RE: Clinical Practice Questions 1 hour ago

CMV pcr positive and treated with valganciclovir and now 2 cmv pcr negative . Due to the fact that there is no final biopsy report , pt creatinine...

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RE: Persistant Hemoptysis In Anti-GBM 2 hours ago

If the serum antiGBM is positive ( using a sensitive commercial ELISA for IgG aGBM) even at very low levels and the patient has symptomatic hemopty...

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RE: Persistant Hemoptysis In Anti-GBM 5 hours ago

Echo EF 65% no abnormalities Patient not dyspneic, not volume overload I think smoking is the cause I found case report about smoking associate...

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RE: Persistant Hemoptysis In Anti-GBM 5 hours ago

I guess my point is that tissue bound anti-GBM antibody can persist for some period (? weeks) after the serum antibody have declined to undetectabl...

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RE: Persistant Hemoptysis In Anti-GBM 5 hours ago

A single breath CO uptake test will distinguish volume expansion pulmonary edema and intra-alveolar hemorrhage. Has an Echocardiogram been done? ...

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RE: Persistant Hemoptysis In Anti-GBM 8 hours ago

Also to check carefully the volume status. Many patients do develop hemoptysis secondary to pulmonary edema as a result of renal dysfunction. A nor...

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RE: Clinical Practice Questions 9 hours ago

If CMV PCR was never positive then CMV GN not present -so was it elevated and high high before treatment ? ------------------------------ [Mark] ...

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RE: Management In ADTKD 17 hours ago

Perhaps we can lobby hospitals and companies to provide free service based on need. ------------------------------ Ashraf El-Meanawy , MD, MS, P...

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RE: Persistant Hemoptysis In Anti-GBM 18 hours ago

Dr. Friedman is quite correct to raise the issue if a procoagulant deficiency state (primarily Fibrinogen) following extensive PLEX with albumin on...

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RE: Steroid dependent FSGS with "tip lesion" 19 hours ago

Thank you Dr Rodby ------------------------------ Asjad Sardar MD SOUTHWEST KIDNEY INSTITUTE Tucson AZ (646) 236-8170 ---------------------------...

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RE: Steroid dependent FSGS with "tip lesion" 19 hours ago

Thank you so much for your input Dr Glassock. He is a caucasian ------------------------------ Asjad Sardar MD SOUTHWEST KIDNEY INSTITUTE Tucs...

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RE: Patient with fabry disease and also possible minimal change 20 hours ago

Just out of curiosity, what was her GLA gene variant, eg E66Q, N215S…? --------------------------------- Oded Friedman ---------------------------...

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RE: Persistant Hemoptysis In Anti-GBM 20 hours ago

If albumin was used as RF, what are his INR, PTT & fibrinogen? --------------------------------- Oded Friedman ---------------------------------

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RE: Management In ADTKD 21 hours ago

Dr Bleyer and rest of respected members thanks a lot Dr Bleyer will contact you for more information and help This is about a student from Pakista...

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RE: Persistant Hemoptysis In Anti-GBM 1 day ago

That provides a good explanation for the recurrence of hemoptysis. He must stop smoking. It could be a life or death decision. -----------------...

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RE: Persistant Hemoptysis In Anti-GBM 1 day ago

Unfortunately patient still active smoker --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 51377736 -------...

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RE: Persistant Hemoptysis In Anti-GBM 1 day ago

Thank you prof Glassock This patient maintains sat on room air X ray no abnormalities so Ct not done Kidney biopsy with fibrosis so usually the...

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RE: Patient with fabry disease and also possible minimal change 1 day ago

I think I would just pull the trigger on steroids, it has been going on long enough if this were NSAIA related MCD it should have resolved by no...

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RE: Persistant Hemoptysis In Anti-GBM 1 day ago

Pretty classical anti-GBM disease in a young man. A complete return to a normal eGFzr is not expected because of the findings in kidney biopsy. Wha...

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RE: Patient with fabry disease and also possible minimal change 1 day ago

If Proteinuria was from fabry it would be progressive with progressive decline in kidney function..it seems like podocytopathy with background of b...

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RE: Persistant Hemoptysis In Anti-GBM 1 day ago

I forget to mention patient started oral cyclo with plasma exchange after Anti GBM result --------------------------------- Mohamed Mahmoud MBBS ...

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Persistant Hemoptysis In Anti-GBM 1 day ago

23 ye,male no hist of DM or HTN Came with 1 month hist of hampotysis. Cr 267, ur 9.3 Pulmonary renal suspected Anti GBM 68 u/ml Plasma Ex started...

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RE: Patient with fabry disease and also possible minimal change 1 day ago

Complicated case, but I will take the Hickam's Dictum position and opine that she has two diseases- 1) Hemizygous Fabry Disease with rather minor c...

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Patient with fabry disease and also possible minimal change 1 day ago

74-year-old female was referred because of Sudden onset of nephrotic syndrome with swelling of her face lower extremities in 9/2024 had protein 5 g...

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RE: Dialysis Question 1 day ago

Thanks . The water plant unit had an issue and water supply was interrupted After about 90 minutes into dialysis machines stopped due to lack of w...

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RE: Anti Gbm Case 1 day ago

Ea and Eb are two different epitopes on the Goodpasture antigen- COLIValpha3- commercial anti-GBM antibody ELISA do not distinguish between these t...

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RE: Anti Gbm Case 1 day ago

Thanks prof . What is Ea and Eb? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Thanksgiving 1 day ago

Thank you very much Pr. Glassock. A very happy thanksgiving to you and all the ASN community contributing to this open forum, which I think is real...

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RE: Clinical Practice Questions 1 day ago

In the original description of CMV Glomerulopathy in kidney transplant the findings were enlargement or necrosis of endothelial cells, macrophage i...

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RE: Dialysis Question 1 day ago

I have tested it in a crude fashion over the years and found that K will rebound slightly higher than the other electrolytes over a few hours. Nev...

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RE: diagnostic ability of ChatGPT 1 day ago

Nice reference tool amongst others. Answers are often vague and lack insight. ------------------------------ John Mellas MD Nephrology and Hyper...

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RE: Clinical Practice Questions 1 day ago

Was C4d positive or negative especially Peritubular capillaries ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC...

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RE: Thanksgiving 1 day ago

Many thanks Dr. Reynolds. Much appreciated. Of course, the ASN Communities is the beneficiary of all those who chose to participate. -----------...

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RE: diagnostic ability of ChatGPT 1 day ago

Only six clinical vignettes. Hardly representative of actual practice. Personally, I would not chose to rely on a CHAT-GTP diagnosis (yet)- these L...

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diagnostic ability of ChatGPT 1 day ago

Many of you may be familiar with the recent randomized controlled study comparing ChatGPT diagnostic capabilities compared to attending and residen...

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RE: Clinical Practice Questions 1 day ago

CMV glomerulopathy typically causes endotheliosis with minimal inflammation. CMV can also cause collapsing glomerulopathy, especially in carriers o...

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RE: Thanksgiving 1 day ago

A belated Happy Thanksgicing day and weekend to you, Dr. Glassock, and all! Please know your active involvement in this ASN Community Open Forum...

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RE: Dialysis Question 2 days ago

Assuming you are sampling peripheral venous blood the equilibrium state for elrctrolytes is quite rapid, usually minutes. It is slower for non-elec...

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RE: Clinical Practice Questions 2 days ago

I would wait to see the final report and not speculate at this point. This very well might be AKI secondary CMV Glomerulitis. Can your lab do in si...

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RE: Clinical Practice Questions 2 days ago

The provisional report so far is ATN and possible glomerulitis . More results to come . Dsa negative If there is cellular rejection in this case ...

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Dialysis Question 2 days ago

After how long after haemodialysis can blood test be taken to reflect accurately potassium and other electrolytes ?

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RE: Clot/ Debris In Right Jugular Vein 2 days ago

Photo --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Clot/ Debris In Right Jugular Vein 2 days ago

Dear all this is photo of jugular vein. Patient had a right jugular central line removed Couple of days ago. Right arm not swollen. No hx of dvt o...

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RE: Management In ADTKD 2 days ago

yes, this is a great idea, but biopsies are hard to come by as individuals are undergoing genetic testing. We are actually trying to collect any ol...

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RE: Anti Gbm Case 2 days ago

It can be difficult to predict risk of DAH in anti-GBM disease. Smoking is tge biggest risk, and smoking must be srticjklu forbidden in anyone with...

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RE: Anti Gbm Case 2 days ago

We decreased the dose of cyclophosphamide from 150 mg to 100 mg and Wcc been holding around 6 The team felt a biopsy would be high risk ( increase...

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RE: Clinical Practice Questions 2 days ago

Will post report once available --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Clinical Practice Questions 2 days ago

If it’s negative on colonoscopy would you stop treatment ? Or you would look at blood cmv pcr --------------------------------- Muhammad Soobadar...

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RE: Thanksgiving 2 days ago

Thanks prof and everyone happy thanksgiving --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Management In ADTKD 3 days ago

@Anthony Bleyer I am interested to know if you performed metabolomic analysis on kidney biopsies from ADTKD-UMOD pateints? Half a core should be su...

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