is not adynamic bone disease. With increased ACE Do you have a 125 Vit D level? Also check monograms complicated case ------------------...

View Discussion