RE: Must Read 41 minutes ago

Many thanks Dr. Mellas for your kind words and sentiment. Barry Brenner was a unique force in Nephrology and he leaves a great legacy of original i...

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Must Read 56 minutes ago

I just read the beautifully written obituary of Barry Brenner by R Brenner, B Brenner, and R Glassock in the November issue of the JASN. It is a ...

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RE: Potassium Threshold For Op Management 8 hours ago

I agree with everything Roger just wrote, including the periods, commas, parentheses, and exclamation point. In this instance, the doctor is treati...

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RE: Potassium Threshold For Op Management 8 hours ago

So a serum K of 6.5mmol/L (non hemolyyzed specimen) l or less AND stable (impaired ) kidney function is a "recommended)"threshold for non ED , Outp...

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RE: Potassium Threshold For Op Management 9 hours ago

personally i find that UK Kidney assn advice very reasonable and welcomed. Can you attach the reference? the key here is stable renal function, ...

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RE: Potassium Threshold For Op Management 9 hours ago

The UK Kidney Association has updated its guidelines for management of Hyperkalemia in the community If K 6-6.5 - if patient is well and there...

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RE: Potassium Threshold For Op Management 13 hours ago

Very reasonable suggestion-if the patient has a serum HCO3- level of <17mmol /L. Many patients will have baking soda in their kitchen cabinets. ...

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RE: Potassium Threshold For Op Management 13 hours ago

Thanks- Thanks- good outcome .-this time. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ---...

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RE: Potassium Threshold For Op Management 13 hours ago

Often high level of serum Potassium are associated with low serum bicarbonate. Why not suggest the patient take 2 grams of sodium bicarbonate? ...

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RE: Potassium Threshold For Op Management 14 hours ago

Hi prof glassock repeat potassium 6.2 . Given dietary advice and zirconium and sent home --------------------------------- Muhammad Soobadar MBCh...

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RE: Genetic Testing Data n=88 21 hours ago

I look at genetic testing as another laboratory test which has to be interpreted in the clinical context. Some are very useful like Dr Ashraf said,...

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RE: Genetic Testing Data n=88 1 day ago

Dr. Sinasi, Yes, a mountain of knowledge but it will be a fun ride and very useful to our patients. We will move descriptive disease nomenclatur...

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RE: Potassium Threshold For Op Management 1 day ago

Thanks- understood - maybe patients like this should always have a medicine cabinet containing "back up" Patiromer. Lets know the outcome ,. H...

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RE: Potassium Threshold For Op Management 1 day ago

Thanks prof glassock and prof balan It would take 3-4 days for patiromer to reach him. He has come in today for bloods and will chase outcome . ...

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

Thanks all for a great discussion. For Dr Rodby: she took only thyroid and vitamins pre admission occasional Tylenol, no hydralazine or allopurinol...

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RE: Transplant case 1 day ago

With a negative neurologic evaluation, consisting of CT and MRI of the brain and a negative CSF the most likely cause for this patient seizure diso...

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RE: Calling All Nephrologists: What's Your Workflow Wisdom? 1 day ago

I second Dr Hirsch with regards to the computer. I can't count the times I've seen physicians see patients from behind the computer, rarely looking...

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RE: Potassium Threshold For Op Management 1 day ago

I would also not worry too much. If he is otherwise stable he should be ok with that potassium. Till tomorrow ------------------------------ Sat...

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RE: Transplant Case 1 day ago

He is pre emptive not started hd yet . EGFR 11. Couple of month . We thought about doing Covid test but then felt even if negative we would not ca...

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RE: Genetic Testing Data n=88 1 day ago

Thanks Dr. Ashraf; PKD1; APOL1, HNF18, etc these are like cars' license plates. The missing circuits in my brain are: what does broken gene ...

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RE: Transplant Case 1 day ago

Did you do a rapid COVID ag test. If negative would you have done anything different. How long has he been waiting is he in good medical condition,...

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RE: immune complex GN with features of Membranous Nephropathy 1 day ago

Patient has HIVICK which has emerged as a separate identity after the use of HAART. Patients are typically treated based on the Primary histolog...

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Transplant Case 1 day ago

Recipient came in to hospital for kidney offer He reported that his family said that his voice changed over Christmas. No fever . He reports cough ...

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RE: Potassium Threshold For Op Management 1 day ago

Did you warn him not to consume any high Potassium foods or drinks? . I might have sent him some Patiromer by courier. . Just a thought. -------...

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Potassium Threshold For Op Management 1 day ago

Patient has ckd 4 Bloods today k6.5 eGFR 23 baseline 21. done by primary care physician . K usually 5.8/5.9 On candesartan Primary care rang n...

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RE: Clot/ Debris In Right Jugular Vein 1 day ago

Thanks prof rodby and prof rodwell --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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immune complex GN with features of Membranous Nephropathy 1 day ago

37 yo AA F patient with HIV on meds, well controlled undetectable viral load, MCTD (myositis, LAD, alopecia. Serologies: ANA 1:2560, Smith, RNP, lo...

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Case 2 days ago

Recipient came in to hospital for kidney offer He reported that his family said that his voice changed over Christmas. No fever . He reports cough...

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RE: Genetic Testing Data n=88 2 days ago

You are right, genetic testing is evolving fast. Kudos to you for being at the forefront. There limited of targetted therapy for found risk alleles...

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RE: Transplant case 2 days ago

See Jeemon G, et al. Indian J Nephrol 2023; 33: 464- 467 for a case report of Seizures due to CNS BK virus infection in a transplant recipient. Unc...

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RE: Transplant case 2 days ago

Sir any of u have ever seen early presentation of PML like this?? Please share ur experience Yahoo Mail: Search, Organize, Conquer

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RE: Transplant case 2 days ago

Although uncommon. BK virus can also produce seizures . (.? Meningo- encephalitis ). Was a BK virus assay done on the CSF fluid. Would anyone consi...

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RE: Renal thrombotic microangiopathy 2 days ago

Dr Kuhn was there any monoclonal band in serum? ------------------------------ Awais Nauman HMC Doha ------------------------------

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RE: Transplant case 2 days ago

Resistance testing involves checking for UL 97 and UL54 genes that encode viral enzymes are required for phosphorylation of Ganciclovir to GTP that...

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RE: Transplant case 2 days ago

We don't have facility of checking cmv resistance against gancyclovir . Can u tell me but more about it Yahoo Mail: Search, Organize, Conquer

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RE: Transplant case 2 days ago

Cyclosporin trough ? Need to repeat BK PCR . you should be able to obtain a CMV resistance panel against Ganciclovir ---------------------------...

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RE: IBD AND KIDNEY 2 days ago

With sterile pyuria of thus magnitude an acute interstitial nephritis is a very likely possibility - either drug induced (levoflocacin ) or related...

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RE: Renal thrombotic microangiopathy 2 days ago

Did you ever do compliment, genetic studies? --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 --------------------...

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RE: Renal thrombotic microangiopathy 2 days ago

Just aguess, but I would restart PLEX and if no response in one week add Obinutuzumab. ------------------------------ Richard Glassock MD, FASN...

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RE: Transplant case 2 days ago

Tacrolimus was switched to cyclosporin later . Bk pcr done only once was 2 * 10 power 7 Eeg was not done , no fits afterwards . Wbc daily 13000 ...

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IBD AND KIDNEY 2 days ago

An 18-year-old male patient with a known history of Crohn's disease is currently being evaluated for biological therapy. During an abdominal MRI ev...

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RE: Transplant case 2 days ago

What was BK PCR at biopsy and now ? What was dose of Ganciclovir when you started ? And now ? Current dose TAC and recent trough levels? What is WB...

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RE: Renal thrombotic microangiopathy 2 days ago

In the meantime, the patient was rehospitalized due to cholestatic hepatopathy, presumably Tocilizumab-induced. Consequently, Tocilizumab was disco...

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RE: Transplant case 2 days ago

Tacrolimus level around time of occurrence of seizures? I note that you had reduced tacrolimus dose after diagnosing BKV nephropathy. However, if t...

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RE: Transplant case 2 days ago

No sir she was not treated with any anticonvulsant. And I reviewed her file again , she had complain of headache for last 6 months, she had non gap...

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RE: Genetic Testing Data n=88 2 days ago

Thank you Dr. Weinstock; I will try to answer your questions, don't have full search ability except manual check: Here are some related to COL4...

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RE: Transplant case 3 days ago

Was her seizure treated with anti- convulsant medication. It is probably to early to declare resistance to Ganciclovir in this case. Short term inc...

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RE: Genetic Testing Data n=88 3 days ago

I would recommending discussing in more depth with Natera Renasight CGC's. They include genetic counseling for patients with each positive test res...

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RE: Transplant case 3 days ago

Sir she had fits only once on 5th day of gancyclovir and dose remained same and today was I guess 21st day of gancyclovir. And the cmv reached yest...

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RE: Transplant case 3 days ago

The seizures are most likely due to Gancyclovir neurotoxicity. If she is still receiving the agent. i would reduce the dose by 50%. -------------...

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