RE: KFRE 1 hour ago

Urine acr 14/05/21 2.9 Urine acr 25/05/23 18.8 Urine acr July 24 12.1 Urine acr November /24 15.2 ( units mg/mmol Cr) ------------------------...

View Discussion

RE: KFRE 1 hour ago

Age 56 Creatinine before op 1.03 after op 1.56 and now 1.51 4 years later I don’t have his blood pressure pre operation but now 123/87 mm hg Than...

View Discussion

RE: KFRE 1 hour ago

Hi thanks all EGFR 41 ml/min/1.732 Urine albumin 372.9 mg/l Urine creatinine 24.6 ( 5.1-14.2) mmol/L Urine acr 15.2 mg/mmol Cr (<3) He does not kn...

View Discussion

RE: Teriflunomide / Leflunomide TDM 2 hours ago

i found this article of the pharmacodynamics of leflunomide Pharmacodynamic analysis revealed no association between A77 1726 concentrations and BK...

View Discussion

RE: Teriflunomide / Leflunomide TDM 8 hours ago

The questions that have not been adequately addressed, in my opinion is 1) whether the failure of Leflunomide therapy for BK viremia is an intrinsi...

View Discussion

RE: Late /wrong referrals of CKD patients 8 hours ago

In my opinion, the first task is to define and identify the clinical and laboratory characteristics of AVOIDABLE UNTIMELY referrals from Primary Ca...

View Discussion

Late /wrong referrals of CKD patients 19 hours ago

Good afternoon I joined a post-graduation about Safety, Quality, Informatics and Leadership at Harvard Medical School, and my capstone project is...

View Discussion

RE: Nephrotic Syndrome And Pregnancy 21 hours ago

Dr. Rodby is correct in saying that LN class-5 vs lupus podocytopathy is a difficult distinction to make without a biopsy. However, if severe nephr...

View Discussion

RE: Nephrotic Syndrome And Pregnancy 22 hours ago

I dont think there is a way to distinguish Class V from a solitary podocytopathy clinically. The former is more common and I would suspect this ...

View Discussion

RE: Teriflunomide / Leflunomide TDM 23 hours ago

Hi , recent studies have not shows any effect of leflunomide or ciprofloxacine on BK viremia or BK nephropathy , careful reduction of IS is the sta...

View Discussion

RE: Nephrotic Syndrome And Pregnancy 23 hours ago

If this severe nephrotic syndrome developed abruptly/suddenly, agree with Dr. Glassock that lupus podocytopathy is a strong possibility. -----...

View Discussion

RE: Nephrotic Syndrome And Pregnancy 1 day ago

Thank you Dr for sharing this interesting case I think it's better to postponed the kidney biopsy since she has normal RFT and she is 23 weeks of...

View Discussion

Nephrotic Syndrome And Pregnancy 1 day ago

A healthy 26 year old Hispanic lady, referred to our office for nephrotic syndrome- she s currently 23 weeks pregnant- started to have swelling aro...

View Discussion

RE: Teriflunomide / Leflunomide TDM 1 day ago

I could find only one reference to your question. See Nesselhauf N, et al.J Nephropathol 2015; 5:34-37 (Open Access). I hope this helps. ------...

View Discussion

RE: AKI/CKD of unknown etiology 1 day ago

Thank you for the response, Dr Rodby. I actually did not repeat the urine micoalbumin/creatinine and protein/creatinine ratio (was checked in the...

View Discussion

RE: Teriflunomide / Leflunomide TDM 1 day ago

Sorry. I omitted to say, leflunomide is prescribed in the setting of renal transplant recipient with history of BK viraemia. --------------------...

View Discussion

RE: AKI/CKD of unknown etiology 1 day ago

"No proteinuria" remember dipstick only picks up albuminuria, would probably do a urine protein/Cr ratio and urine albumin/Cr ratio, see if ther...

View Discussion

AKI/CKD of unknown etiology 1 day ago

I have a delightful 58 y.o. female with a history of GERD x 30 years (was on PPI and now on H2 blocker), GAD, prior episode of shingles and underly...

View Discussion

RE: PGNMID 1 day ago

If you can start with dara I would, (from attached) "In conclusion, this study supports and extends the recently reported prospective cl...

View Discussion

RE: KFRE 1 day ago

I think you have to look at patient's age, BP before and after, creatinine before and after, and proteinuria before and after. If there is ANY e...

View Discussion

RE: Renal Biopsy Post Plex 1 day ago

We do all the plex in the hospital, and thrombocytopenia is extremely rare. WE replete with albumin unless coats are awry or we have a bleeding ris...

View Discussion

RE: Renal Biopsy Post Plex 1 day ago

PLEX may remove platelets and cause thrombocytopenia. Obviously, this might increase risk of post-biopsy bleeding. Fortunately, this complication o...

View Discussion

POCUS training in nephrology - position statement 1 day ago

Dear Nephrology Educators, Attached is a position statement on multi-organ POCUS training in nephrology, co-authored by 21 educators from 12 c...

View Discussion

RE: KFRE 2 days ago

KFRE is only valid in CKD stage 3A -5. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------...

View Discussion

RE: Renal Biopsy Post Plex 2 days ago

Octoplas as replacement fluid for PLEX should reduce the risk of bleeding after Kidney Biopsy, compared to 5% albumin replacement fluid for PLEX. ...

View Discussion

RE: PGNMID 2 days ago

I think you should complete your search for a clone with a bone marrow biopsy and if enlarged Lymph Norse are found on exam or CT, these should be ...

View Discussion

Renal Biopsy Post Plex 2 days ago

Is there any increased risk of bleeding in patient undergoing renal biopsy after plasma exchange with octoplas? Thanks

View Discussion

PGNMID 2 days ago

Hello all, I would appreciate your thoughts on this patient. 31 year old female patient initially presented in 2019 with hematuria sub-nephrotic...

View Discussion

RE: Teriflunomide / Leflunomide TDM 2 days ago

Interesting question. How strong is the evidence that any kind of TDM for teriflunomide or leflunomide improves outcome in RA or kidney disease. So...

View Discussion

Teriflunomide / Leflunomide TDM 2 days ago

Hi all, Can I please get your insight and experience with teriflunomide / leflunomide TDM? So far I have gathered that the sample taken needed ...

View Discussion

RE: KFRE 2 days ago

What is his eGFR and urine albumin now?When was the uninephrectomy performed? Do you happen to know his birthweight ? ---------------------------...

View Discussion

RE: Access Issue With Recurrent Bactaeremia 2 days ago

I assume endocarditis has been looked for with a TEE. Ifyou are concerned about eptic thrombophlebitis as the source of recurrent Staph. aureus bac...

View Discussion

RE: KFRE 2 days ago

Thanks prof glassock. This patient had renal cell cancer and right nephrectomy . --------------------------------- Muhammad Soobadar MBChB UK --...

View Discussion

RE: KFRE 2 days ago

I do not think that this question has been studied, but I suspect that it would give an underestimate of true risk, but it would all depend on the ...

View Discussion

RE: Access Issue With Recurrent Bactaeremia 2 days ago

If his cultures are currently negative you should proceed with fistula and make him take good care of it. History generally repeats itself and he i...

View Discussion

RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 3 days ago

Hello ! In the attachment is my Case regarding complexities of managing dialysis in patients with mental health challenges and the unique int...

View Discussion

RE: Access Issue With Recurrent Bactaeremia 3 days ago

Yes there was a line holiday before new tunnelled line was inserted . Blood cultures were negative before new line went in. Patient refuses to hav...

View Discussion

KFRE 3 days ago

Is KFRE equation valid in patients with single kidney ? Bw

View Discussion

RE: Access Issue With Recurrent Bactaeremia 3 days ago

was there a "line holiday" between lines? "He has agreed to have line out 5 days post admission and is on iv flucoxacillin." looks like yes but I a...

View Discussion

Access Issue With Recurrent Bactaeremia 3 days ago

Hi everyone , I have slightly challenging case in terms of vascular access and recurrent s aureus bactaeremia. 34 male previous failed transplant ...

View Discussion

RE: Renal Artery Stenosis Case 3 days ago

I will find out about nsaid No Doppler but ct Angio Bw --------------------------------- Muhammad Soobadar MBChB UK -----------------------------...

View Discussion

RE: resistant hypertension in hemodialysis patient even after bilateral renal embolization 3 days ago

Anass: 4 qstns: 1. how many Hrs of HD each time plz? Lengthening the time may be very helpful2. Is potential improvement in compliance entirely dep...

View Discussion

RE: resistant hypertension in hemodialysis patient even after bilateral renal embolization 3 days ago

The BP was initially controlled then rose again. Reminds me of a case I had of a patient whose BP was controlled after surgical renal sympathecto...

View Discussion

RE: igan nephropathy 3 days ago

AKI with gross hematuria following an URI in IgAN has been repeatedly described in the literature since the early 1980's. Most cases will spontaneo...

View Discussion

RE: resistant hypertension in hemodialysis patient even after bilateral renal embolization 3 days ago

According to your records, on 12/03/2023 and on 27/03/2023 the patient underwent embolization of the left kidney. What was the indication for embol...

View Discussion

RE: resistant hypertension in hemodialysis patient even after bilateral renal embolization 3 days ago

A few comments; a 20 yo female with ESKD with psychological/financial issues raises the question of medication compliance. Quite difficult for such...

View Discussion

RE: resistant hypertension in hemodialysis patient even after bilateral renal embolization 3 days ago

The main cause of HTN in majority of cases in dialysis patients is excesses of total of body water (TBW) and excesses of total body Na (Removing th...

View Discussion

RE: Mulytidrug resistant Nephrotic syndrome 3 days ago

Great comment. Gave you seen favorable responses ro Obi in patients with secondary (late) treatment unresponsive NS and FSGS lesions ? ----------...

View Discussion

igan nephropathy 3 days ago

Good morning, I saw a 18 y/o Male who presented to hospital with chief complaint of gross hematuria and Acute kidney Injury (creatinine up to 2 ...

View Discussion

RE: resistant hypertension in hemodialysis patient even after bilateral renal embolization 3 days ago

Has anyone studied the effects of renal denervation in a dialysis patient with resistant hypertension after bilateral renal embolization.? I cant f...

View Discussion