RE: Crescentic GN, IgA, Pulm Hemorrhage and low C' 1 hour ago

My take is a bit different. The clinical presentation is quoted compatible with IgA Vasculitis. Admittedly the low C3 and C4 are disconcerting, but...

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RE: Would you rebiopsy? Is this C3GN? 1 hour ago

Biopsy results attached ------------------------------ Nimra Sarfaraz (516) 637-3820 ------------------------------ Files Attached DocumentRE:...

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RE: Crescentic GN, IgA, Pulm Hemorrhage and low C' 2 hours ago

I agree the IgA may be a red herring, THIs severe a case with so many autoimmune markers suggests a drug induced vasculitis. Is was the patient ...

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Crescentic GN, IgA, Pulm Hemorrhage and low C' 2 hours ago

Colleagues, Looking for a unifying dx and direction on further therapy. 80 yo woman with no past medical history presented in renal failure (Cr...

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RE: ATI, Anuria post kidney transplant 3 hours ago

Evidence for Obinutuzumab based on phase 2 study presented at 2024 ASN although encouraging far from definitive - would proceed with Rtx and slowly...

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RE: DR MISMATCH in Kidney Allocation 4 hours ago

Another point, please Can I know the number of kidney transplant for 6 mismatched couples or DR mismatched couples done recently in the US ? is th...

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RE: neuropsychiatric Management 5 hours ago

In all the neuropsychiatric relapses of lupus that I have treated, and almost all of them are due to non-compliance, I have used cyclophosphamide m...

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RE: Anca vasculitis relapse without circulating antibodies 7 hours ago

Thanks- the KB is consistent with Crescentic IgAN or IgAV. Did the patient have arthralguas, abdominal pain or a leukocytoclastic skin rash at init...

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RE: neuropsychiatric Management 7 hours ago

Opinion but not evidence based suggestion would be that parenteral agents are preferred in a non-compliant patient with LN and CNS involvement- I w...

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RE: Anca vasculitis relapse without circulating antibodies 7 hours ago

Hi Prof Glassock, Unfortunately, EM wasn't carried out. The LM and IF were: Light Microscopy: Processed material, four slides prepared conta...

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RE: Pla2r positive MN 7 hours ago

The addition of two vasodilating drugs may help to explain the rising proteinuria. Neither seen to be indicated. Do you have a recent antiPlA2R ant...

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RE: Pla2r positive MN 9 hours ago

So this gentlemam, actually 74 year old Arrived on March 2024, pla2r 346, eGFR>60 urinary PCR 6340 Urinary ACR. 5015 On April PCR 15500,...

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RE: Pla2r positive MN 9 hours ago

Appearance or worsening of Proteinuria in face of decreasing AntiPla2r titres have been documented in Kidney Tranplant Recipeints. It's thought to ...

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RE: DR MISMATCH in Kidney Allocation 9 hours ago

I am not aware of any program that denies patients transplant because of DR mismatch. ------------------------------ Awais Nauman HMC Doha -----...

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RE: neuropsychiatric Management 10 hours ago

Yes she is --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 51377736 ---------------------------------

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RE: neuropsychiatric Management 10 hours ago

Thanks. Is the patient on Hydroxychloroquine? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------...

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RE: DR MISMATCH in Kidney Allocation 11 hours ago

Hi can anyone post their program For live donor work up both for recipient and Donor Thanks --------------------------------- Muhammad Soobadar M...

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RE: DR MISMATCH in Kidney Allocation 11 hours ago

Agree with you all But I need to defend this particular view that using DR match alone as prerequisite is not mandatory in living donor program. U...

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RE: ATI, Anuria post kidney transplant 11 hours ago

He has received an additional 5 PLEX sessions, planning to give one more to complete a total of 12 sessions He hasn't received any RTX yet Plan ...

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RE: neuropsychiatric Management 13 hours ago

HB 11,wbc 8,plat 170 no MAHA Diagnosed before hot AIHA --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 51...

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RE: Pla2r positive MN 17 hours ago

You had posted that his presenting GFR was "reasonable". What was the actual SCr/eGFR and is it improving. An increase in GFR may facilitate increa...

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RE: Pla2r positive MN 18 hours ago

What is the duration of observation? How long since the PLA2R antibody has fallen be > 50% from baseline? Also, this magnitude of a decrease in ant...

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RE: neuropsychiatric Management 19 hours ago

I assume that the patient is already on Hydroxychloroquine. I would consider adding Rituximab or IVIgG to the regimen. PLEX can be added as a last ...

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RE: neuropsychiatric Management 21 hours ago

Only on month with poor compliance Her creat is normal not rising Albumine/ratio 600 Serology done once at diagnosis Not repeated I have concep...

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RE: neuropsychiatric Management 22 hours ago

How long was she on mycophenolate sodium + prednisone (appears to be less than 1 month) before she developed seizures? Compliance with medications?...

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RE: Would you rebiopsy? Is this C3GN? 22 hours ago

Recent UPr/Cr and UAlb/Cr values are confounded by dialysis-requiring AKI. Both AKI and intermittent dialysis cause rapid changes in the denominato...

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RE: Would you rebiopsy? Is this C3GN? 22 hours ago

AKI especially "ATN" can produce significant proteinuria. If he is at the stage of requiring dialysis, there has been insufficient time to resolve ...

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Pla2r positive MN 1 day ago

A 80 year old man with "acute on chronic cognitive decline" and nephrotic syndrome. Reasonable GFR. Classical pla2r IgG4 on biopsy. Pla2r titer ...

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neuropsychiatric Management 1 day ago

I have patient 21 yrs female recently diagnosed SLE. Lupus nephritis class III. 11/24 Normal Renal profile, she was on myfortec 720 bid and steroid...

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RE: Low Potassium 1 day ago

As Dr Rodby mentioned hypokalemic hypertension with high aldosterone and typically very low renin with urinary K loss. The DD is 1ry hyperaldostero...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

Dr. Glassock I edited the post to add those values in there :) Dr. Venkat Here is a table of the UPC/ UMicroalbumin/Creat that I could find in t...

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RE: Low Potassium 1 day ago

Agree with Drs. Rodby and Mellas. A MRA should be better treatment than Nifedipine and oral K for her presumed Primary Aldosteronism. -----------...

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RE: Low Potassium 1 day ago

Clinicians who saw her --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Low Potassium 1 day ago

Many thanks prof rodby I am not at Hospital till next Thursday . Will do when I am back . Patient told me she had this blood pressure for ages not...

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RE: Low Potassium 1 day ago

Agree with Dr Rodby on all comments. When I see patients like this, with the elevated aldo/renin ratio and no cofounding elements such as meds I pr...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

Sorry, I missed the normal C3/C4 levels. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ----------------...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

Sorry! Complement levels ok on initial workup in April. I'll work on getting the biopsy with imaging tomorrow ------------------------------ Nimr...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

"(UM/Creat 1649 12.16), 24 hour protein 5.8 g 12.23." I assume UM/Creat means urine microalbumin/creatinine or UAlb/Cr. I note that UM/Creat and ...

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RE: Cause of Disproportionally High Urea 1 day ago

Dr Friedman you are right, while calculating 24 Hr clearance I put the values as 282 and 0.85 per Litre instead of per day and indeed the clearance...

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RE: Cause of Disproportionally High Urea 1 day ago

Then why our values disagree to a minor degree is because I also added non-urea N and to a major degree because I assumed 282 mmol/L rather than 28...

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RE: Would you rebiopsy? Is this C3GN? 1 day ago

What is meant by "low grade" subepithelial deposits of C3? What did the EM show?. What were the C3/ C4 levels? So far, the description of the kidne...

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RE: Cause of Disproportionally High Urea 1 day ago

I just back calculated from a Urea of 282 to Nitrogen and Protein. 282 mmol of urea = 0.282 mols or urea, each mole of urea has 28 Gram Nitrogen...

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Would you rebiopsy? Is this C3GN? 1 day ago

Hi! I'm taking care of a 67M that got biopsied for nephrotic syndrome in 4.4.2024. PMHx: DM, autoimmune hepatitis, HTN, CHF EF 45, AFib on apixaban...

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RE: Measurement of Electrolytes 1 day ago

Thanks for the detailed explanation. ------------------------------ Brian Cronin MD, FASN Hypertension Nephrology Associates, P.C. Huntingdon Val...

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RE: Cause of Disproportionally High Urea 1 day ago

Agree with Dr Rodby that unit conversion requires work. From the values presented and 1; assuming the patient is in a steady state and 2; convert...

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RE: Cause of Disproportionally High Urea 1 day ago

these units drive me batty but I think a blood "urea of 33 mmol/l" is the same as a blood urea of 198 mg/dl or a BUN of 92 mg/dl. BUN 92 mg/dl,...

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RE: Low Potassium 1 day ago

According to your values, the patient is making more than 3 liters of urine a day (may have a concentration defect brought on by hypoK) , unless th...

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RE: Cause of Disproportionally High Urea 1 day ago

I just used the values you provided of UUN 282 mmol/L, 24-hr UV 1.822 L & wt 70 kg to plug into Maroni equation after I adjusted it for SI units. W...

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RE: Low Potassium 2 days ago

Thanks prof glassock and prof Rodby Blood pressure chronically high in clinic was 170/79 mm Hg. Medication - nifedipine 30mg mr and ran out of Sa...

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RE: Measurement of Electrolytes 2 days ago

Just to get back to first principles on how these techniques work. Ion selective electrodes (ISE) measure a voltage across an ion selective membran...

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