RE: Recurrent ascites in ESRD pt 2 hours ago

TB is quite common cause of ascites in our Esrd patients,may relook at PET CT for omental thickening and of course the peritoneal biopsy is the gol...

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RE: Recurrent ascites in ESRD pt 6 hours ago

So thus case still lacks a "diagnosis" to explain the refractory recurrence of ascites. If all known causes have been excluded, would it be appropr...

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RE: primary membranous nephropathy 7 hours ago

I do not think so. I do not know of any widely used protocol for a Primary MN (with or without anti-PLA2R auto-antibody) that employing CYC that do...

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RE: primary membranous nephropathy 7 hours ago

Does anyone have experience with Niles protocoll without Prednisone? ------------------------------ Argyrios Georgalis MD Cantonal Hospital Grau...

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RE: Is kinetic eGFR valid for use in oligoanuric patient? 9 hours ago

I would consider the GFR as essentially zero. I see no clear advantage of a "kinetic" eGFR in this setting. Just an opinion . Other opinions welcom...

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RE: Recurrent ascites in ESRD pt 11 hours ago

As of now, she got a peritoneal dialysis catheter to help with regular drainage as well as a peritoneal biopsy. I will keep you all posted on the r...

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RE: Recurrent ascites in ESRD pt 11 hours ago

when you say nephrogenic-what would the mechanism be (assuming that if pts has been on dialysis for some time residual kidney function is nil or qu...

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Is kinetic eGFR valid for use in oligoanuric patient? 12 hours ago

Greetings for community members. Occasionally we are consulted to do dose adjustment for antibiotics in AKI patient. Due to unstable creatinine w...

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RE: Recurrent ascites in ESRD pt 13 hours ago

"The last few times, cell counts have been around 80-100, with 2% neutrophils, and 89% lymphocytes." If this is truly a lymphocytosis and not a m...

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RE: Pluvicto for a patient on HD 14 hours ago

Once had to deal with I 131 for HD pt with thyroid cancer, normally (nl GFR) they just urinate the radioactivity seen the toilet. but here HD was a...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 16 hours ago

Me too. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: primary membranous nephropathy 16 hours ago

Very high titer anti-PLA2R levels (>150RU/ml) is reasonably well established as a risk factor fir progression and a sign of likely resistance to RT...

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RE: Pluvicto for a patient on HD 17 hours ago

As you might expect, published literature on the use of Pluvicto in dialysis patients with metastatic prostate cancer is very limited and subject t...

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RE: primary membranous nephropathy 1 day ago

Respected Panel members , I had a question. If in this patient, biopsy was possible and Primary Membranous Nephropathy was confirmed, does the t...

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Pluvicto for a patient on HD 1 day ago

Does anyone have any experience with providing hemodialysis for patients receiving Pluvicto (lutetium Lu 177 vipivotide tetraxetan) with ESKD? Spe...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

Agree ------------------------------ John Mellas MD Nephrology and Hypertension Specialists St Louis MO 3145372356 ------------------------------

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RE: Sarcoidosis Case 1 day ago

I really doubt 8 days of steroids would not make either sarcoidosis or vasculitis free ("disappear) of histologic pathology, but the problem is t...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

With urinary findings and pathology findings, I would not be so sure that removal of the adenoma would help the BP, but at this age I would give it...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

Sono completamente d'accordo. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

personally if AVS is easily accessible I would perform it but if it's not available I would think about surgery anyway. Would you ? --------...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

Dr Mellas I'm not sure whether this is plasma renin activity or plasma renin concentration.. perhaps Dr. Aledan can clarify this for us and also if...

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RE: Sarcoidosis Case 1 day ago

How high was serum calcium initially? Urinalysis findings -active vs. bland? Results of hypercalcemia work-up (PTH, 25-OH and 1-25 dihydroxy vitami...

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RE: primary membranous nephropathy 1 day ago

Thanks prof glassock really informative and grateful to have your input and learn from such a world giant of nephrology 😃 ----------------------...

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Sarcoidosis Case 1 day ago

Dear colleagues , Would be helpful for some input. 18 male fit and well 2-3 month history of joint pain Vomiting 2-3 weeks ago Aki- Efgr 20-30 fr...

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RE: Atrasentan experience and first thoughts 1 day ago

Hello, there were no changes to any medications , so as not to influence the effect of Atrasentan. He just had his labs done after week 2. eGFR : ...

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RE: Atrasentan experience and first thoughts 1 day ago

Thanks for sharing your experience Dr Dastoor. Were any changes made in dosages of ARBs/SGLT2/MRA upon initiation of atrasentan, for I think 15% im...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

aldo-renin ratio elevated but not impressive. If considering surgery would you perform selective adrenal sampling? ------------------------------...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

The question of life long MRA vs adenoma removal has historically been decided by individual patient details--Is the BP 120 on one medicine? Or, 14...

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RE: Recurrent ascites in ESRD pt 1 day ago

Ascitis hipertensiva in Dialis with abdominal pain we locate a Peritoneal cath to be easier drain and avoid múltiples abdominal punctures and the p...

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RE: Atrasentan experience and first thoughts 1 day ago

In regards to the cost of the drugs , I think we may need to look at a new concept like cost per eGFR protected per year ( Value : V1-eGFR) . This ...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 1 day ago

Thanks Dr. Glassock, I'm aware of the inaccuracies of the term hypertensive nephropathy but perhaps this could be one of the rare cases in which va...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

A nice study of the ream pathology of PA can be found in Ogata H et al Hypertension 2021; 78: 411-421. Did you bc do EM. The hematuria might be due...

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RE: Treatment of IgA vasculitis with RPGN 2 days ago

Too my knowledge there gave been two RCT of CYC in IgAN (Ballardie and Roberts and STOp IgAN) and one in Iga V ( Pillebout) . None if the patients ...

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RE: Recurrent ascites in ESRD pt 2 days ago

What is the consensus diagnosis in this perplexing case? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885...

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RE: Recurrent ascites in ESRD pt 2 days ago

Interestingly, the last few times we did peritoneal fluid analysis, she did have 89-90 lymphocytes. ( Total count 80-100, with 80-90% lymphocyte pe...

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RE: Recurrent ascites in ESRD pt 2 days ago

Thank you! The last few times, cell counts have been around 80-100, with 2% neutrophils, and 89% lymphocytes. Cultures have always been negative. ...

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RE: Recurrent ascites in ESRD pt 2 days ago

Did the episodes of peritonitis have positive cultures. Also, what were the cell counts and differential of the PD fluid? Wondering about a lymphat...

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RE: Treatment of IgA vasculitis with RPGN 2 days ago

One reason for this opinion-based practice may be difference in age of onset. IgA vasculitis has higher incidence in children and there may be grea...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

Thanks all for your comments. Agree with Dr. Glassock that hypertensive nephropathy is not really exist and this what concern me about the kidney ...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

Patients under 35 years old with confirmed PA, marked hypokalemia, and a clear unilateral adrenal adenoma (e.g., >1 cm) on imaging (CT/MRI) may not...

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RE: Recurrent ascites in ESRD pt 2 days ago

"Dr. Rodby- Somehow, I was under the impression that "dialysis associated (Nephrogenic) ascites" was becoming much less common (for reasons that I ...

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RE: Treatment of IgA vasculitis with RPGN 2 days ago

I too have always had a problem with this. From https://kdigo.org/wp-content/uploads/2017/02/KDIGO-GD-Guideline-Key-Takeaways-for-Clinicians-I...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

Dr. Venturelli- Thanks, but really dislike the term "hypertensive nephropathy " as it implies a causative inference that does not really exist. Wou...

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RE: Treatment of IgA vasculitis with RPGN 2 days ago

Can you cite where you learned of this apparently "conflicting " rationale? I would presume that this is opinion and not evidence based. As we know...

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Treatment of IgA vasculitis with RPGN 2 days ago

I would like to ask regarding the rationale of not involving cyclophospsmide in treatment of IgA vasculitis associated with RPGN,while involving it...

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RE: Recurrent ascites in ESRD pt 2 days ago

Greetings Varsha I strongly suggest to perform a celular count of the fluid. Recently, I had a similar case of an HD patient with refractory asci...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

Just an opinion. Since the patient has overt hyperaldosteronism and imaging shows a unilateral disease pre - surgical AVS might not be needed. ...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

My apology. Attached. --------------------------------- Hayder Aledan MD, FASN Professor Basra Nephrology and Transplantation Center Basra ...

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RE: Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

No attachments. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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Primary Aldosteronism With Hamaturia And Proteinuria For Possible Surgery 2 days ago

A 34-years-old woman with a diagnosis of primary aldosteronism was referred from endocrinologist because of proteinuria and hematuria. She was on ...

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