RE: Chronic TMA 4 hours ago

Thanjs. I reexamined the parer. I csn't find the evidence that the SCr level improved before the therapy with ECU. Can you be mote specific where y...

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RE: Chronic TMA 11 hours ago

Dear Dr Glassock: Re: Keratishvili D, et al KI Reports, March 2026With respect, I have a divergent opinion. If you look at Fig ! F & G of this repo...

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RE: Biopsy dilemma in setting of severe refractory ITP 12 hours ago

Thank you. I just looked it up and you are correct. Her MGUS has been IgG kappa but type 1 cryos also can be associated with IgG kappa. Of course I...

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RE: hemodialysis 12 hours ago

What is the biomarker for the posited "cerebral stunning "-? what would a cerebral MRI show during "cerebral stunning".? Troponin T is suggested ...

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RE: Biopsy dilemma in setting of severe refractory ITP 13 hours ago

My understanding is with type 2 and type 3 Cryo associated with Sjogren or Hepatitis most the time RF factor is very high, which is negative in her...

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RE: Lithium Nephropathy 14 hours ago

Dr Tirolien: Any follow up on your patient w. Lithium nephropathy? ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ o...

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RE: Reference values for blood anion gap 14 hours ago

Thank you, everyone! Best Vikas

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RE: Chronic TMA 15 hours ago

I have sent for anti factor H antibodies, reports are awaited. Yes I agree MLPA will add more information, but patient refusing to get further test...

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RE: Chronic TMA 15 hours ago

Thank you for sharing the relevant literature. ------------------------------ Payal Gaggar MD, DM Nephrology Asst prof Nephrology Nizams Institut...

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RE: Chronic TMA 15 hours ago

I will discuss with my pathologist regarding this sir. ------------------------------ Payal Gaggar MD, DM Nephrology Asst prof Nephrology Nizams ...

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RE: Chronic TMA 16 hours ago

Correction: Van Doorn. Also second Van Doorn et al., paper attached here. ------------------------------ Jonathan Zuckerman MD, PhD UCLA Los Ang...

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RE: Chronic TMA 16 hours ago

Also wanted to highlight the following articles on the topic of renal limited TMA (attached). Maisons et al., KI 2024: Study of >700 patients w...

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RE: Biopsy dilemma in setting of severe refractory ITP 18 hours ago

Labs were just repeated and cryoglobulins, anti PLA2R, and ANCA still pending So far most telling is ACR 12 with UPCR 1.3 gms. C4 9, C3 139. Repe...

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RE: Chronic TMA 18 hours ago

Is your genetic testing sufficient to rule out CNVs? Even if this genetic variant is a VUS it may act as a facilitator for HUS due to other genetic...

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RE: Chronic TMA 18 hours ago

Dr Gaggar: Thank you for the post. Would it be possible for you to upload anonymized renal Bx pictures plz? ------------------------------ Prem C...

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RE: hemodialysis 1 day ago

What is the biomarker for the posited "cerebral stunning "-? what would a cerebral MRI show during "cerebral stunning".? Interesting hypothesis. Wh...

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RE: hemodialysis 1 day ago

This is "Cerebral stunning" similar to "Cardiac stunning" with hemodialysis treatments - Home Dialysis Central https://homedialysis.org › lif...

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RE: EPS 1 day ago

Dr Rodby Thank you very much salil mangi ------------------------------ Salil Mangi MD South Texas Kidney Specialists, P.A. Mcallen TX (956)...

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RE: Reference values for blood anion gap 1 day ago

A thorough and clinically pragmatic response as usual. Thank you Dr. Emmett. ------------------------------ Mario Rubin, M.D. Houston TX (713) 25...

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RE: Reference values for blood anion gap 1 day ago

Dr. Rubin – thanks for the kind shout-out. I agree that the normal AG range is an area of significant confusion! At my hospital the normal range ci...

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RE: Chronic TMA 1 day ago

Well controlled hypertension with evidence of TMA on biopsy certainly strengthens the case for therapy aimed at the alternative complement pathway....

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RE: EPS 1 day ago

If the patient is "asymptomatic" you and she are lucky and I suppose even the more reason to continue it, fibrosis is slow and insidious, and I wou...

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RE: Chronic TMA 1 day ago

Yes hypertension is well controlled with 2 anti hypertensives. ------------------------------ Payal Gaggar MD, DM Nephrology Asst prof Nephrology...

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RE: Chronic TMA 1 day ago

ANA blot is negative and no systemic features of connective tissue disorder. ------------------------------ Payal Gaggar MD, DM Nephrology Asst p...

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RE: Chronic TMA 1 day ago

Thank you for inputs and sharing the article Prof Rodby. ------------------------------ Payal Gaggar MD, DM Nephrology Asst prof Nephrology Nizam...

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RE: EPS 1 day ago

Dr Rodby One of the dilemma that I have is how to follow up after tamoxifen is started because the patient is asymptomatic right now . I might ...

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RE: Chronic TMA 1 day ago

Dr. Gaggar: Is hypertension well controlled in your patient? I assume ANA and other systemic sclerosis-related auto-antibodies are negative. Sclero...

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RE: EPS 1 day ago

Even if tamoxifen is a "Hail Mary", EPS is a devastating disease without an accepted therapy (other than getting off PD and possibly transplanting)...

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RE: Biopsy dilemma in setting of severe refractory ITP 1 day ago

@William Whittier You have been summoned to give us the 2026 opinion on transvenous renal biopsy (from Dr Glassock above). I myself (sharing an...

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RE: Chronic TMA 1 day ago

We see a lot of less obvious renal TMAs here, cases suggestive in the kidney biopsy (TMA is such a pattern of injury diagnosis with such a long lis...

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RE: Chronic TMA 1 day ago

APLA, protein C, S, Antithrombin 3 , all are within normal limits. Will see this paper. Thanks for the inputs Prof Glassock. --------------------...

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RE: Chronic TMA 1 day ago

See Keratishvili D, et al KI Reports, March 2026. This patient seems to have a chronic Renal limited TMA. have you evaluated him for anti-phospholi...

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Chronic TMA 1 day ago

A 39-year-old male with a 4-year history of hypertension presented with impaired renal function (serum creatinine 1.76 mg/dL [155 µmol/L], eGFR 50 ...

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RE: Biopsy dilemma in setting of severe refractory ITP 2 days ago

Cryoglobulins just ordered. RF to be repeated. Details of prior RF no known since initial evaluation at other hospital. Hep C negative previously. ...

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RE: EPS 2 days ago

Thank you. I was curious because the ISPD does not provide a specific dose or regimen for tamoxifen in EPS. As the authors of the UpToDate card sta...

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RE: EPS 2 days ago

Dr. Rubin up-to-date mentions a dose of 10 mg three times a day for at least three months which is why I decided on that dose and the duration. s...

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RE: EPS 2 days ago

@Salil Mangi I am curious, how did you come up with 3 months? The suggested initial dose is 20 mg for 6-12 months with adjustments according to c...

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RE: Reference values for blood anion gap 2 days ago

While we re-read the classical jewel attached, let's see what the main source says! @Michael Emmett ------------------------------ Mari...

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RE: EPS 2 days ago

Thank you, Drs Glassock,Rubin,Bargman and Rodby for your input. I am going to put the patient on Tamoxifen for 3 months and hope that it helps. s...

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RE: Reference values for blood anion gap 2 days ago

I have looked into this nd the best answer I could find was also this: From UPTODate "Historically, the normal range for the AG has been 12±...

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RE: Hypercalcemia in a Critically Ill Patient with MAC Infection 2 days ago

Did he have any evidence of rhabdomyolysis as a cause of his dialysis-dependent AKI, such as elevated CPK, severe hypocalcemia and severe hyperphos...

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Reference values for blood anion gap 2 days ago

Hello, I seek guidance on what has changed, if anything, with the reference range for blood anion gap. On recent LabCorp reports, I see the refer...

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Encourage fellows to volunteer as case report reviewers for Kidney Week 2026! 2 days ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

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Volunteer by April 29 to serve as a case report reviewer for Kidney Week 2026! 2 days ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

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RE: EPS 2 days ago

let's face it, EPS is devastating and tamoxifen is pretty benign so I would absolutely use it... The reports of using sodium thiosulfate (referre...

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RE: hemodialysis 2 days ago

12.5-25 G mannitol IV given through hd port before start of HD.We used to do it not infrequently back in the day at UVA to prevent disequilibrium s...

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RE: Hypercalcemia in a Critically Ill Patient with MAC Infection 2 days ago

These findings are more suggestive of immobilization hypercalcemia , but the absence of 1,25 dihydroxy vitamin D suppression is a bit atypical. Do ...

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RE: EPS 2 days ago

Thanks Dr. Bargman. Very helpful advice. My enthusiasm for steroids and Tamoxifen was misguided, probably because of my paucity of "hands-on ";expe...

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Hypercalcemia in a Critically Ill Patient with MAC Infection 2 days ago

We would appreciate insights from colleagues regarding the following challenging case of hypercalcemia in an ICU patient. Case Summary: A 76-year-...

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RE: Severe COVID in Renal Transplant Patient - Tocilizumab? 2 days ago

@Azam Mughni In addition to ECMO and as previously suggested, your patient may have a superinfection (PJP, fungus) and requires, if not already d...

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