RE: lupus proteinuria 15 minutes ago

Hello,the safest approach is still to *do* the biopsy. Bridge warfarin with therapeutic LMWH for 3–5 days (CHEST 2022 peri‑op antithrombotic guidan...

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RE: Hypercalcemia in a patient with SLE/MCTD 20 minutes ago

Thanks- How long had she been taking 50,000 IU of Vitamin D per week when the 25 Hydroxy Vitamin D leveks was measured. Are you sure she did n...

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RE: Hypercalcemia in a patient with SLE/MCTD 28 minutes ago

@Awais Nauman: I share your impression that her generalized lymphadenopathy with increased FDG uptake in the lymph nodes, spleen and bone marrow (+...

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RE: Hypercalcemia in a patient with SLE/MCTD 40 minutes ago

I agree with Dr. Glassock that sarcopenia by decreasing urinary creatinine, may significantly overestimate 24 hour urinary albumin or u Rd binary a...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 hours ago

But HCQ blocks conversion of 25 hydroxy Vitamin D conversion ro 1,25 dihydroxy Vitamin D ------------------------------ Richard Glassock MD, FASN...

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RE: Hypercalcemia in a patient with SLE/MCTD 3 hours ago

Thanks for sharing the case Dr Venkat. Do you think Lupus is the cause of lymphadenopathy and FDG avid spleen and bone marrow and does it merit t...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 4 hours ago

Dr Foster: Your comments intrigued me although I have been doing dialysis for over 40 yrs...here is the paper you referred to by Dr Johnson -----...

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RE: lupus proteinuria 6 hours ago

Has the patient been evaluated for antiphospholipid antibody syndrome and renal vein thrombosis beside with class 5 lupus nephritis? ------------...

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RE: Hypercalcemia in a patient with SLE/MCTD 12 hours ago

The marked discrepancy between UACR and UPCR is noted and suggest TI disease, as pointed out by Dr. Venkat but because of the high probability of l...

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RE: Hypercalcemia in a patient with SLE/MCTD 17 hours ago

Truly a mystery. I agree that her low muscle mass and hypoalbuminemia are likely from her chronic inflammation. Some years ago when I was your coll...

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RE: Acidosis vs proteinuria 21 hours ago

So far as I know, whatever albuminuria might be induced by alkali administration. , whether it is glomerular or tubular in origin is completely unk...

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RE: Hypercalcemia in a patient with SLE/MCTD 22 hours ago

Normal or even low serum phosphorous levels may be more common in Vitamin D intoxication than suggested in textbooks. 50,000 units per week is a hi...

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RE: Hypercalcemia in a patient with SLE/MCTD 23 hours ago

@Richard Glassock, @Anatole Besarab: Thanks for your responses and suggestions.During her initial visit with us a year ago, her serum calcium (unco...

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RE: Acidosis vs proteinuria 23 hours ago

Not to my knowledge, but this would be a good study! ------------------------------ Hunter Huston MD, FASN NASHVILLE TN ------------------------...

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Kidney biopsy needles- Bard Monopty 1 day ago

I'm being told that the Bard Monopty 16 gauge needles are being discontinued. Is anyone else having this issue? Are there other 16 gauge kidney bio...

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Glomcon RADIANT program 1 day ago

Hello All, Please encourage your fellows to apply to new Rare Disease and Nephrology Research Training Program. The program is intended to teach...

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RE: lupus proteinuria 1 day ago

I think you have an excellent grasp of your case. Agree that a Class V lupus MGN is by far the most likely. Of course a biopsy would really hel...

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RE: Acidosis vs proteinuria 1 day ago

Dr. Huston. Thanjs for the post. Does anyone know what happens to urinary albumin excretion rates fin these these healthy non-acidotic athletes whe...

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lupus proteinuria 1 day ago

38 y.o. Hispanic F referred to office on 4/22/2025 for proteinuria in the setting of active SLE. - Initially diagnosed SLE in 2014 on MM, tapering ...

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RE: Hypercalcemia in a patient with SLE/MCTD 1 day ago

I missed the ionized values. Yes , when Calcium exceeded 12mg/dL , ionized Ca exceeded the upper limits of normal. I think the excess vit D being t...

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RE: Are KDIGO 2025 TSAT and Ferritin Targets (TSAT ≤40%, Ferritin ≤700 ng/mL) for Dialysis Anemia Management Evidence-Based? 1 day ago

The controversy goes beyond just the original PIVOTAL Study and the restriction placed by geographic and ethnic factors. I frankly disagree that ...

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RE: Acidosis vs proteinuria 1 day ago

There is some data to back this up. What is unknown is whether in this situation it translates into clinical consequences -----------------------...

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RE: Hypercalcemia in a patient with SLE/MCTD 1 day ago

The ionized calcium was elevetad on several determinations. As far as I can tell, 25-OH vitamin D leveks were never measures. Hypervitaminosis D is...

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RE: Hypercalcemia in a patient with SLE/MCTD 1 day ago

Agree that this is a fascinating case. I would only mention a couple of aspects. The hypercalcemia was noted while she was taking 50K of vitam...

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RE: Acidosis vs proteinuria 1 day ago

Dr Glassock, it's interesting the point about NaCl vs Bicarbonate. I do quite a lot of work in the sports performance arena and both of these point...

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RE: Hypercalcemia in a patient with SLE/MCTD 1 day ago

A lymph node biopsy showed non granulomatous inflammation, making Sarcoidosis unlikely. The 1,25 dihydroxy Vitamin D level was normal during hyperc...

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RE: Hypercalcemia in a patient with SLE/MCTD 1 day ago

Still, I would like to see an ACE level. Likely to have some form of granulomatous inflammation. ------------------------------ Sinasi Salman ...

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RE: Acidosis vs proteinuria 1 day ago

It would be of great interest to study the 24 hour urine excretion of Na and Cl and creatinine in your cases. It is highly unlikely that NaHCO3 alo...

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RE: Hypercalcemia in a patient with SLE/MCTD 1 day ago

Dr. Venkat - fascinating case. The hypercalcemia is most liklely due to 25-hydroxy Vitamin D intoxication (exogenous) .. Hydroxychloroquine (HCQ) i...

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RE: Acidosis vs proteinuria 1 day ago

Thx for the comments. I'm surprised no one else has seen this. I'm not an academician but I know the value of clinical trials and published reports...

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Hypercalcemia in a patient with SLE/MCTD 1 day ago

I wish to obtain the opinion of Forum participants regarding the cause of hypercalcemia in this patient with SLE/MCTD. I am sorry about the lengthy...

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RE: Mpo Vasculitis Case 1 day ago

The finding of immune complex deposits in many sites along with full house Ig and C deposition is of significant concern, independent of the + anti...

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RE: Are KDIGO 2025 TSAT and Ferritin Targets (TSAT ≤40%, Ferritin ≤700 ng/mL) for Dialysis Anemia Management Evidence-Based? 1 day ago

All sites in the PIVOTAL trial were in the UK thus generalization of thec findings to all dialysis patients everywhere should be made with due caut...

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RE: Are KDIGO 2025 TSAT and Ferritin Targets (TSAT ≤40%, Ferritin ≤700 ng/mL) for Dialysis Anemia Management Evidence-Based? 2 days ago

Any comments or opinions Dr. Besarab? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------------...

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RE: Mpo Vasculitis Case 2 days ago

Agree with above I would watch closely for now ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University ...

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RE: Acidosis vs proteinuria 2 days ago

Proteinuria increase with NaHCO3 rx? I have not seen this nor have I seen it written anywhere (see attached) I have to think that prote...

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RE: Acidosis vs proteinuria 2 days ago

Sodium Chloride may raise BP in many CKD patients and increase proteinuria--a low NaCl diet is an effective way to increase the effect of RASI on p...

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Are KDIGO 2025 TSAT and Ferritin Targets (TSAT ≤40%, Ferritin ≤700 ng/mL) for Dialysis Anemia Management Evidence-Based? 2 days ago

KDIGO 2025 suggests maintaining TSAT up to 40% and ferritin up to 700 ng/mL in dialysis patients with anemia. These targets appear to be largely ba...

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RE: Acidosis vs proteinuria 2 days ago

Addendum- it would be of interest to know howyou are assessing changes in proteinuria. If it is UPCR a ruse in "proteinuria" after correction if ac...

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RE: Acidosis vs proteinuria 2 days ago

Your experience is at variance with the published data on the effects of Bicarbonate therapy of CKD. See Hultin S et al KI Reports 2021 6: 695-706 ...

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RE: high anti-GBM titers on dialysis 2 days ago

Not all anti-GBM antibodies are capable of provoking lung hemorrhage. Thus as been explained on the basis of epitope specificity , not assessed wit...

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RE: Mpo Vasculitis Case 2 days ago

Thanks for the Folllw-Up. The anti-MP0 antibody (by ELISA) was either a "false positive" or the kidney biopsy did not provide an adequate sample.. ...

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Acidosis vs proteinuria 2 days ago

It is my experience that adding sodium bicarbonate to a CKD patient's regimen will often worsen proteinuria, as well as increasing BP and lowering ...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 3 days ago

I agree with Dr. Jorge Roman's post. I would perhaps add that if you do an averaged CCr + CUN with a 24 hour urine collection, you could perhaps b...

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RE: Mpo Vasculitis Case 3 days ago

More info about biopsy Current conclusion is: Conclusion: Native renal biopsy: On light microscopy one glomerulus shows a focal abnormality r...

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high anti-GBM titers on dialysis 3 days ago

92 year old, functional as baseline, baseline creatinine at 0.8-0.9 mg/dl from January 2025 w/ bland UA, non smoker. Came in for fall w/ decrease P...

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RE: Lab potassium normal range 3 days ago

Ted: To this extremely interesting discussion, I hesitate to add, 2 slides I had come across sometime ago, more in keeping with the predicament tha...

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RE: Lab potassium normal range 3 days ago

Eagerly awaiting the follow up data. ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 --------...

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RE: Immunosupressants withdrawl in SLE patients with ESRD 3 days ago

Totally agree. ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 ------------------------------

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 3 days ago

And here we are well over 1/2 a Century after chronic dialysis become common and we still check Urea and Creatinine, not able to define much less m...

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