RE: preoperative hyponatremia 1 hour ago

In my experience Anesthesiologist will not let you decide, they simply won't do it - at least in my neighborhood. As you know SIAD = [syndrome of...

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RE: Re: pt with resistant HTN 2 hours ago

Low Renin HTN should not be treated with RAS blockers This patient is on wrong medicines Clonidine + Metoprolol is a bad combination. We have d...

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preoperative hyponatremia 4 hours ago

I am usually asked to evaluate patients preoperatively for hyponatremia in relation to anesthesia clearance. I need your help answering the followi...

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RE: Re: pt with resistant HTN 5 hours ago

Dr. Hirsch raises some interesting points regarding sodium balance and blood pressure control. In terms of dietary interventions, what is importan...

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RE: ATI, Anuria post kidney transplant 5 hours ago

If EM is not strictly conclusive,rebiopsy is warranted to uncover undetected underlying evolving pathology. ------------------------------ Ahmed ...

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RE: Re: pt with resistant HTN 6 hours ago

Point well taken, loop diuretics are extremely potent with nl GFR ( When I think of how much time I spend in the bathroom after just a couple cups ...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 8 hours ago

I am a Nephrology fellow resident from India.Can I apply from india mam ?? Will I be eligible for grant mam ? ------------------------------ Keer...

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RE: ATI, Anuria post kidney transplant 9 hours ago

Most recently UPr/Cr 2.6 g/g, 75 RBCs/HPF, UPr 392.7 mg/dL and urine output 500-600 mL/day. Even if one ignores the UCr (spot value unreliable as s...

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RE: Renal Artery Stenosis Case 18 hours ago

With unilateral stenosis, creatine may not be the best indicator to be followed for worsening stenosis. But stenotic kidney volume can be followed...

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RE: Renal Artery Stenosis Case 19 hours ago

Agree with no intervention at time being. Attached the indication for intervention for atherosclerotic RAS. https://academic.oup.com/ndt/articl...

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RE: Re: pt with resistant HTN 19 hours ago

Is there any role for use of loop diuretics for treatment of HTN in patients with preserved GFR? --------------------------------- Hayder Aledan ...

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RE: Re: pt with resistant HTN 21 hours ago

Good suggestion, but until the huge NaCl intake is curtailed, the efficacy of any diuretic regimen will be compromised. ------------------------...

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RE: Re: pt with resistant HTN 21 hours ago

Many good points already mentioned. The one thing left that I would add is a loop diuretic and titrate until the blood pressure is controlled or th...

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RE: Renal Artery Stenosis Case 1 day ago

I fully agree. No reason to intervene now, but I would follow the patient for worsening kidney function and further aggravation of the degree of RA...

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RE: Renal Artery Stenosis Case 1 day ago

With 50% stenosis and good BP control with anti hypertensive drugs, I would not advise invasive intervention. ------------------------------ Vito...

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CALL FOR CASE SUBMISSIONS ANNUAL DIALYSIS CONFERENCE (MARCH 2025). FELLOWS GRANTS AVAILABLE FOR SELECTED CASES! 1 day ago

Dear fellow educators, We cordially invite your fellows to submit a challenging or interesting dialysis case for presentation at our upcoming co...

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RE: Renal Artery Stenosis Case 1 day ago

the CTA evaluated both kidneys? ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical Center Chicago...

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CALL FOR CASE SUBMISSIONS ANNUAL DIALYSIS CONFERENCE (MARCH 2025). GRANTS AVAILABLE FOR SELECTED CASES! 1 day ago

Dear all, We cordially invite you to submit a challenging or interesting dialysis case for presentation at our upcoming conference in Las Vegas,...

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RE: Steroid resistance nephrotic syndrome 1 day ago

I agree. It was a long shot anyway. But that genetics cannot be ignored. Especially the 'likely pathogenic' bit. Is there any family history of amy...

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RE: Renal Artery Stenosis Case 1 day ago

Was the hypertensive crisis due to NSAID use? If so there is no need to do anything else. Perhaps the knee replacement would help. If obese, semagl...

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RE: Renal Artery Stenosis Case 1 day ago

So she is now in her mid-60's? What has happened to kidney function over time, especially with increase in ACEi dose? Any reason for the HTN crisis...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 1 day ago

Hello! I am doing first year nephrology fellowship and I am interested in any opportunity regarding nephrology especially home dialysis topic.I t...

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RE: ATI, Anuria post kidney transplant 1 day ago

My thought this is not recurrent FSGS and as there is no rejection so this is ATN and UTI I would worried about low TAC levels and uptitrate to tro...

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RE: Steroid resistance nephrotic syndrome 1 day ago

Thanks. No amyloid by EM. Biopsy consistent with a diffuse Podocytopathy .. ------------------------------ Richard Glassock MD, FASN Laguna Wood...

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RE: Steroid resistance nephrotic syndrome 1 day ago

I attached the EM report. ------------------------------ Sura Alsaffar MD Pediatric Nephrology Fellow SUNY Downstate Health Science Univers...

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RE: Steroid resistance nephrotic syndrome 1 day ago

The early course of SSNS and a multi-relapsing course would not be very compatible with an underlying renal hereditary Amyloidosis, but the genetic...

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RE: NELL-1 positive membranous 1 day ago

Your assumption is correct. The only way we know by stopping amphetamine if it is the culprit if that is not possible then use ritixumab or obi is ...

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RE: NELL-1 positive membranous 1 day ago

This assumption is correct Only way we will know by stopping the drugIf not possible ritixumab or obi should tried Sent from my iPhoneSpelling mist...

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RE: Steroid resistance nephrotic syndrome 1 day ago

If EM was done in this biopsy, it should have excluded Amyloidosis as a cause. Do you have an EM report? ------------------------------ Richard ...

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RE: NELL-1 positive membranous 1 day ago

I do not think that any connection between Amphetamine use and MN (of any subtype ) exists. Is this a correct assumption? -----------------------...

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RE: ATI, Anuria post kidney transplant 1 day ago

Dr. Amara: Thanks for the update. Encouraged by improving urine output of 500 to 600 ml/day. Can you please obtain UAlb/Cr ratio and UPr/Cr ratio o...

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Renal Artery Stenosis Case 1 day ago

I saw a lady who left artery renal stenosis in 1980 presented with resistant HTN. She was in her 20. She had a graft from saphenous vein to left re...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 2 days ago

Hello dearI will be so, proud if I got this chance to attend the conference in Las Vegas 2025..iam from Iraq Arabic board certified in nephrology a...

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RE: NELL-1 positive membranous 2 days ago

I would look hard for a malignancy , hepatitis etc (see below) ask hard for supplements, skin creams. then when coming up negative which I assume y...

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RE: NELL-1 positive membranous 2 days ago

He is too young for some CA associated with NELL1 but not impossible, prostate CA comes to mind. Treating with anti-CD20 is the best option now. I ...

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RE: ATI, Anuria post kidney transplant 2 days ago

@K.K. Venkat @Mark Lerman Quick update Start to pass urine ~500 -600 ml/d Repeat UPCR 2.6 gm/gm (Attached) Repeat UA: Pus cells 5-8 RBcs 70...

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RE: Steroid resistance nephrotic syndrome 2 days ago

All but 3 appear relatively preserved and mildly enlarged with somewhat smooth thickening of the peripheral capillary walls and generally patent lu...

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RE: preoperative nephrology evaluation 2 days ago

None that I know of. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Steroid resistance nephrotic syndrome 2 days ago

For how long was the first course of steroids? Why was followed by MMF? Steroids can work to reduce proteinuria in non-immunological way by acting...

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RE: NELL-1 positive membranous 2 days ago

reposting to see if any other additional suggestions or input to help with this case? ------------------------------ Jagmeet Dhingra MD, FASN Bea...

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RE: Steroid resistance nephrotic syndrome 2 days ago

Thank you Dr. Balan. I posted the genetic test results. ------------------------------ Sura Alsaffar MD Pediatric Nephrology Fellow SUNY Downst...

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RE: Steroid resistance nephrotic syndrome 2 days ago

Gene Condition(s) Inheritance Variant(s) Zygosity Classification -FGA Hereditary Renal Amyloidosis (AD), Congenital Fibrinogen Deficiency (AD/AR) ...

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RE: Nephrotic Syndrome In A Young Lady 2 days ago

I do not think it will change decision about treatment if staining is negative or positive. This an antibody driven disease. Other antigen are bein...

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RE: Steroid resistance nephrotic syndrome 3 days ago

With SSNS it is not likely that genetic testing will be informative . But it would be nice to know what kind of Amyloidosis gene was detected. -...

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RE: Steroid resistance nephrotic syndrome 3 days ago

Can you post the genetics report? ------------------------------ Satish Balan MD DM DNB Senior Consultant Department of Nephrology Kerala Institu...

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RE: Steroid resistance nephrotic syndrome 3 days ago

For Obi in children and SRNS see Chan Y, et al Ped Nephrol 2024; October 28. ------------------------------ Richard Glassock MD, FASN Laguna Wood...

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RE: Steroid resistance nephrotic syndrome 3 days ago

Thank you Dr. Rodby. Actually patient is not responding to steroids anymore. And regarding to OBI is there any ongoing trial or study on childr...

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RE: Steroid resistance nephrotic syndrome 3 days ago

The good news is that this is steroid responsive, I agree that a hip infection would be highly unusual with anti-CD 20 alone, and is more likely ...

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RE: ATI, Anuria post kidney transplant 3 days ago

Would continue Plex until EM is available -would continue Tac at therapeutic levels , If EM does not not support FSGS then would try to switch to B...

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RE: Steroid resistance nephrotic syndrome 3 days ago

Very little data in children But at the ASN Renal week a pilot study with Obinutuzumab is SRNS in Adults due to Primary FSGS was very encouraging. ...

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