RE: Be aware of the infectious consequences of therapy with complement inhibitors 4 hours ago

"Errare humanum est" Thank you for your prompt response Dr. Java. It exemplifies, once again, that we have only uncover the tip of the iceberg an...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 4 hours ago

Apologies for misspelling Dr. Rubin's name. I find it sloppy when people misspell names. I am so embarrassed I did this. SO SORRY!! -------------...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 4 hours ago

Dear Dr. Rubio, Thank you so much for highlighting the work! Dr. Glassock brings up an important question that we have attempted to address i...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 4 hours ago

@Anuja Java @Richard Glassock I am unable to provide an answer to your question, Dr. Glassock. I would like to consult with a colleague (Dr. An...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 4 hours ago

Dr. Rubin- Many thanks for this very important post and citation. With respect to quantifiable risks of infection (mainly encapsulated bacteria )...

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Be aware of the infectious consequences of therapy with complement inhibitors 5 hours ago

I have attached an excellent review (just released online and written by well-known experts) on the infectious consequences of complement inhibitor...

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RE: Pseudohypertension or true uncontrolled HTN 5 hours ago

Dr. Rodby- Would you attempt to assess central Aortic mean pressure, by non-invasive means, before beginning antihypertensive therapy in this pat...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 8 hours ago

Dr Bianco: Apart from 'intermittently' low CH50, is there any other evidence that complement is activated? I may have missed something. I would sug...

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RE: Please help with a case of IGA nephropathy 8 hours ago

A clinical "remission" of IgAN might be defined as proteinuria < 0.5gm/d, absence of hematuria /hemoglobinuria and a stable , preferably normal . e...

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RE: Pseudohypertension or true uncontrolled HTN 9 hours ago

I attached the article that shows what Dr Glassock is referring to. I just worry about the specificity of Osler's sign, psueudo HTN is a...

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RE: Please help with a case of IGA nephropathy 9 hours ago

Ideally "remission" - a term we are still defining in IgAN... - would be great pre-pregnancy, but she did respond to tarpeyo and MMF as proteinuria...

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RE: Hemodialysis Associated Headache 9 hours ago

The most common cause of headache on HD is vigorous fluid removal & taking post-HD weight below the target wt. I am well-aware there might be other...

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RE: Please help with a case of IGA nephropathy 9 hours ago

What us the current level of dipstick hematuria? What is the patients BMI? The desire for pregnancy in the face id active inflammatory (partially t...

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Please help with a case of IGA nephropathy 10 hours ago

28‑year‑old female with no significant past medical history presented in April 2024 with intermittent microscopic/gross hematuria for several years...

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RE: Hemodialysis Associated Headache 14 hours ago

What is the predialysis and post dialysis Na levels and what Dialysate Na are you using . What happens to the patients Blood pressure , can u ela...

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RE: Hemodialysis Associated Headache 18 hours ago

I already tried but no response --------------------------------- Jehad Yousef MD, MBBS Jordan ministry of health ---------------------------------

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RE: Hemodialysis Associated Headache 23 hours ago

Could be a " Histamine Release " headache. Have you tried pre-dialysis anti-histamine therapy.? ------------------------------ Richard Glassock M...

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RE: Hemodialysis Associated Headache 1 day ago

Thank you for drawing my attention to this point. --------------------------------- Jehad Yousef MD, MBBS Jordan ministry of health ------------...

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RE: Hemodialysis Associated Headache 1 day ago

Thank you for your response. I will read these articles and try to implement them. --------------------------------- Jehad Yousef MD, MBBS Jordan...

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RE: Hemodialysis Associated Headache 1 day ago

Attached a few article I have on this. ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrolog...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

Seems that the episode of TMA, suspected to be aHuS although you did not mention what was your work up , has resolved . In the absence of a high ri...

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RE: Hemodialysis Associated Headache 1 day ago

I had few patients like that, some of them had significant improvement in symptoms after switching to different dialyzer membrane Don’t have an art...

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RE: Conventional treatment resistant Anti GBM disease 1 day ago

Dr. Sampathkumar: 1. Was urine available for examination on initial presentation and what did it show, ATN-compatible vs. nephritic? 2. Have you re...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

I think it depends on the clinical situation. If the creatinine is worsening or proteinuria is worsening, then I agree C5 blockade would be appropr...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Dear Dr Leung, At the time of the initial presentation, the patient had laboratory evidence consistent with microangiopathic hemolysis, inclu...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Dear Dr Venturelli, Thank you for you suggestion. I will speak with the nephropathologist! Patricia ------------------------------ Patr...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Dear Dr Glassock, The patient has even done the genetic panel and it was negative. ADAMTS13 was normal also, it was repeated and normal aga...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Hi!! Yes and it was normal. ------------------------------ Patricia D' Almeida Bianco, MD Nephrologist Hospital Santa Casa de Porto Alegre Bra...

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RE: Conventional treatment resistant Anti GBM disease 3 days ago

In anti-GBM disease one cannot define treatment resistance on clinical parameters alone. Despite very responsive immunological disease (rapidly fal...

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RE: Conventional treatment resistant Anti GBM disease 3 days ago

Similar associations of anti-GBM disease with COVID19, HIV and Influenza A exist. As far as I can tell, no TMA was concomitantly present . I know o...

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RE: Pseudohypertension or true uncontrolled HTN 3 days ago

With a positive Osler sign , this is most likely Pseudo -hypertension due to Monkebergs arterial sclerosis. X-rays of the arms will likely reveal a...

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RE: Pseudohypertension or true uncontrolled HTN 3 days ago

Im not sure you will be able to tell without an arterial line? Im also not sure it is worth it Personally I would add 5 amlodipine (5 not 10, ...

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Pseudohypertension or true uncontrolled HTN 3 days ago

An 88 yr old male with a normal renal fn ( creat 0.96, eGFR 72) was referred to me today for uncontrolled systolic HTN. 4 months ago, his SBPs at h...

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RE: recurrent fainting with peritoneal dialysis start, ? vagal reaction 3 days ago

Here is the article in question. Files Attached Documentrecurrent fainting with peritoneal dialysis start, ? vagal reaction Attachments

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RE: Conventional treatment resistant Anti GBM disease 3 days ago

Thanks @prof glassock What about kidney biopsy of patient with dengue ? Any tma? --------------------------------- Muhammad Soobadar MBChB UK ...

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RE: recurrent fainting with peritoneal dialysis start, ? vagal reaction 3 days ago

baseline BP is good, and yes supine positioned ------------------------------ Radu Raducu MD MD Sanford Hospital BIsmarck ND (203) 606-7322 ----...

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RE: simultaneous liver kidney transplant 3 days ago

Dear Dr David Goldfarb Thanks for the reference. I will talk with my lab and then will contact the author regarding the same . Thanks again --...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 3 days ago

This thread has been highly instructive. Thanks for sharing literature Dr Rubin and Dr Lerman on different benign to maligant pathways of CRC and t...

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RE: simultaneous liver kidney transplant 3 days ago

@Satish Balan, with respect to measurement of plasma oxalate, see this reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC12231001/ The usual meth...

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RE: Conventional treatment resistant Anti GBM disease 3 days ago

I have no personal experience with this combination- but Dengue and anti-GBM antibody disease has been reported (with anti-MPO ANCA ) See Lizarraga...

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RE: recurrent fainting with peritoneal dialysis start, ? vagal reaction 3 days ago

Just to be sure, what is her baseline blood pressure and is infusing dialysate in the supine position? ------------------------------ Satish Bala...

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RE: One and half nephrectomy, normal looking GFR but hyperkalemia, question on K physiology 3 days ago

Unlike Roger, this is a situation where I find urine chems very helpful. I would do a 24 hr urine collection for K and creatinine, with a serum K a...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 3 days ago

these are results so fa 1. Cancer post kidney transplant BRONZE CONTRIBUTOR Mark Lerman Posted ...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 3 days ago

If you want to share your email address with me privately, my email address is MJL 972@aol.com. I can then email you the information that you need ...

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RE: Sigmoid Adenocarcinoma in Renal Tx patient on MMF/CyA/Pred - to Stop MMF or not 3 days ago

You must be a member of the American Society of Transplantation, and then once you're a member, you join the kidney pancreas community of practice....

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RE: Dual mutations of uncertain significance 3 days ago

DGKE is a recessive gene, therefore, in this case, the most parsimonious conclusion is that the case is, at best, a heterozygous carrier of a VUS. ...

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RE: Conventional treatment resistant Anti GBM disease 3 days ago

Thanks for case Vascultis titres negative ? I don’t have experience in eculuzimab in this context I would continue with oral cyclo and get fertilit...

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RE: recurrent fainting with peritoneal dialysis start, ? vagal reaction 3 days ago

I found two case reports in Peritoneal Dialysis International in 1993. Very similar to what Dr. Raducu is describing. In one report from Spain, two...

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Conventional treatment resistant Anti GBM disease 3 days ago

I will be grateful for inputs on this case of a 20 year old college student who came with fever, oliguria and AKI. His IgM anti Dengue antibody was...

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RE: SLE - Pre-Pregnancy Immunosuppression swap dilemma 3 days ago

Initial Bx done over 20 years ago. We don't have the records. She is reluctant for another Bx. However, She appreciate that should the proteinuria ...

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