RE: VHL and kidney transplant 3 hours ago

I think your patient has to be anephric ti be safe from RCC, and thus the timing of nephrectomy and transplantation could be a bit tricky if not de...

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RE: Absolute GFR? 3 hours ago

This is my opinion, I expect some criticism. what does it really matter what his GFR is? If he has CKD it cant be that low if you have to jump t...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 3 hours ago

I like MTX better than MMF, but I'm not sure if I can support that. I just feel that MMF is not really a vasculitis drug while there is a lot of ev...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 4 hours ago

Sorry, was the CRP 0.4 mg/dL. I may have misread the value in the previous post a s4 mg/dl which would have yielded a value of 40 mg/L . Sent fro...

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RE: Absolute GFR? 4 hours ago

Thank you for updating us. If available , it should be done in this case. Sent from Outlook

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 5 hours ago

Dr. Besarab, her MCV and MCHC were low so all picture goes with IDA and marker of inflammation such as ESR and CRP were normal. Dr. Torralba, tha...

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RE: Absolute GFR? 6 hours ago

Plasma disappearance of (cold, non radioactive ) Iohexol has been validated as a reasonably accurate way to measure (rather than estimate ) GFR in ...

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RE: Absolute GFR? 8 hours ago

But we are still using formulas without a creatine excretion rate. If true GFR is say decreased 50 , some urinary creatinine is probably secreted a...

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RE: Absolute GFR? 8 hours ago

Dr Glassock I agree, in special populations or in specific disease states such as acromegaly we do not habe enough data to know which approach accu...

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RE: Lupus Case 8 hours ago

KDIGO, EULAR/EDTA, ACR Guidelines - all call for triple therapy. pulse steroids followed by reduced dose schema plus two immunosuppresants. Patie...

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RE: Absolute GFR? 8 hours ago

What is the patients actual BSA? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------------------...

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RE: Sarcoidosis Case 9 hours ago

Sarcoidosis can only be diagnosed based on biopsy showing NCGs. ACE level - is really not too helpful- even if high you will still need biopsy show...

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RE: Absolute GFR? 9 hours ago

For de-indexed eGFR multiply the value of the BSA indexed eGFR by the ratio of actual BSA to 1.73M2 ------------------------------ Richard Glasso...

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RE: Absolute GFR? 9 hours ago

Use creatinine based eGFR de-indexed (for BSA). Cystatin C eGFR indexed to normal BSA has the same errors as a Creatinine eGFR indexed to a normal ...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 9 hours ago

https://pubmed.ncbi.nlm.nih.gov/34235884/ - the 2021 Amer College of Rheumatology Vasculitis Guidelines, specifically for TAK, call for treatment w...

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RE: Absolute GFR? 9 hours ago

Following review, he had not followed through on the 24 hr collection correctly and it was before Cystatin c was available. I will use these. Ab...

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RE: Absolute GFR? 10 hours ago

Thank you. I actually did do the corrected creat clearance and cyst/creat eGFR at his initial evaluation. . I will check asap. I will check his fil...

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RE: Absolute GFR? 11 hours ago

I agree with Dr. Venturelli. In the normalized eGFR/1.73 m2, it is presumed that weight muscle mass remains proportional to height and weight. Even...

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RE: rapidly progressive case of IgA nephropathy 11 hours ago

Based on the proteinuria, eGFR trajectory and signs of active inflammation I think the answer to this question is YES! --------------------------...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 12 hours ago

serum ferritin 23 ng/ml, TSAT 5% and CRP 4 mg /d (10 fold increase over normal)l. suggest two processes, iron deficiency and inflammation as contri...

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RE: mn with serum positive plar2 /negative on biopsy 12 hours ago

Thanks prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: rapidly progressive case of IgA nephropathy 13 hours ago

Is it still indicated to administer pulse steroid and MMF even with the primary impression that its non rapid progressive GN with 6% glomerular cre...

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RE: Absolute GFR? 13 hours ago

If you're using a eGFR formula that is indexed for body surface of 1.73 m^2 in very large (or small) individuals, adjusting for BSA might provide a...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 16 hours ago

Yesterday world up showed serum creatinine 0.6, serum ferritin 23 ng/ml, TSAT 5% and CRP 4 mg /dl. Discussion with a rheumatologist suggest high d...

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Absolute GFR? 19 hours ago

I have a patient with acromegaly and found equations online where we correct the egfr epi equations using the patients body surface area. Is it cor...

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RE: Case Of AKI And Nephrotic syndrome 1 day ago

C3 /C4 normal --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Case Of AKI And Nephrotic syndrome 1 day ago

Thanks- see you there. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Case Of AKI And Nephrotic syndrome 1 day ago

Biopsy done yesterday no EM as yet Thanks prof glassock ( I see you will be on glom con I will be attending from UK and look forward to your talk ...

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RE: Case Of AKI And Nephrotic syndrome 1 day ago

What did the EM show? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Sarcoidosis Case 1 day ago

This is almost certainly Saecoidosis, I would treat the patient according to this diagnosis , as Dr. Rodby suggests. ----------------------------...

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RE: mn with serum positive plar2 /negative on biopsy 1 day ago

As far as I know, no data. The prognosis will be determine by what happens to the serum anti-PLA2R antibody levels with RTX therapy, in my opinion....

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RE: Sarcoidosis Case 1 day ago

Thanks prof rodb( love the title!!!) renal biopsy was done and ace levels came after >120( 29-112 U/L) 1-25 oh not done and seem he has gone h...

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RE: Case Of AKI And Nephrotic syndrome 1 day ago

Dear Colleagues Her Biopsy is attached below. will have to discuss with hepatologist( not herptelogist) haha!! for management her mpo is 1 and nor...

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RE: mn with serum positive plar2 /negative on biopsy 1 day ago

thanks very helfpul those kind of cases do they have worse outcome in terms of ESKD/Mortality compared to serum positive plar2 and iHC postive pl...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 1 day ago

why antihypertensive therapy was only Olmesartan and spironolactone? her blood pressure is 220/130, accelerated hypertension. -------------------...

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RE: Primary vs Secondary IgAN 2 days ago

My patient actually has IGA dominant full house pattern of injury with the diagnosis suggestive hydralazine induced SLE with the significant protei...

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RE: Primary vs Secondary IgAN 2 days ago

Unfortunately I was not able to get original biopsy report. Is there anything else one can do to differentiate. I did find that IgG intensity is al...

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RE: Primary vs Secondary IgAN 2 days ago

.

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RE: Primary vs Secondary IgAN 2 days ago

I generally agree regarding most situations of primary vs secondary IgAN. The two situations where the absence of staining might be helpful would b...

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RE: Primary vs Secondary IgAN 2 days ago

ThanksBajinder Reen Sent from my iPhoneSpelling mistakes are regretted which are not intentional

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RE: Primary vs Secondary IgAN 2 days ago

Unfortunately , according to more recent studies the specificity of KN55 staining of kidney tissue fir IgAN is limited and probably of not much dia...

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RE: Primary vs Secondary IgAN 2 days ago

Mayo offers a KM55 IHC for tissue ------------------------------ Jonathan Zuckerman MD, PhD UCLA Los Angeles CA (310) 794-1485 ------------------...

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RE: Primary vs Secondary IgAN 2 days ago

Which lab does km55 staining on one my patient --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 ------------------...

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RE: Unveiling Takayasu's Arteritis In A Young Female With Severe Hypertension 2 days ago

The results for anemia suggest iron deficiency may be present. However, peripheral smear not availabl3e. Suggest it ne done along with iron indices...

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RE: Primary vs Secondary IgAN 2 days ago

If possible, one could consider staining the biopsy for KM55 (specific for gd-IGA molecules). If positive would further favor IgAN. Though data her...

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RE: mn with serum positive plar2 /negative on biopsy 2 days ago

Rare cases of PLA2R negative staining can occur which are only detectable by mass spec https://www.sciencedirect.com/science/article/pii/S008525382...

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RE: rapidly progressive case of IgA nephropathy 2 days ago

Unless this this is ANCA + disease, RTX in not indicated in IgAN. It might be effective in IgAV, but this patient did not have the clinical criteri...

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RE: rapidly progressive case of IgA nephropathy 2 days ago

In addition to steroids and MMF,Rinvoq may also provide some added protection, opinion based --------------------------------- Bajinder Reen MD E...

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RE: rapidly progressive case of IgA nephropathy 2 days ago

The reason I decided against pulse IV steroid therapy followed by oral steroid therapy is severe tolerability issues in this patient. She has previ...

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RE: rapidly progressive case of IgA nephropathy 2 days ago

The patient may not have met the criteria for Cresenteric IgA , but perhaps now may meet it, perhaps only confirmed by biopsy. I agree with Dr. Gla...

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