RE: can loop diuretics causes hyponatremia 3 minutes 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 1 hour 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? 6 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 6 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 10 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 13 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 14 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 14 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 17 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 18 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 21 hours 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? 23 hours 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 23 hours 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 1 day 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 1 day 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 2 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? 2 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 2 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 2 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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RE: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 3 days ago

The edema is due to Nifedipine - not MMF. It should be stopped. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 38...

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

What happened to eGFR and hematuria?There are no FDA approved assays for gdIgA and the value of such monitoring in therapy if IgA remains unproven....

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

Clinical Question: MMF-related Hair Loss and Edema in IgAN – Continue or Hold? 55-year-old woman with biopsy-confirmed IgA nephropathy (October 20...

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RE: Effect of Starvation/Malnutrition on Kidney Health 3 days ago

During the winter of 1944–1945, the Nazi occupying forces imposed embargo on transport of food to the western Netherlands as a revenge for attacks ...

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RE: Fibrillary GN 3 days ago

I agree fully with Dr. Rodby. If autoimmune, infections and cancer causes have been reasonably excluded , therapy of FGN is highly uncertain, but o...

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RE: Fibrillary GN 3 days ago

It seems you have ruled out any secondary cases of Fib GN , cancer, paraprotein, hepatitis, I'm not sure everyone is always this diligent, well don...

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RE: Effect of Starvation/Malnutrition on Kidney Health 3 days ago

Dr Soleimani, Thank you for your thoughtful comments on starvation and renal disease. I suspect you are correct that these multifaceted renal eff...

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Fibrillary GN 3 days ago

Thanks our members community for helping us in difficult cases I need your help in this case A 52 year old female patient ,hypertensive 10 year...

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RE: Effect of Starvation/Malnutrition on Kidney Health Thursday, July 31 @ 8:41 AM

A good article on the impact of malnutrition on the incidence of AKI. Xiang Xiang 1,✉, Xinchen Zhu 2, Lijuan Zhang 1 Int J Clin Pract. 2023...

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RE: Kidney transplantation in a patient with monoclonal C3G Wednesday, July 30 @ 4:43 PM

The efficacy of CAR-T depends on continual presence of chimeric cells direct to abnormal clones of CD19 clonotyoe . The immunosuppression required ...

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RE: FSGS with progressive worsening of renal function Wednesday, July 30 @ 2:36 PM

He did have PVR's of 500-700 per urology office , when they placed foley, the retention was not long enough to cause hydro. would not be able to at...

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