RE: Proteinuria in a deaf patient 5 minutes ago

Very interesting case Dr. Rumjon the co-existence of NC granulomatous TIN and anti PLA2R negative membranous nephropathy really points towards s...

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RE: SLE - When To Stop Immunosuppressives 3 hours ago

Sm antigen is what I would like to call, a deeper antigen... It will probably never become negative , even in remission. Reports in CarT also show ...

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RE: SLE - When To Stop Immunosuppressives 10 hours ago

Dr. Venkat seems that activity on kidney (re)biopsy does a pretty bad job at predicting relapse in patients with proliferative LN ---------------...

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RE: Kidney transplantation in a patient with monoclonal C3G 10 hours ago

Do someone have any experience with auto-HSCT to obtain hematological response (and possibly get rid of residual disease) in patients with monoclon...

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RE: Absolute GFR? 11 hours ago

I will get to his file asap and get this info , I did correct for it at the consult . I should update you by tomorrow --------------------------...

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RE: Absolute GFR? 11 hours ago

Thank you Dr Glassock. In response to your queries: 1) I do not stage. I find no use in assigning a number to a clinical situation. I imagine tha...

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RE: Absolute GFR? 11 hours ago

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

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RE: Absolute GFR? 12 hours ago

Thank you all so much for your advice and expert opinions. I actually am comfortable with the actual patient this is why he was not fully pres...

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RE: SLE - When To Stop Immunosuppressives 12 hours ago

Yes, I do - but it is only an opinion. Or a Hypothesis! ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ...

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Proteinuria in a deaf patient 13 hours ago

Dear all, I have a bit of perplexing case and was wondering whether anyone had seen something like this. My pt is 44 years old, born in Lebanon ...

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Membranous nephropathy and smoldering myeloma 13 hours ago

I have a 76 yo Hispanic patient who presented with nephrotic syndrome. Creat 1.46. uacr 8500. An IgA monoclonal protein was found but his m spike w...

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RE: SLE - When To Stop Immunosuppressives 13 hours ago

Drs. Glassock and Rodby: In the patient posted by Dr. Dastoor, biopsy does not show any activity (except perhaps one wire loop deposit), there is n...

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RE: Absolute GFR? 13 hours ago

The late Dr Larry Wesson mentored me when I started as an Assistant Professor at Thomas Jegfferson Univ School of Medicine in 1975. My background i...

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RE: Absolute GFR? 14 hours ago

Dr. Hirsch- nice. Highly appropriate comments. Just curious- do you use an "age adapted" threshold of eGFR for "diagnosing " (and staging) CKD? -...

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RE: Absolute GFR? 15 hours ago

I agree with Dr Rodby. There are a few niches--transplant, perhaps med dosing, unusual body compositions--in which a more precise GFR might help, b...

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RE: SLE - When To Stop Immunosuppressives 15 hours ago

I fundamentally agree with Dr. Rodby. MMF is not carcinogenic- unlike AZA. A real dilemma if she wants to get pregnant? She is definitely nit in a ...

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RE: SLE - When To Stop Immunosuppressives 16 hours ago

Sorry , some technical issues , had to send 3 times ( attached are her serial labs at our clinic , big time gaps as she is a random visitor from Su...

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RE: SLE - When To Stop Immunosuppressives 17 hours ago

this is a tough one, this is what I would do she has significant fibrosis, the biopsy while not having any "Active lesions" does have one wire ...

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RE: SLE - When To Stop Immunosuppressives 17 hours ago

In my opinion, this patient not in a complete immunological remission and is thetefore at rusk for a relapse of LN upon discontinuance of MMF. The ...

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RE: SLE - When To Stop Immunosuppressives 17 hours ago

Urine sediment/dysmorphic RBCs? Current SCr/eGFR? Inflammatory markers? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ---...

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SLE - When To Stop Immunosuppressives 21 hours ago

Have a 31 year old female , known lupus nephritis since age of 19. She has received MMF and RTX in the past , and currently is on a regimen of pred...

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RE: Absolute GFR? 1 day ago

Dr Rodby I completely get what you say but if an individual is very large (has a BSA that is very far from 1.73) I do not use an indexed eGFR formu...

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RE: Absolute GFR? 1 day ago

I do not disagree that one can use repeated urine analysis to see what is happening t the patient as he has had DM, hypertension , dyslipidemia and...

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RE: VHL and kidney transplant 1 day 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? 1 day 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 1 day 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 1 day 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? 1 day 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 1 day 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? 1 day 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? 1 day 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? 1 day 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 1 day 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? 1 day ago

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

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RE: Sarcoidosis Case 1 day 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? 1 day 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? 1 day 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 1 day 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? 1 day 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? 1 day 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? 1 day 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 1 day 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 1 day 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 1 day ago

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

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RE: rapidly progressive case of IgA nephropathy 1 day 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? 1 day 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 1 day 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? 1 day 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 2 days ago

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

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RE: Case Of AKI And Nephrotic syndrome 2 days ago

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

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