RE: can loop diuretics causes hyponatremia 9 minutes ago

Thank you, Dr. Campese, for your post and your question about my suggestion : " …… that ACEi through hemodynamic effects may alter the ability to e...

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RE: metabolic acidosis 23 minutes ago

Urinary Ammonium and an Arterial Blood gas. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------...

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metabolic acidosis 1 hour ago

I am seeing in the clinic a 26-year-old lady who has chronically a metabolic acidosis Her most recent lab work: Urine analysis pH of 7.5 3+ leu...

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RE: can loop diuretics causes hyponatremia 1 hour ago

Very nice paper. Hence, the use of furosemide to treat SIADH in the pre vaptan and oral urea era. Would like to see urine Na, K, osm on one of Dr...

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RE: Sjogren nephritis 2 hours ago

Thank you FEIRON made no sense to me and I could not find it It is not easy growing old Tony Sent from Outlook

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RE: Sjogren nephritis 2 hours ago

Tony, here is the link to the official Quantiferon site: https://quantiferon.com/jp/cd/patient-resources/quantiferon-tb-gold-2/ In the posted p...

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RE: Sjogren nephritis 2 hours ago

Dr. Venkat Thank you , I tried to find the Acronym on the internet and I got zilch. Granted there are mant such acronyms which are new to me as the...

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RE: Sjogren nephritis 2 hours ago

Dr. Besarab: I believe Quantiferon testing was done to look for tuberculosis as cause of sterile pyuria. Dr, Mohamed: Can you please provide tren...

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RE: can loop diuretics causes hyponatremia 3 hours ago

I have attached a study by Dr. Schrier suggesting that the effect of furosemide on free water clearance may be independent of vasopressin. I find i...

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RE: Sjogren nephritis 3 hours ago

What specifically does QuantiFERON measure? Persistent leukocyturia with neg urine cultures? ------------------------------ Anatole Besarab MD...

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RE: Sjogren nephritis 3 hours ago

It appears that U/A has leukocytes but no hematuria or proteinuria. Do you have random urine pr/cr, albumin etc ? One of the earliest renal manifes...

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RE: can loop diuretics causes hyponatremia 4 hours ago

it should be remembered that loop diuretics affect both concentration and dilution. The amount of tubular fluid leaving the ascending loop is incre...

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Sjogren nephritis 5 hours ago

A 65-year-old female with a history of hypertension and Sjögren's disease is being monitored by nephrology for chronic interstitial nephritis. She ...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 10 hours ago

As far I know that DHP-CCBs are safe in HF, but NDHP-CCBs such as Verapamil and Diltiazem can aggravate HF by their negative chronotropic effects. ...

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RE: can loop diuretics causes hyponatremia 10 hours ago

My statements were based on old studies of the effects of furosemide on C-H2O during a water diuresis in non-edematous subjects without hyponatremu...

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RE: can loop diuretics causes hyponatremia 14 hours ago

@Richard Glassock please Dr Glassock, can you elaborate more how loop diuretics impairs free water excretion as we are learned that they excrete wa...

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RE: can loop diuretics causes hyponatremia 17 hours ago

Furosemide impairs free water excretion during a water diuresis, this effect will increase the likelihood if developing hyponatremia free water con...

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RE: can loop diuretics causes hyponatremia 18 hours ago

Agree wuth the comments. The lowest U osmolality I ever saw in a patient receiving furosemide or other loop blocker was about 180mOsm but patients ...

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RE: can loop diuretics causes hyponatremia 18 hours ago

A good point, Dr. Rodby. While furosemide is known to lower urine osmolality, the extent of the decrease can vary. Some studies indicate a reductio...

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RE: can loop diuretics causes hyponatremia 21 hours ago

The answer really depends on what the loops diuretic is being used for, for instance If I were to take a loop diuretic and lose enough Na, and I re...

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RE: can loop diuretics causes hyponatremia 22 hours ago

Yes, furosemide can cause hyponatremia, and the underlying pathophysiology was discussed in Dr. Glassock's post. In brief, while loop diuretics pr...

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RE: can loop diuretics causes hyponatremia 1 day ago

hi, sometimes in these situations, hypertonic saline bolus (3% saline 100ml) can be helpful provided some sodium load to help with some blood pr...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 1 day ago

"The pathomechanism of edema of CCBs will not be mitigated by any diuretics as it is distributional and not retentional." Comment; I concur with ...

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RE: can loop diuretics causes hyponatremia 1 day ago

I agree with Dr Glassock's very nice description. In general loop diuretics inhibit urine concentration, hence maintain H2O clearance and thiazides...

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RE: can loop diuretics causes hyponatremia 1 day ago

"can loop diuretics worsen hypo-natremia if used in . . . decompensated heart failure?" YES but; You need to stop Spironolactone You need to st...

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RE: can loop diuretics causes hyponatremia 1 day ago

I agree with you. I have seen hyponatremia down to PNa < 128 mEq/L ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsd...

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RE: can loop diuretics causes hyponatremia 1 day ago

My impression is that the uncommon development of hyponatremia with use of loop-acting diuretic is largely due to augmentation of thirst and consum...

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can loop diuretics causes hyponatremia 2 days ago

greetings to all community members my question is can loop diuretics worsens hyponatremia if used in volume excess states specifically decompensa...

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RE: Effect of Starvation/Malnutrition on Kidney Health 2 days ago

Thank you for the teference. Yes starvation tend to occur during periods of war, but it can happen during periods of peace, In the mid 1930's ov...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

The pathomechanism of edema of CCBs will not be mitigated by any diuretics as it is distributional and not retentional. Spironolactone by its anti...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

I did not know that Spironolactone was effective in drug-induced alopecia. Do you have a reference? ------------------------------ Richard Glasso...

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RE: Effect of Starvation/Malnutrition on Kidney Health 2 days ago

It is historically important to remember that much of the pathophysiology and medical management of starvation and re-feeding were studied immediat...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

Can add spironolactone 100 mg if K ok for hair loss Should also help w edema --------------------------------- Shahzad Safdar MD Mt. Auburn Neph...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 2 days ago

Could use topical minoxidil to mitigate the hair loss. --------------------------------- Graham Abra Redwood City CA -----------------------------...

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RE: Fibrillary GN 3 days ago

Because FGN can occasionally undergo a spontaneous remission , I am very skeptical of case reports claiming efficacy for any therapy, including ste...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 3 days ago

Agree to stop Nifedipine as it is the cause of pedal edema and increasing urinary albumin excretion. Pedal edema from DHP-CCBs can occur few days ...

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RE: Fibrillary GN 3 days ago

Regarding the question of searching for secondary causes in DNAJB9-associated FGN, I think in most cases of glomerular diseases, we screened for au...

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RE: Fibrillary GN 3 days ago

A case report of 2 cases with primary FGN showed great reduction of proteinuria and stabilization of kidney function with pulse MPD followed by ora...

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RE: Fibrillary GN 3 days ago

Addendum- so far as I know Pegacetocoplan or Iptacopan have not been studies for efficacy and safety in FFN . I would not recommend their use in th...

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RE: Fibrillary GN 3 days ago

In the broadest sense, all DNAJB9 deposition disease (FGN) is idiopathic. The use of the term "idiopathic" adds little to the description of DNAJB9...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 3 days ago

I'm very sorry for the confusion. I just realized that I had already stopped the nifedipine and replaced it with losartan about six months ago. Tha...

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RE: Fibrillary GN 3 days ago

DNAJB9 deposition is seen in both "Primary and Secondary" FGN. The use of the terms Primary and Secondary in tge context of FGN are confusing and d...

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RE: Fibrillary GN 3 days ago

Or it is present in both idiopathic and secondary FGN --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt -------------...

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RE: Fibrillary GN 3 days ago

Isn’t DNAJB9 only found in primary fibrillary GN? So why do we look for secondary causes? --------------------------------- Alaa Nabih Abdalla nep...

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RE: Fibrillary GN 3 days ago

No one really knows. Either would be OK in this case, if you want to use a maximally agressive therspy , with some attendant risks of AE. It is a j...

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RE: Fibrillary GN 3 days ago

CD19 of zero mean that peripheral B cells have been adequately depleted but probably we need tissue B cells depletion so I suggest if you have acce...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 3 days ago

Thanks a lot as Dr Glassok said Nifedepine should be stopped and you should increase losartan to maximum tolerated dose . Very rare MMF induce...

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RE: Fibrillary GN 3 days ago

Thanks very much much CD19 zero Immunoglobulin assay : IgG ,IgM IgA all were low So my question can l strat cyclophosphamide now or not ?? ...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 3 days ago

She's been on nifedipine for several years-could this side effect really present only now? I'll go ahead and stop it nonetheless. Also, any thought...

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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 3 days ago

Sorry, I forgot to mention-creatinine was 1.18 mg/dL, 24-hour creatinine clearance was 92 mL/min, and urinalysis showed 0–3 RBCs/HPF. -----------...

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