RE: Hyperkalemia Post Kidney Transplant 1 hour ago

I agree that the measurement of plasma renin and aldosterone is superior to the TTKG measurement. The TTKG formula was developed based on the princ...

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RE: Hyperkalemia Post Kidney Transplant 2 hours ago

In the evaluation of chronic hyperkalemia with relatively preserved GFR, I wonder if TTKG really adds much. Measurement of PRA-and serum aldosteron...

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RE: Hyperkalemia Post Kidney Transplant 4 hours ago

That is why it is critical to measure the circulating aldosterone level in this, and other individuals post transplant with hyperkalemia. If the al...

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RE: Hyperkalemia Post Kidney Transplant 4 hours ago

In my practice I do use TTKG for chronically elevated K based on the fact that K secretion is a distal nephron process so that the gradient for ser...

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RE: Hyperkalemia Post Kidney Transplant 5 hours ago

The original post suggested that these patients have low blood pressure and are not hypertensive. Does this not make Gordon Syndrone Type IV RTA un...

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RE: Calciphylaxis 5 hours ago

Are the skin lesions painful? Where are they located? Can you post a photography? I hope the dermatologist does not do "diagnostic " skin biopsy as...

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RE: Hyperkalemia Post Kidney Transplant 5 hours ago

Interesting question. It is critical to determine whether the serum aldosterone level is increased or suppressed. If increased, it falls under the ...

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RE: Hyperkalemia Post Kidney Transplant 5 hours ago

Many thanks Dr. Lerman. Great advice. I think we need PRA and serum aldosterone levels to separate TypeIV RTA from Pseudohypoaldosteronism Ty9e as ...

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RE: Hyperkalemia Post Kidney Transplant 5 hours ago

Would add that type IV RTA due to CNI is most likely cause , although Bactrim prophylaxis can also contribute . If Hypertension is present then dru...

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RE: Calciphylaxis 6 hours ago

We use sodium thiosulfate all the times, watch for qt interval, also cinacalcet is reported to help as tolerated, surgical debridement, and increas...

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Calciphylaxis 8 hours ago

70 y/o patient ESRD on home hemodialysis for more than 7 years, HTN, HLD, DM, Secondary hyperparathyroidism, Atrial fibrillation, s/p parathyroidec...

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RE: Hyperkalemia Post Kidney Transplant 8 hours ago

Thanks - although uncommon acquired Pseudohypoaldosteronism Type 1 or Type 2 (Gordon Syndrome) can be seen in renal transplant recipients receiving...

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RE: Hyperkalemia Post Kidney Transplant 13 hours ago

Serum K ranges from 5.8 - 6 Not on RASi eGFR preserved --------------------------------- Ahmed Emara MD, FASN Ain shams university, cairo Ca...

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RE: Severe AIN with Crescents 16 hours ago

complements have been normal x 2 during the course of hospital stay. will circle back with the final path report once available -------------...

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RE: Severe AIN with Crescents 16 hours ago

mpo / pr3 negative, updated / edited the case- along with urine eos 1% - no eosinophilia. after the prelim bx , repeated mp/ pr3- negative again. ...

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RE: ADPKD ON JYNARQUE 22 hours ago

this may shed light on using sglt2 nature.com/articles/s41467-022-35537-2 lays theoretical basis for using these drugs in PCK intersting ph...

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RE: Severe AIN with Crescents 1 day ago

I agree with all of tge suggestions if Dr. Venkat, with the addition of the % eosinophils in tge interstitial infiltrate and the peripheral blood e...

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RE: Hyperkalemia Post Kidney Transplant 1 day ago

How are you defining "Hyperkalemia" ? Are these patients receiving RAS inhibitors.? What is the average eGFR in these patients? -----------...

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Hyperkalemia Post Kidney Transplant 1 day ago

Hi everyone I need to get your thoughts on a recurring issue we’ve been encountering post-transplant: persistent hyperkalemia. Despite dietary m...

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RE: Severe AIN with Crescents 1 day ago

Questions/comments: 1. ANCA results? 2. Is patient on hydralazine or allopurinol - may cause crescentic GN? 3. Type of interstitial infiltrate - if...

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Severe AIN with Crescents 1 day ago

63-year-old female with a past medical history of T2DM, bacteremia, perinephric abscess, leg wounds and urinary retention who presented with rash a...

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RE: ADPKD ON JYNARQUE 1 day ago

Dear Dr. Glassock, the evidence provided in the article that you mention in KI it cannot be considered convincing. The study is too small (only 2...

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RE: ADPKD ON JYNARQUE 1 day ago

Really interesting conversation about SGL2Is and ADPKD and mechanisms--thanks to all-- and the proof will be in the pudding, when the relevant stud...

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RE: ADPKD ON JYNARQUE 1 day ago

6.Kapoor S, Rodriguez D, Riwanto M et al. Effect of sodium-glucose cotransport inhibition on polycystic kidney disease progression in PCK rats. PLo...

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RE: ADPKD ON JYNARQUE 1 day ago

7.Morioka F, Nakatani S, Uedono H et al. Short-term dapagliflozin administration in autosomal dominant polycystic kidney disease-a retrospective si...

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RE: ADPKD ON JYNARQUE 1 day ago

I am not sure this has been established in human patients with ADPKD who are also on RASi. Can you cite any supporting literature for this statemen...

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RE: Hypocalcemia And Hypoparathyroidism 1 day ago

Thanks will do Very helpful --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH (513) 841-0222 ----...

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RE: ADPKD ON JYNARQUE 1 day ago

Thanks But if pt not on Tolvaptan SGLTI will cause high vasopressin which will cause increase expansion of Cysts -------------------------------...

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RE: ADPKD ON JYNARQUE 1 day ago

My point was if decreased renal mass led to increased SNGFR and Glomerular HTN as part of the progressive nature of ADPKD, I would have predicted t...

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RE: ADPKD ON JYNARQUE 2 days ago

Thanks Dr. Rodby for arguing that SGLT2i have no physiological basis for being "renoprotective" in ADPKD. A counterargument is that as cysts expand...

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RE: ADPKD ON JYNARQUE 2 days ago

ADPKD is a genetically programmed tubular disease RAASi : ACEI and ARB work by lowering (ostensibly) predominantly by lowering glomerular capill...

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RE: ADPKD ON JYNARQUE 2 days ago

Until the knowledge gap is filled by well designed RCT this issue will remain as a conundrum for physicians and patients alike. See the excellent r...

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RE: Hypocalcemia And Hypoparathyroidism 2 days ago

Dr Edward Brown at the Brigham has described activating antibodies against the calcium sensing receptor in a variety of conditions causing hypopara...

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RE: Unknown left pleural effusion 2 days ago

I am not a radiologist, but the path of the catheter seems to me to be more of a subclavian than IJ insertion site. Maybe a lateral Chest x-Ray wou...

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RE: Unknown left pleural effusion 2 days ago

The tunneled catheter was inserted in the left internal jugular vein, october 2024, chest x ray on april 2025 was normal, all the symptoms started ...

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RE: Unknown left pleural effusion 2 days ago

Totally agree. Not clear why the Subclavian rather than IJ was chosen. Had the TIJ and LIJ been compromised before? Or was this just a "bad" inadve...

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RE: Multi-center Study - Kidney Transplant for Oxalate Nephropathy 2 days ago

How many patients with PH have you done ?What is 1 and 3 yr graft survival? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] ...

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RE: Hypocalcemia And Hypoparathyroidism 2 days ago

Thanks Dr Glassock Regyanti-Cytokine antibodies characteristic of auto- immune poly-glandular syndrome Type 1 (Il-22 ,etc) I did not I thought t...

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RE: ADPKD ON JYNARQUE 2 days ago

Thanks Dr Glassock I think KDIGO still did not recommend --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincin...

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RE: IgA Kappa PGMID and EGPA 2 days ago

This thread reminds me of the difficulty in unequivocally establishing monoclonality of Ig depidits.using frozen IF and anti-Kappa and Anti-Lambda ...

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RE: ADPKD ON JYNARQUE 2 days ago

A recent crossover study from Japan showed benefit on eGFR-Creat-CystC in patients with ADPKD already treated with high dose Tolvaptan.( See Uchiya...

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RE: Hypocalcemia And Hypoparathyroidism 2 days ago

Very interesting case. Dis you examine the profile of anti-Cytokine antibodies characteristic of auto- immune poly-glandular syndrome Type 1 (Il-22...

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Hypocalcemia And Hypoparathyroidism 2 days ago

49-year-old female with history of partial colectomy 2006 due to diverticulitis 18 inches of colon removed possible sero negative Rheumatoid arthri...

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RE: Autosomal dominant Tubulointerstitial Kidney Disease 2 days ago

Do canadian patients are eligible If yes I will enroll two patients --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0...

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ADPKD ON JYNARQUE 2 days ago

I have a patient who is 43 years of age with ADPKD with creatinine 2 GFR 42. Proteiniris 254 mg is there any role for SGL2 inhibitor with his condi...

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RE: Autosomal dominant Tubulointerstitial Kidney Disease 3 days ago

I also have a quite newly discovered patient with HNF-beta1 mutation. Do you also include such patient into your registry? I have referred the pati...

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RE: IgA Kappa PGMID and EGPA 3 days ago

I arrived at a 16-gage needle because unless there was significant loss of glomerular density (Fibrosis) ,one good pass was all that was needed. I ...

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RE: IgA Kappa PGMID and EGPA 3 days ago

That's a good questions. There is also the issue of over submission to IF and EM at the expense of LM even when the biopsy is adequate. --------...

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RE: IgA Kappa PGMID and EGPA 3 days ago

I will also add that radiologist here at UCLA are also excellent (with on-site adequacy). They use 18 g and we rarely have inadequate specimens. Th...

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RE: IgA Kappa PGMID and EGPA 3 days ago

I do not think there is fixed choice. Institution choice affect. In our group we use 18g which has internal diameter of 0.838 mm (say 0.8). The 16g...

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