RE: Renal Biopsy On Mechanical Ventilation 1 hour ago

Cr going down 190 Uo 2400 ml /day Plat improved 200,wbc. 5 , HB 9 --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egyp...

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RE: Renal Biopsy On Mechanical Ventilation 1 hour ago

Thanks for the update. Current SCr/eGFR and hematological status/TMA parameters? ------------------------------ K.K. Venkat MD Troy MI (248) 420 ...

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RE: Renal Biopsy On Mechanical Ventilation 1 hour ago

I have update This patient thankfully weaned from MV ANTI B2 GLYCOPROTIEN: Ab IgG Normal Range IgG 120 ANTI CARDIOLIPIN IgM :: Normal Rang...

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RE: NSAIDS and CKD 1 hour ago

Great comments. The link you posted is not working. Please revise it. Thank you https://www.nejm.org/doi/full/10.1056/NEJMoa1611593 -----------...

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RE: NSAIDS and CKD 3 hours ago

Thanks for pinging me @David Goldfarb! Excellent comments and most points I would make are already done. In almost all the epidemiological stud...

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RE: NSAIDS and CKD 3 hours ago

Just to add to the literature here, this is a review that I asked @Swapnil Hiremath to write for Current Opinion which wisely makes "the case for c...

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RE: NSAIDS and CKD 3 hours ago

I find my experience with iv toradol is supportive of mild to moderate AKI in a variety of clinical situations such that the event that precipitate...

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RE: NSAIDS and CKD 6 hours ago

I would make a distinction between "avoid" and "use with caution". Certainly, there are situations were NSAIDs should be avoided: For example, p...

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RE: NSAIDS and CKD 7 hours ago

I doubt we have good data on the risk of high K in patients in patients given NSAIDs on top of dual RASI as the latter is a relatively recent strat...

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RE: seronegative lupus nephritis or the new terminology of the non-lupus -fullhouse nephropathy 13 hours ago

Interesting , thank you Dr Richard Will wait the EM report Dr saja ------------------------------ Saja Mohammed MD, MBChB, MS Doctor SQUH ...

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RE: NSAIDS and CKD 1 day ago

For what it's worth, these pro, con and commentary articles from Kidney360 in November 2020 are a really nice summary of exactly that. Si...

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RE: NSAIDS and CKD 1 day ago

I fully agree with the comments from Drs. King , Rodby and Hirsch about the "danglers " of NSAID in CKD and the "hazards" of developing an EMR meth...

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RE: NSAIDS and CKD 1 day ago

I agree. My main concern for NSAIDs in CKD is hyperkalemia, esp in pts with dual RAASI and/or advanced CKD Also, in any modern era patient on dua...

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RE: NSAIDS and CKD 1 day ago

This is such an important discussion IMO, but no suppose I am a NSAID non-fearer. MCD with AIN is idiosyncratic and rare CKD causation and prog...

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RE: gross hematuria 1 day ago

Notice u did a CT pyelogram. Was a CT angio done at that time? Some lesions would pop up only on the angio. Overall it does sound like a urology is...

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RE: gross hematuria 1 day ago

caucasian rbcs were not dysmorphic. when I spoke to urology , cysto did not identify any source of bleeding. they were surprised given the ong...

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RE: gross hematuria 1 day ago

Ethnicity? Dysmorphic RBCs? During cystoscopy was blood coming from ureter or urieters? ------------------------------ [Mark] [Lerman] [MD,FASN,F...

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RE: NSAIDS and CKD 1 day ago

I would love a reopening of the whole "avoid NSAIDs" discussion. In my practice, I see large numbers of patients with opioid use disorder leading...

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RE: NSAIDS and CKD 1 day ago

In my opinion, an effort of develop EMR prompts regarding the use of NSAIDs in "CKD" will be a very difficult and unrewarding task. Maybe, once AI ...

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RE: seronegative lupus nephritis or the new terminology of the non-lupus -fullhouse nephropathy 1 day ago

See Wen Y-Ket al Renal Failure 2010; 32; 1025-1031. About 13% of cases showing "full house" deposition had Post-infectious GN. This case certainly ...

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RE: seronegative lupus nephritis or the new terminology of the non-lupus -fullhouse nephropathy 1 day ago

Thanks- if the EM shows findings compatible with PIGN ( lots of sub-epithelial hump-like deposits and a paucity of sub-endothelial deposits ) I pro...

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IgA with Acute Kidney Injury 1 day ago

Present a case of a 60 y/o white male sent to me from his cardiologist for "difficult to manage hypertension and abnormal renal function with prote...

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RE: seronegative lupus nephritis or the new terminology of the non-lupus -fullhouse nephropathy 1 day ago

Thank you dr Richard for your valuable response regarding the question about the LM findings was suboptimal sample contain only 4 glomeruli o...

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RE: PKD by US/MRI. Negative genetic testing. 1 day ago

I think that the enlarged kidneys suggest ADPKD, possibly due to a de novo mutation.in PKD1 not detected by standard genetic screening. The questio...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 1 day ago

Dr. Venkat. thanks. Great answer. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------------------...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 1 day ago

Our program never used alemtuzumab. I am trying to answer your question regarding CNI-monotherapy in the US based on what I have seen in the litera...

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RE: PKD by US/MRI. Negative genetic testing. 1 day ago

Actually her kidneys are enlarged with a mix of multiple cysts, both large and small, throughout both kidneys. ------------------------------ M....

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NSAIDS and CKD 2 days ago

We all advise our CKD patients to avoid NSAIDS, but I am having difficulty finding studies associating NSAID use with increased risk of CKD progres...

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recurrent membranous? 2 days ago

Hi, I have a 84yo patient, who I dx w/ membranous in 2017. She has positive PLA2R, 10g proteinuria, alb 2.0, etc and did great on CNI + low dose ...

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gross hematuria 2 days ago

Hi, I have a 35 yo patient who developed sudden onset of gross hematuria (w/ clots) in February, and has not stopped since (~2 months) No preced...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 2 days ago

Just curious - how frequently is a CNI-only regimen (with Alemtuzuman, Basiluximab or ALG induction )used for allograft rejection prophylaxis in lo...

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RE: PKD by US/MRI. Negative genetic testing. 2 days ago

Do the details of the MRI provide any clues in this case? For example: the TKV is increased but is this increase biased by several very large cysts...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 2 days ago

The evidence supporting beneficial effects of mTORi in decreasing post-transplant malignancies is convincing only with regards to squamous cell car...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 2 days ago

Thanks Dr.Lerman. Any comment on the use of CNI monotherapy in this case. Can the lack of MMF (or mTORi) play any roles in determining susceptibili...

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RE: seronegative lupus nephritis or the new terminology of the non-lupus -fullhouse nephropathy 2 days ago

Addendum- It is often forgotten that in otherwise typical Post streptococcal GN that the serum C3 levels may be normal during the first 4 week...

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RE: seronegative lupus nephritis or the new terminology of the non-lupus -fullhouse nephropathy 2 days ago

Thanks for posting this challenging case. Additional information is required to provide advice. 1) was IF staining for IgM staining carried out? ...

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seronegative lupus nephritis or the new terminology of the non-lupus -fullhouse nephropathy 2 days ago

I have one case to share with you and need an expert opinion a 47-year-old female with morbid obesity, referred from the general hospital with t...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 2 days ago

The risk of PTLD is greater in EBV mismatched kidney transplant patients who receive Alemtuzumab induction vs basiliximab but not greater than ATG ...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 3 days ago

Dr. Soobadar: The following is a short review of the pathology of chronic AMR: https://www.ajkd.org/article/S0272-6386(15)01047-1/fulltext ----...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 3 days ago

Dr. Soobadar: Electron microscopy for rejection what would you see ? No deposit just cells ?In glomerular capillary wall duplication (Transplant...

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RE: PKD by US/MRI. Negative genetic testing. 3 days ago

Here is a fairly recent very valuable reference concerning the utility and pitfalls of genetic testing in ADPKD. The likelihood of finding a pathog...

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RE: PKD by US/MRI. Negative genetic testing. 3 days ago

I have seen several cases with PKD1 VUS in the past, will wait for those results first to see if anything can explain your case. Best regards...

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RE: Nephrotic syndrome w/o definitive diagnosis (post biopsy) 3 days ago

Thank you Dr. Choi for thus very informative follow up. It beautifully illustrates the fine pint ifxa fundamental principle in nephropathology; nam...

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RE: Nephrotic syndrome w/o definitive diagnosis (post biopsy) 3 days ago

I wanted to follow up on this case. I tried to obtain chyluria multiple times, but every time I ordered it, Quest either wouldn't do it or, even ...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 3 days ago

I think this case raises some issues that would most appropriately be addressed by a"Transplant Nephrologist" 1) does Alemtuzumab induction th...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab 3 days ago

It may a bit premature to start any kind of therapy for the glomerular disease . If this is de novo PGNMID then cline directed therapy may be requi...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab Friday, April 12 @ 5:04 PM

I agree with dr Glassock that there is discrepancy between light microscopy and EM finding that suggests the disease has ongoing inflammation of pr...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab Friday, April 12 @ 4:55 PM

Prof glassock I think tac monotherapy post campath is a standard for some transplant centres --------------------------------- Muhammad Soobadar ...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab Friday, April 12 @ 4:53 PM

Thanks really helpful. Electron microscopy for rejection what would you see ? No deposit just cells ? And rejection can present without Proteinuri...

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RE: Transplant Question Cd68 Cell 12 Years. Post. Alentuzumab Friday, April 12 @ 3:56 PM

I agree with Dr. Venkat- thus might be recurrent or de novo GN. (? PGNMID, cryoglobulinemic GN) The sub- -endothelial ED deposits and the MPGN patt...

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