RE: SIADH in a patient with SAH 1 hour ago

Thanks for the explanation on idiogenic osmoles, Dr. Tijani. It would be interesting to see if they increase with exogenous amino acid infusion. ...

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RE: Persistent Hyperkalemia 1 hour ago

Just trying to propose another idea. There is a pediatric entity I have thinked of. Could that be possibly transient PHA (pseudohypoaldosteronism) ...

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RE: Persistent Hyperkalemia 2 hours ago

More questions than answers. Even if you had a Ucreat, what would a high UK/Ucreat ratio checked after diuresing with bicarb/lasix mean about hype...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 4 hours ago

Please see details about fellows' application for ADC sponsorship below: Nephrology Fellows (non-pediatric) Nephrology fellows are invited to sub...

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RE: chronic Hyponatremia, now hypo osmolar , euvolemic , asymptomatic, and undetsctable urine Na 4 hours ago

Hyponatremia is due in part to hyperglycemia. Probably on a very low Na intake. His poly pharmacy needs to be addressed. There may be component of ...

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RE: Renal thrombotic microangiopathy 5 hours ago

Abdominal pain is also a very common presenting feature of TAFRO- i am still inclined to consider this case as "atypical " TAFRO syndrome. Can you ...

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chronic Hyponatremia, now hypo osmolar , euvolemic , asymptomatic, and undetsctable urine Na 5 hours ago

White gentleman age 56, with history of schizoaffective disorder and bipolar transferred to our mental health unit with suicidal ideation. Lacks ca...

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RE: Persistent Hyperkalemia 5 hours ago

"Usually she comes in with fatigue" Did she have significant muscle weakness and hypoteflexia? If yes, this would argue against pseudo-hyperkalem...

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RE: Renal thrombotic microangiopathy 5 hours ago

The initially normal serum albumin with "anasarca" continues to trouble me, in so far as a primary diffuse podocytopathy. LM findings are also at v...

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RE: Persistent Hyperkalemia 5 hours ago

Excess oral K intake is a very rare cause of hyprkalemia when GFR is normal except when drugs or other compounds interfere with tubular K secretion...

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RE: Persistent Hyperkalemia 7 hours ago

"Isn't it essentially impossible to become significantly hyperkalemic with normal kidney function based on K ingestion alone?" agree with the ...

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RE: Renal thrombotic microangiopathy 8 hours ago

Although SAlb remains unchanged, some improvement in SCr and proteinuria has occurred. Current prednisone dose? How long has been on prednisone?Adu...

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RE: Persistent Hyperkalemia 9 hours ago

Isn't it essentially impossible to become significantly hyperkalemic with normal kidney function based on K ingestion alone? Various populations ...

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RE: Persistent Hyperkalemia 9 hours ago

There have been some anecdotal cases of hyperkalemia induced by Tirzepatide. i would advise exploring this possibility. -----------------------...

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RE: Persistent Hyperkalemia 10 hours ago

I agree that is quite unusual to see no EKG changes in somebody with normal renal function with the potassium of we used to be taught of mechanism ...

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RE: Persistent Hyperkalemia 10 hours ago

Will check . The time we checked it was the same as serum. And, there was no definite cause for a pseudohyperkalemia - will surely check again. Tha...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 11 hours ago

Hi, How can we apply for travel support to attend ADC, Las Vegas 2025? ------------------------------ Sherzod Abdullaev MD Head of departmen...

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RE: Renal thrombotic microangiopathy 11 hours ago

At this point, i would favor a podocytopathy. If already on steroids for >8 weeks without some response, would add plasma exchange and rituximab ...

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RE: Kidney Transplantation immunity 11 hours ago

@Riyadh Alsaegh, do you have new information about your patient?. Thank you. ------------------------------ [Benjamin] [Gomez] [] [JProfessor of...

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RE: Persistent Hyperkalemia 11 hours ago

24 hour colletions or potassium and creatinine X 3 sets to ind out urine K excretion this should inform about how much postassium she is taking. ...

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RE: Renal thrombotic microangiopathy 11 hours ago

He's hospitalized again due to recurrence of edema and abdominal pain (bowel edema?). Bone marrow: small population with monoallelic clonality of...

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RE: Persistent Hyperkalemia 12 hours ago

I am struck by the relatively normal ECG with K levels of 9. Would rule of pseudohyperkalemia a little more thoroughly: 1. Either separate the ...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 12 hours ago

Good morning, after some inquiries, I have attached more details about fellows' application for ADC sponsorship for next year's meeting (availab...

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RE: interesting case 13 hours ago

Sir we don't have the facility of EM . and his biopsies were run outside so we don't have blocks. But sure I can send you the written report tomorr...

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RE: SIADH in a patient with SAH 13 hours ago

To be sure, idiogenic osmoles are defined as organic molecules that are produced by cells to regulate their volume and composition.. -An osmole is...

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RE: interesting case 14 hours ago

Do you have EM on the first transplant kidney biopsy? If not, can you have the paraffin block processed for EM? Can you post the LM and IF report f...

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RE: Liver Tx Alone In CKD patients 14 hours ago

In CKD, GFR > 30 mL/min/1.73 m2 for deceased donor liver transplant-alone and [More]

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RE: interesting case 14 hours ago

Thankyou all for your valuable comments.Can anyone please send me the reference articles/case series/case reports of 1. Missed membranous on LM and...

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RE: Liver Tx Alone In CKD patients 18 hours ago

So we can conclude that in living donor programs, decision of combined liver and kidney transplant may be based on GFR measurements of the recipien...

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RE: Persistent Hyperkalemia 1 day ago

here are the articles: Did not include dig or Foxglove... ------------------------------ Roger Rodby MD, FASN Professor of Medic...

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RE: SIADH in a patient with SAH 1 day ago

Appreciate thoughts from Dr. Tijani, Dr. Glassock and Dr. Mario. This patient likely had severe intracellular potassium, Phosphate, Magnesium and...

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RE: Persistent Hyperkalemia 1 day ago

I love it. Sounds like a script from Dr. House. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ---------...

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RE: SIADH in a patient with SAH 1 day ago

The phenomenon of redistribution of water into the ECF and Na into the ICF (causing hyponatremia ) due to severe total body K deficits is well desc...

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RE: SIADH in a patient with SAH 1 day ago

Thanks! Sent from my iPhone

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RE: SIADH in a patient with SAH 1 day ago

As you may recall the idea of "idiogenic osmoles" was generated from experiments in rabbits to account for the intra-cerebral changes which are ass...

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RE: IgA Nephropathy 1 day ago

"My question is: Why did the three studies exclude these patients?" this is the problem with so many past IgAN studies, you can't prove slowing p...

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RE: Persistent Hyperkalemia 1 day ago

Some fun ideas: any possibility of Digoxin ingestion? Foxglove? Chan Su, a traditional Chinese medicine (dig effects) toad venom (di...

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RE: SIADH in a patient with SAH 1 day ago

you can always go back and edit your posts: ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medica...

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RE: SIADH in a patient with SAH 1 day ago

The idea is borrowed from what is generally accepted as the pathogenesis of ODS in the acute/subacute setting, when managing Hyponatremia. There, t...

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RE: SIADH in a patient with SAH 1 day ago

@Tunde Tijani Interesting hypothesis! Is there published data to back it up? If so, please provide the references. Thank you ------------------...

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RE: SIADH in a patient with SAH 1 day ago

Typo: please substitute ‘intracellular’ for intercellular. Sent from my iPhone > On Sep 18, 2024, at 4:31 PM, Tunde Tijani wrote: > > “.. is ...

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RE: SIADH in a patient with SAH 1 day ago

“.. is it possible for intracellular osmolality to drop due to lack of solute? ..” Plausibly, if in the context of marked malnutrition/inanition, ...

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RE: Persistent Hyperkalemia 1 day ago

First presentation with high K - (not sure if you were looking for a specific chemistry) - Thanks Na 137, K 9.3, Cl 110, HCO3 22, BUN 8, creat 0...

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RE: IgA Nephropathy 1 day ago

As always great questions Dr. Hirsch. Thanks. Unfortunately, the answers are speculative and not evidence based. Recent data (e.g. RADAR from UK) s...

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RE: Persistent Hyperkalemia 1 day ago

Thank you. Any reason to suspect fluoride intoxication or trans-cellular K+ redistribution? Can you plz track down the very fist chem-10 panel for ...

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RE: Persistent Hyperkalemia 1 day ago

Thanks-normocytic normochrimic anemia. Unexplained. Any splenomegaly.? Peripheral blood smear will be very helpful for RBC morphology . ---------...

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RE: Renal Cystic Kidney Disease 1 day ago

Do you have a birth weight on this patient? Adaptive hyperfiltration injury seems to be a likely explanation for the proteinuria. ---------------...

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RE: Renal Cystic Kidney Disease 1 day ago

Thank you @Fouad Chebib Patient has proteinuria since age of 16 years, almost 30 years. His albumin is normal and has no oedema, does have mild H...

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RE: Persistent Hyperkalemia 1 day ago

Calcium 7.8 to 9.2 (bicarb and diuretics for treatment may have caused some fluctuation) - but not high. ------------------------------ Dilip Un...

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RE: Persistent Hyperkalemia 1 day ago

Was your patient ever hypercalcemic?... ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ of Iowa Associates In Kidney...

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